Abstract 1497: Enhanced atherogenesis and altered High Density Lipoprotein in patients with Crohn’s Disease
Introduction: Atherosclerosis has been characterized as a low-grade chronic inflammatory disease. Conversely, accelerated atherogenesis has been shown to be a hallmark of chronic inflammatory disease states such as RA and SLE. The aim of our study was to explore whether Crohn’s disease (CD), characterized by inflammatory episodes, is also associated with accelerated atherogenesis.
Methods: In 60 CD patients and 122 matched controls, carotid intima media thickness (IMT), a validated marker for the status and progression of atherosclerosis, was measured ultrasonographically. Additional subgroup analyses including plasma levels of acute phase reactants and HDL protein profiling were performed in the first consecutive 11 patients with CD in remission, 10 patients with active CD and 15 healthy controls.
Results: Carotid IMT in patients with CD was increased when compared to healthy volunteers (0.71 (0.17) and 0.59 (0.14) mm, p<0.0001). In the subgroup analysis, HDL in controls and patients in remission were identical ((1.45 (SD 0.48) and 1.40 (0.46)mol/L: p=0.797), whereas HDL during exacerbation was profoundly reduced (p=0.022). In regression analysis, inflammatory activation (CRP) correlated inversely with HDL (r2=0.24, p=0.002). HDL protein profiling during exacerbations, revealed distinct deviations using SELDI-TOF MS analysis.
Conclusions: Patients with CD have increased IMT compared to matched controls, indicative of accelerated atherogenesis. The changes during CD exacerbation of both HDL-concentration as well as composition imply a potential role of impaired HDL protection in these patients. Overall, these findings underscore the relevance of early cardiovascular prevention in CD patients.