engleski

Carotid intima-media thickness in children with inflammatory bowel disease

Carotid intima-media thickness (cIMT) reflects early structural changes on arteries and independently predicts cardiovascular risk in asymptomatic individuals. Previous studies showed increased cIMT in adult inflammatory bowel disease (IBD) patients compared with healthy subjects. This study aims to identify early structural changes in carotid arteries in IBD patients as early as childhood and adolescence. Methods The study includes 161 children with the mean age of 14.08±2.88 (6-18) years – 55 with newly discovered active disease ; 53 in clinical remission defined with disease activity pediatric indices for Crohn disease and ulcerative colitis (PCDAI, PUCAI) ; and 53 healthy subjects. We used an automatised edge-tracking system (Vivid E9, General Electrics, software 112 (1.7) ; linear probe 11L-D). In the longitudinal view, we measured cIMT on the posterior common carotid artery wall at end-diastole, 1 cm proximal to the bifurcation in a length of 1 cm. We calculated the mean value of three measurements on each side. We used the ANOVA test (SPSS 20.0) for comparisons, with the level of significance P<0.05. Results mean cIMT value in patients with the active IBD was 0.49±0.05 mm. Although we observed a slight increment in cIMT depending on the disease activity, the difference did not reach statistical significance (P=0.373). In patients with Crohn disease, cIMT was 0.48±0.04 mm, and in children with ulcerative colitis, it was 0.49±0.05 mm (P=0.336). Conclusion An increase in cIMT reflects structural changes in arterial walls, which require time. It seems that such changes induced with chronic inflammation are not visible in the pediatric population, which emphasises a potential preventive role of a prompt, adequate anti- inflammatory treatment.

carotid intima-media thickness ; children ; inflammatory bowel disease

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