Sa1261 Association of Family Planning Issues and Quality of Life and in Inflammatory Bowel Disease

Abstract

In the last decades an ever-growing body of evidence has suggested the involvement of intestinal microvascular endothelial cells in development and maintenance of inflammatory bowel diseases (IBD). Changes in structure and function of endothelium, mediated by a multifaceted network of chemokines, cytokines and inflammatory growth factors, are a distinctive feature of active disease. In addition, human intestinal microvessels taken from inflamed mucosa exhibit consistent degrees of endothelial dysfunction, with significant impairment of acetylcholine-induced vasodilation based on decreased endothelial nitric oxide (NO) synthase (eNOS) activity. By “endothelial dysfunction” is comprehensively meant a condition in which the varied homeostatic functions of endothelium are impaired. Endothelial function can be measured through the flow-mediated dilation (FMD) technique, a wellestablished non invasive procedure in which changes in the calibre of the brachial artery induced by an increased vessel wall shear stress are measured ultrasonographically. AIM: The present study was designed to evaluate whether FMD at the brachial artery was impaired in a sample of patients with Crohn's disease (CD) and ulcerative colitis (UC) in comparison to healthy control subjects. As a secondary measure of interest, intima-media thickness at the common carotid artery (ccIMT) was also calculated. MATERIALS AND METHOD: 49 patients (25 males; mean age, 41 yrs ± 16) with CD (26) and UC (23) in moderate-severe activity phase were included. Endothelial function was assessed through FMD and shear stress reactive hyperemia determination; moreover, ccIMT was measured ultrasonographically. Statistical analyses were made by using Statistica 6.1 software (StatSoft Inc.. Tulsa. OK. USA). RESULTS: In IBD patients FMD% values were significantly lower than in controls (6.3±3.3 vs 8.1±3.4, p=0.013). Such difference was not related to age, sex, disease duration, or comorbidity (such as, hypertension or diabetes). On the contrary, ccIMT measurements did not differ consistently between cases and controls. CONCLUSIONS: IBD group showed significant levels of endothelium dysfunction compared with controls. In our view, this result was more likely related to systemic inflammation than to traditional risk factors. By contrast, the lack of significant differences in ccIMT was possibly related to the low mean age and disease duration in our study population. Future studies of endothelial function are warranted comparing case series before and after remission obtained under elective treatments.