Association between carotid intima-media thickness and ulcerative colitis
A systematic review and meta-analysis
Keywords:
Inflammatory bowel disease, Ulcerative colitis, Carotid intima-media thickness, Atherosclerosis, Cardiovascular diseaseAbstract
Background: Early detection of atherosclerosis is an essential means of decreasing cardiovascular events and its associated mortality. Systemic inflammatory diseases such as ulcerative colitis (UC), are thought to be a contributing factor to atherosclerosis due to the rise of inflammatory cytokines. Objective: The aim of this systematic review and meta-analysis was to assess the association between atherosclerosis and UC. Methods: This systematic review and meta-analysis was performed in February 2017 with no date restrictions. PubMed, Cochrane Library and Embase were searched to discover all available observational studies on atherosclerosis among UC patients. The STROBE criteria were used to assess the quality of the included articles. Heterogeneity was assessed by the I-square statistic and publication bias with funnel plot and Egger’s regression test. Overall summary mean difference was calculated as study effect size using random effect model. Comprehensive Meta-Analysis Software version 2.2 was used to perform analyses. Results: A total of 5 articles met our eligibility criteria. We included a sum of 206 UC patients and 229 non-UC individuals in our review with a mean difference of c-IMT ranged from 0.03±0.0 to 0.16±0.03 mm, and a pooled mean difference of 0.127 mm (95% CI 0.058–0.195: I2 =90.266%). Potential publication bias did not exist for the UC. Conclusion: Our findings showed significant differences in carotid intima-media thickness among UC and Non-UC groups, making c-IMT a viable choice as a predicting marker for atherosclerosis. Thus, we suggest that policy makers assess and consider its application in future protocols for the follow up and management of UC patients.
References
Akdogan RA, Durakoglugil ME, Kocaman SA, Cicek Y, Durakoglugil T, Ergul E, et al. Increased pulse
wave velocity and carotid intima-media thickness in patients with ulcerative colitis. Digestive diseases and
sciences. 2013; 58(8): 2293-300. doi: 10.1007/s10620-013-2634-9. PMID: 23508984.
Loftus EV, Jr. Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and
environmental influences. Gastroenterology. 2004; 126(6): 1504-17. PMID: 15168363.
Cibor D, Domagala-Rodacka R, Rodacki T, Jurczyszyn A, Mach T, Owczarek D. Endothelial dysfunction
in inflammatory bowel diseases: Pathogenesis, assessment and implications. World journal of
gastroenterology. 2016; 22(3): 1067-77. doi: 10.3748/wjg.v22.i3.1067. PMID: 26811647, PMCID:
PMC4716020.
Pedersen J, Coskun M, Soendergaard C, Salem M, Nielsen OH. Inflammatory pathways of importance for
management of inflammatory bowel disease. World journal of gastroenterology. 2014; 20(1): 64-77. doi:
3748/wjg.v20.i1.64. PMID: 24415859, PMCID: PMC3886034.
Au K, Singh MK, Bodukam V, Bae S, Maranian P, Ogawa R, et al. Atherosclerosis in systemic sclerosis: a
systematic review and meta-analysis. Arthritis and rheumatism. 2011; 63(7): 2078-90. doi:
1002/art.30380. PMID: 21480189, PMCID: PMC3128188.
Wu GC, Leng RX, Lu Q, Fan YG, Wang DG, Ye DQ. Subclinical Atherosclerosis in Patients With
Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis. Angiology. 2016. doi:
1177/0003319716652031. PMID: 27252243.
Jarvisalo MJ, Jartti L, Nanto-Salonen K, Irjala K, Ronnemaa T, Hartiala JJ, et al. Increased aortic intima- media thickness: a marker of preclinical atherosclerosis in high-risk children. Circulation. 2001; 104(24):
-7. doi: 10.1161/hc4901.100522. PMID: 11739310.
Kim KO, Jang BI, Lee SH. Does carotid intima-media thickness increase in patients with inflammatory
bowel disease? Intest Res. 2014; 12(4): 293-8. PMID: 25374495, PMCID: PMC4214956. doi:
5217/ir.2014.12.4.293.
Dagli N, Poyrazoglu OK, Dagli AF, Sahbaz F, Karaca I, Kobat MA, et al. Is inflammatory bowel disease a
risk factor for early atherosclerosis? Angiology. 2010; 61(2): 198-204. doi: 10.1177/0003319709333869.
PMID: 19398421.
Papa A, Danese S, Urgesi R, Grillo A, Guglielmo S, Roberto I, et al. Early atherosclerosis in patients with
inflammatory bowel disease. European review for medical and pharmacological sciences. 2006; 10(1): 7- 11. PMID: 16494104.
