Influence of inflammatory bowel diseases on the risk of early atherosclerosis

Background. Atherosclerosis is a major cause of cardiovascular morbidity and mortality, closely associated with chronic vascular inflammation.

Aim. To evaluate the impact of inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), on the risk of early atherosclerosis.

Materials and methods. A single-center cohort study was conducted between 2022 and 2024 at the Gastroenterology Department of Clinical Hospital №1 of Sechenov First Moscow State Medical University (Sechenov University). The study included 115 participants: 44 patients with UC, 37 with CD and 34 healthy controls. Inclusion criteria were age ≥18 years and confirmed UC or CD diagnosis based on clinical, endoscopic and histological findings. Exclusion criteria were severe concomitant diseases, high cardiovascular risk, previously diagnosed cardiovascular diseases and other systemic inflammatory conditions. Vascular changes were evaluated through ultrasound Doppler imaging of brachiocephalic arteries (intima–media thickness, presence of plaques), sphygmometry (Cardio-Ankle Vascular Index – CAVI, Ankle Brachial Index – ABI) and biochemical inflammatory markers (C-reactive protein – CRP, fibrinogen), as well as lipid profiles. Primary endpoints included carotid intima-media thickness and inflammatory marker levels.

Results. Patients with UC and CD showed significantly increased carotid intima-media thickness compared to controls (0.07–0.08 cm vs. 0.06 cm; p<0.05), along with elevated levels of CRP (highest in CD; p<0.01) and fibrinogen (p<0.05). Lipid profiles did not differ significantly between groups, emphasizing inflammation as the primary factor contributing to early atherosclerosis in IBD.

Conclusion. Patients with IBD have increased levels of CRP and fibrinogen, thickening of the intima–media complex of the carotid arteries, and a trend to more frequent occurrence of atherosclerotic plaques. The lipid profile in such patients may remain within the normal range, which confirms that inflammation plays a crucial role in the initiation of atherosclerosis in IBD.