State of vascular endothelium in patients with chronic inflammatory bowel diseases and different nutritional status
Background. Evaluation of endothelial function by non-invasive methods plays a major role in predicting the course of various diseases, the risk of complications and assessing the treatment. The purpose was to evaluate endothelial function in patients with chronic inflammatory bowel disease (IBD) according to their nutritional status by determining the state of vascular endothelium with reactive hyperemia test and the content of nitrogen oxide metabolites (NOx). Materials and methods. 120 chronic IBD patients (81 individuals with nonspecific ulcerative colitis (NUC) and 39 — with Crohn’s disease (CD)) were divided into groups depending on the anthropometric characteristics: I — reduced nutritional status (n = 70); II — normal nutritional status (n = 20); III — increased nutritional status (n = 30). In the blood serum of patients, the level of NOx was determined according to V.A. Metelskaya technique. To assess endothelial function, endothelium-dependent vasodilation of the brachial artery was determined by reactive hyperemia test. Results. Based on conducted studies, a significant decrease in the NOx serum content was observed: 1.7-fold (p < 0.01) — in NUC patients and 1.9-fold (p < 0.001) — in BD patients. Reduction of the NOx content in the blood serum did not depend on the nutritional status of individuals with chronic IBD. Violation of vascular endothelial function was found in 76.7 % of cases: decreased endothelial function — in 49.2 %, endothelial dysfunction — in 27.5 %. Changes in vascular endothelial function were found in 75.7 % of group I patients, 75 % of group II and 83.4 % of group III patients, mainly due to decreased endothelial function. Conclusions. It is shown that 71 % of chronic IBD patients have a significant decrease in serum NOx, which does not depend on their nutritional status. Patients with NUC have more significant changes in the incidence of detected disorders and more pronounced increase in the diameter of the brachial artery compared with CD patients. Reduced nutritional status was accompanied with the changes in vascular endothelial function in 75.4 % of cases.
Alexakis C, Kumar S, Saxena S, Pollok R. Systematic review with meta-analysis: the impact of a depressive state on disease course in adult inflammatory bowel disease. Aliment Pharmacol Ther. 2017 Aug;46(3):225-235. doi: 10.1111/apt.14171.
Stepanov YuM, Stoykevich MV, Sorochan OV. Application of 5-aminosalicylic acid preparations in the treatment of inflammatory bowel diseases. Gastroenterologìa. 2016;(61):80-87. doi: 10.22141/2308-2097.3.61.2016.79163. (in Ukrainian).
Stepanov YuM, Skyrda IYu, Petishko OP. Chronic inflammatory bowel disease: epidemiological features in Ukraine. Gastroenterologìa. 2017;51(2):97-105. doi: 10.22141/2308-2097.51.2.2017.101703. (in Ukrainian).
Rusyn VI, Sirchak YeS, Kurchak NYu, Moskal OM. Dynamics of endothelium dysfunction indexes in patients with chronic pancreatitis after cholecystectomy under the influence of L-arginine L-glutamate. Achievements of Clinical and Experimental Medicine. 2014;(1):101-103. (in Ukrainian).
Kalinkina NV. Osobennosti metabolizma oksida azota pod vliianiem razlichnykh kumuliativnykh doz antratsiklinovykh preparatov. Diss. kand. med. nauk [Features of nitrogen oxide metabolism under the influence of various cumulative doses of anthracycline drugs. PhD diss.]. Donetsk; 2010. 6 p. (in Russian).
Nikitina VV, Zakharova NB, Gladilin GP, Korshunov GV. The impact of concentrations of nitric oxide and activity of oxistat on development of inflammatory alterations in vascular wall. Klinicheskaya Laboratornaya Diagnostika. 2014;59(5):11-13. (in Russian).
Storch AS, Mattos JD, Alves R, Galdino IS, Rocha HNM. Methods of endothelial function assessment: description and applications. Int J Cardiovasc Sci. 2017;30(3):262-272. doi:10.5935/2359-4802.20170034.
Vizzardi E, Gavazzoni M, Della Pina P, et al. Noninvasive assessment of endothelial function: the classic methods and the new peripheral arterial tonometry. J Investig Med. 2014 Aug;62(6):856-64. doi: 10.1097/JIM.0000000000000096.
Boiko TI, Stoikevich MV, Kolbasina EV, Sorochan EV. Status of vascular endothelial function in patients with chronic inflammatory bowel diseases. Modern Gastroenterology. 2010;1(51):5-10. (in Russian).
Flammer AJ, Lüscher TF. Three decades of endothelium research: from the detection of nitric oxide to the everyday implementation of endothelial function measurements in cardiovascular diseases. Swiss Med Wkly. 2010 Dec 1;140:w13122. doi: 10.4414/smw.2010.13122.
Shabrov AV, .Apresyan AG, Dobkes AL, et al. Current methods of endothelial dysfunction assessment and their possible use in the practical medicine. Rational Pharmacotherapy in Cardiology. 2016;12(6):733-742. doi: 10.20996/1819-6446-2016-12-6-733-742. (in Russian).
Lebedev PA, Kalakutskii LI, Vlasova SP, Gorlov AP. Diagnostika funktsii sosudistogo endoteliia u bol'nykh s serdechno-sosudistymi zabolevaniiami: metodicheskie ukazaniia [Diagnosis of vascular endothelial function in patients with cardiovascular diseases: guidelines]. Samara; 2004. 18 p. (in Russian).
Eniukov IS. Metody, algoritmy, programmy mnogomernogo statisticheskogo analiza [Methods, algorithms, multidimensional statistical analysis programs]. Moscow: Finansy i statistika; 1986. 232 р. (in Russian).
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