Papa A, Santoliquido A, Danese S, Covino M, Di Campli C, Urgesi R, et al. Increased carotid intima-media
thickness in patients with inflammatory bowel disease. Alimentary pharmacology & therapeutics. 2005;
(9): 839-46. doi: 10.1111/j.1365-2036.2005.02657.x. PMID: 16225493.
Theocharidou E, Gossios TD, Giouleme O, Athyros VG, Karagiannis A. Carotid intima-media thickness in
patients with inflammatory bowel disease: a systematic review. Angiology. 2014; 65(4): 284-93. doi:
1177/0003319713477471. PMID: 23423851.
Libby P, Ridker PM, Hansson GK. Inflammation in atherosclerosis: from pathophysiology to practice. Journal of the American College of Cardiology. 2009; 54(23): 2129-38. doi: 10.1016/j.jacc.2009.09.009.
PMID: 19942084, PMCID: PMC2834169.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational
studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology
(MOOSE) group. JAMA. 2000; 283(15): 2008-12. PMID: 10789670.
Kayahan H, Sari I, Cullu N, Yuksel F, Demir S, Akarsu M, et al. Evaluation of early atherosclerosis in
patients with inflammatory bowel disease. Digestive diseases and sciences. 2012; 57(8): 2137-43. doi:
1007/s10620-012-2148-x. PMID: 22466100.
Theocharidou E, Gossios TD, Griva T, Giouleme O, Douma S, Athyros VG, et al. Is there an association
between inflammatory bowel diseases and carotid intima-media thickness? Preliminary data. Angiology.
; 65(6): 543-50. doi: 10.1177/0003319713489876. PMID: 23748978.
Jain SS, Shah DK, Gambhire PA, Varma RU, Contractor QQ, Rathi PM. Early atherosclerosis in ulcerative
colitis: cross-sectional case-control study. Journal of digestive diseases. 2015; 16(11): 656-64. doi:
1111/1751-2980.12297. PMID: 26512945.
Ozturk K, Guler AK, Cakir M, Ozen A, Demirci H, Turker T, et al. Pulse Wave Velocity, Intima Media
Thickness, and Flow-mediated Dilatation in Patients with Normotensive Normoglycemic Inflammatory
Bowel Disease. Inflamm Bowel Dis. 2015; 21(6): 1314-20. doi: 10.1097/MIB.0000000000000355. PMID:
, PMCID: PMC4450917.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. Strengthening the
Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting
observational studies. BMJ. 2007; 335(7624): 806-8. doi: 10.1136/bmj.39335.541782.AD. PMID:
, PMCID: PMC2034723.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;
(7414): 557-60. doi: 10.1136/bmj.327.7414.557. PMID: 12958120, PMCID: PMC192859.
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical
test. BMJ. 1997; 315(7109): 629-34. PMID: 9310563, PMCID: PMC2127453.
Paoletti R, Gotto AM, Hajjar DP. Inflammation in atherosclerosis and implications for therapy. Circulation.
; 109(23 suppl 1): III-20-6. doi: 10.1161/01.CIR.0000131514.71167.2e. PMID: 15198962.
Simon A, Gariepy J, Chironi G, Megnien JL, Levenson J. Intima-media thickness: a new tool for diagnosis
and treatment of cardiovascular risk. J Hypertens. 2002; 20(2): 159-69. PMID: 11821696.
Yan F, Tian L, Yu H, Baskota A, Gao Y, Li S, et al. Association of lipoprotein subclasses and carotid
intima-media thickness in the Chinese population. Clinical Lipidology. 2014; 9(4): 407-15. doi:
2217/clp.14.22.
Yeboah J, Crouse JR, Hsu FC, Burke GL, Herrington DM. Brachial flow-mediated dilation predicts
incident cardiovascular events in older adults: the Cardiovascular Health Study. Circulation. 2007; 115(18):
-7. doi: 10.1161/CIRCULATIONAHA.106.678276. PMID: 17452608.
Rosvall M, Persson M, Ostling G, Nilsson PM, Melander O, Hedblad B, et al. Risk factors for the
progression of carotid intima-media thickness over a 16-year follow-up period: the Malmo Diet and Cancer
Study. Atherosclerosis. 2015; 239(2): 615-21. doi: 10.1016/j.atherosclerosis.2015.01.030. PMID:
Schicho R, Marsche G, Storr M. Cardiovascular complications in inflammatory bowel disease. Current
drug targets. 2015; 16(3): 181-8. doi: 10.2174/1389450116666150202161500. PMID: 25642719, PMCID:
PMC4366573.
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.