Lipid abnormalities in inflammatory bowel disease

Yıl 2017, Cilt: 16 Sayı: 2, 60 - 63, 29.08.2017

Muhammet Yener Akpınar , Yasemin Özderin Özin İsmail Hakkı Kalkan , Mustafa Kaplan , Mahmut Yüksel Zeki Mesut Yalın Kılıç İlyas Tenlik Fatih Saygılı Özlem Akdoğan Ertuğrul Kayaçetin

https://doi.org/10.17941/agd.338670

Öz

Background and Aims: Chronic inflammation and increased
atherosclerosis are main characteristic features of inflammatory bowel disease.
Plasma lipid abnormalities in inflammatory bowel disease as a potential cause
of cardiovascular disease has been examined in various studies. In this study,
we have analyzed variables such as medication, operation history, and disease
duration that can affect plasma lipid levels in inflammatory bowel disease. Materials and
Methods: Consecutive inflammatory bowel disease patients who were followed and
treated between January 2016-March 2016 in Türkiye Yüksek İhtisas Training and Research
Hospital Inflammatory Bowel Disease Polyclinic were included in the study. Results: Overall 138
patients (ulcerative colitis: 71 patients, Crohn’s disease: 67 patients) were
analyzed. The median age of patients was 45 years old, and 91 were male while
47 were female. Levels of total cholesterol and low-density lipoprotein were
significantly higher in ulcerative colitis than in Crohn’s disease (p = 0.003
and p = 0.001, respectively). Lipid parameters were not different among
proctitis, distal colitis, and extensive colitis. Also, lipid parameters were
not different between inflammatory, penetrant, and stricturing phenotypes in
Crohn’s disease. Lipid parameters were not different among patients whether
they received azathiopurine and 5-aminosalicylates. Total cholesterol and
low-density lipoprotein levels were significantly lower in patients who
received anti- tumor necrosis factor than in patients who did not receive anti-
tumor necrosis factor (p=0.01 and p=0.02, respectively). Total cholesterol,
triglyceride, high-density lipoprotein, and low-density lipoprotein levels were
not correlated with medical treatment duration. Conclusion: For preventing atherosclerosis, it is
important to be informed about medication, inflammatory bowel disease type,
disease phenotype, and operation history, which can affect lipid levels in
inflammatory bowel disease.

Anahtar Kelimeler

Atherosclerosis, inflammatory bowel disease, lipid

İnflamatuvar barsak hastalıklarında lipid anormallikleri

Öz

Giriş ve Amaç: İnflamatuvar barsak hastalıkları kronik inflamasyon ve aterosklerozda
artışla karakterize hastalıklardır. Birçok çalışmada inflamatuvar barsak
hastalıklarında kardiyovasküler hastalıklar için potansiyel neden olabilecek
lipid anormallikleri araştırılmıştır. Biz bu çalışmamızda inflamatuvar barsak
hastalıklarında lipid parametreleri üzerinde etkisi olabilecek ilaç tedavisi,
operasyon ve hastalık süresi gibi değişkenleri inceledik. Gereç ve Yöntem: Türkiye Yüksek İhtisas Eğitim ve Araştırma
Hastanesi İnflamatuvar Barsak Hastalıkları Polikliniği’nde Ocak 2016-Mart 2016
arasında ardışık olarak takip ve tedavi edilen hastalar çalışmaya alındı. Bulgular: Çalışmaya toplam 138 hasta (ülseratif kolit: 71 hasta,
Crohn: 67 hasta) alındı. Hastaların yaş ortalaması 45 olup 47 kadın, 71 erkek
hasta vardı. Total kolesterol ve düşük yoğunluklu lipoprotein seviyeleri
ülseratif kolit hastalarında Crohn hastalığına göre anlamlı olarak fazlaydı
(sırasıyla p=0,003 ve p=0,001). Ülseratif kolitte proktit, sol kolon tutulumlu
ve ekstensif tutulumlu hastalar arasında total kolesterol, trigliserid, yüksek
yoğunluklu lipoprotein ve düşük yoğunluklu lipoprotein seviyeleri arasında fark
yoktu. Crohn hastalarında inflamatuvar, penetran ve striktüran fenotipler arasında
total kolesterol, trigliserid, yüksek yoğunluklu lipoprotein ve düşük
yoğunluklu lipoprotein arasında fark yoktu. Azatiyopürin ve mesalazin alan ve
almayan hastalar arasında bakılan lipid parametreleri için fark bulunmadı.
Anti-tümör nekrozis faktör alan hastalarda ise total kolesterol ve düşük
yoğunluklu lipoprotein kolesterol seviyeleri anti-tümör nekrozis faktör almayan
hastalara kıyasla anlamlı olarak daha düşük izlendi (sırasıyla p=0,01 ve
p=0,02). Hastaların aldıkları ilaç tedavi süreleri ile total kolesterol,
trigliserid, düşük yoğunluklu lipoprotein ve yüksek yoğunluklu lipoprotein
seviyeleri arasında korelasyon izlenmedi. Sonuç: İnflamatuvar barsak hastalıklarında lipid anormallikleri üzerine etkili
olabilecek ilaç, operasyon, hastalık fenotipi ve hastalık tutulum yeri gibi
faktörlerin bilinmesi, ateroskleroz gibi potansiyel komplikasyonların
önlenebilmesine olanak tanıyabilir.

Anahtar Kelimeler

Ateroskleroz, inflamatuvar barsak hastalığı, lipid

Kaynakça

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