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Endothelial Dysfunction and Arterial Stiffness in Patients with Inflammatory Bowel Disease: A Systematic Review and
Hao Wu1,2, Meihua Xu3, Hong Hao1
1Center for Precision Medicine and Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA.
Insights
Patients with inflammatory bowel disease (IBD) show increased arterial stiffness and carotid intima-media thickness (cIMT), indicating endothelial dysfunction. These findings suggest IBD patients need proactive cardiovascular disease risk assessment.
Area of Science:
- Cardiovascular Medicine
- Gastroenterology
- Clinical Research
Background:
- Population studies suggest a link between inflammatory bowel disease (IBD) and increased cardiovascular disease (CVD) risk.
- Endothelial function, arterial stiffness, and carotid intima-media thickness (cIMT) are key indicators of cardiovascular health.
Purpose of the Study:
- To evaluate endothelial function, arterial stiffness, and cIMT in patients with IBD through a meta-analysis.
- To synthesize evidence from existing clinical studies to quantify cardiovascular risk markers in IBD.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, and Web of Science.
- A random-effects model meta-analysis included 41 studies with 2330 IBD patients and 2032 controls.
- Key cardiovascular parameters analyzed included cIMT, pulse wave velocity, augmentation index, and flow-mediated dilatation.
Main Results:
- Patients with IBD exhibited significantly increased cIMT (Cohen's d: 0.63) and carotid-femoral pulse wave velocity (Cohen's d: 0.76).
- Augmentation index was significantly higher (Cohen's d: 0.35), while brachial artery flow-mediated dilatation was significantly decreased (Cohen's d: -0.73) in IBD patients.
- The meta-analysis confirmed significant endothelial dysfunction, increased arterial stiffness, and elevated cIMT in the IBD population.
Conclusions:
- Patients with inflammatory bowel disease demonstrate significant markers of endothelial dysfunction and arterial stiffness.
- Elevated cIMT in IBD patients suggests subclinical atherosclerosis.
- Aggressive cardiovascular risk stratification is recommended for patients diagnosed with IBD to mitigate potential CVD events.
Abstract:
Population-based studies have suggested that patients with inflammatory bowel disease (IBD) might be at an increased risk for cardiovascular diseases. A meta-analysis was performed on clinical studies to evaluate endothelial function, arterial stiffness, and carotid intima-media thickness (cIMT) in patients with IBD, after searching PubMed, Embase, Cochrane library, and Web of Science databases. A random-effects model was used to allow for the pooling of studies and for determination of the overall effect. After exclusion, a total of 41 eligible studies with 2330 patients with IBD and 2032 matched controls were identified and included for the analysis. It was found that cIMT was significantly increased in patients with IBD as compared with that in matched controls (Cohen's d: 0.63; 95% CI: 0.34, 0.93; I2 = 91.84%). The carotid-femoral pulse wave velocity was significantly higher in patients with IBD compared to that in matched controls (Cohen's d: 0.76; 95% CI: 0.54, 0.98; I2 = 70.03%). The augmentation index was also significantly increased in patients with IBD compared to matched control subjects (Cohen's d: 0.35; 95% CI: 0.08, 0.63; I2 = 61.37%). Brachial artery flow-mediated dilatation was significantly decreased in patients with IBD than that in matched controls (Cohen's d: -0.73; 95% CI: -1.10, -0.36; I2 = 81.02%). Based on the meta-analysis, it was found that patients with IBD exhibit significant endothelial dysfunction, increased arterial stiffness, and cIMT. Thus, patients with IBD may benefit from aggressive risk stratification for cardiovascular diseases.
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