Echo Intima-Media Thickness (IMT) in the Evaluation of Early Atherosclerosis in Inflammatory Bowel Disease (IBD) Patients – a Prospective Study

Introduction: Inflammatory bowel diseases (IBD) are accompanied by an early and accelerated atherosclerotic process. Previous studies showed that Doppler ultrasonography and intima-media thickness (IMT) is a reliable marker for early atherosclerosis diagnosis. The aim of our study was to evaluate the presence of early atherosclerosis in a group of subjects with inflammatory bowel diseases, using Doppler ultrasonography and intima-media thickness (IMT) as a marker of subclinical atherosclerosis. Methods: A case-control study was conducted on 61 patients with inflammatory bowel disease and 19 healthy individuals. The included patients had an established IBD diagnosis, based on clinical, endoscopic, and histological criteria for at least 12 months. Results: In our study echo IMT was not significantly higher in IBD patients than in matched healthy controls. We found no difference between Crohn’s disease and ulcerative colitis patients or between conventional or biologic treatment regarding the echo IMT. Severity of the disease and its duration were predictors of an increased IMT. We found that disease activity (measured by the endoscopic scores and CRP) correlates with higher values of echo IMT. Also the presence of anemia reached statistical significance and was correlated with increased echo IMT in the biologic treatment group. Conclusions: In our study we found an increased echo IMT in IBD patients versus control, but the values did not reach statistical significance. We found no difference between Crohn’s disease and UC, conventional or biologic treatment. Age and duration of disease were corelated with increased IMT. Disease that was not controlled (high endoscopic, clinical and biological markers of activity) was correlated with increased echo IMT. The limitations of our study are that in our patients therapy was started early in the course of the disease and that the majority of the patients were in remission when echography was made. Further studies are necessary to evaluate factors correlated with early atherosclerosis in IBD and how echo IMT can be used as a tool in the proactive evaluation of these patients.