State of vascular endothelium in patients with chronic inflammatory bowel diseases and different nutritional status

Abstract

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.