Prognosis of atherosclerosis in patients with ulcerative colitis in the Zabaykalsky Krai, Russia

Objective: To investigate indicators of arterial stiffness and subclinical atherosclerosis in patients with ulcerative colitis (UC) in the Zabaykalsky Krai, as well as to develop prognostic criteria for the early development of atherosclerosis in these patients. Materials and methods. Data obtained from the patient registry at the Chita Regional Clinical Hospital for patients with inflammatory bowel disease (IBD) were analyzed. This retrospective study included 70 patients aged 20–50 with ulcerative colitis that had lasted more than one year. The control group consisted of 50 healthy volunteers matched for age and sex. All participants underwent 24-hour blood pressure monitoring with arterial stiffness analysis using the BPLabWin device (Petr Telegin LLC, Nizhny Novgorod, Russia) with Vasotens software. Ultrasound examinations of the carotid and femoral arteries were performed using a focused protocol on a Vivid S60N device (USA/China). The data were statistically analyzed using the IBM SPSS Statistics Version 25.0 software package. Results. Increased arterial stiffness was observed in 73% of patients with ulcerative colitis, which is 2.8 times higher than in the control group (p < 0.05). Subclinical atherosclerosis manifestations were 5 times more common in patients with ulcerative colitis compared to the control group (p < 0.05). Early predictors of atherosclerosis were identified, including age 41–50 years, UC clinical duration more than 3 years, and a continuous or recurrent course of IBD with a frequency of attacks more than twice per year. Conclusion. Subclinical atherosclerosis is more commonly detected in young patients with ulcerative colitis, which impacts cardiovascular risk. Preventing atherosclerosis in these patients involves screening high-risk groups for vascular disease, intensifying anti-inflammatory therapy, and achieving remission of inflammatory bowel disease.

1. Sinh P, Cross RK. Cardiovascular Comorbidities and Inflammatory Bowel Disease: Causes and Consequences. Gastroenterol Hepatol (N Y). 2024;20(4):204–215.

2. Sun HH, Tian F. Inflammatory bowel disease and cardiovascular disease incidence and mortality: A meta-analysis. Eur J Prev Cardiol. 2018;25(15):1623–1631. doi: 10.1177/2047487318792952

3. Panhwar MS, Mansoor E, Al-Kindi SG, Sinh P, Katz J, Oliveira GH, Cooper GS, Ginwalla M. Risk of Myocardial Infarction in Inflammatory Bowel Disease: A Population-based National Study. Inflamm Bowel Dis. 2019;25(6):1080–1087. doi: 10.1093/ibd/izy354

4. Lee MT, Mahtta D, Chen L, Hussain A, Al Rifai M, Sinh P, Khalid U, Nasir K, Ballantyne CM, Petersen LA, Virani SS. Premature Atherosclerotic Cardiovascular Disease Risk Among Patients with Inflammatory Bowel Disease. Am J Med. 2021;134(8):1047–1051.e2. doi: 10.1016/j.amjmed.2021.02.029

5. Ghoneim S, Shah A, Dorepatil A, Butt MU, Wagray N. The risk of cerebrovascular accident in inflammatory bowel disease in the United States: a population-based national study. Clin Exp Gastroenterol. 2020;13:123–129. doi:10.2147/CEG.S250182

6. Zhilin IV, Zhilina AA, Ivanova OV, Dianova IV. Epidemiology of ulcerative colitis in the Zabaykalsky Krai. Russian Journal of Preventive Medicine. 2022;25(8):42–47. (In Russ.). doi: 10.17116/profmed20222508142

7. Kniazev OV, Shkurko TV, Kagramanova AV, Veselov AV, Nikonov EL. Epidemiology of inflammatory bowel disease. State of the problem (review). Russian Journal of Evidence-Based Gastroenterology. 2020;9(2):66–73. (In Russ.). doi: 10.17116/dokgastro2020902166

8. Balakhonova TV, Ershova AI, Ezhov MV, Barbarash OL, Bershtein LL, Bogachev VYu, Voevoda MI, Genkel VV, Gurevich VS, Duplyakov DV, Imaev TE, Konovalov GA, Kosmacheva ED, Lobastov KV, Mitkova MD, Nikiforov VS, Rotar OP, Suchkov IA, Yavelov IS, Mitkov VV, Akchurin RS, Drapkina OM, Boytsov SA. Focused vascular ultrasound. Consensus of Russian experts. Cardiovascular Therapy and Prevention. 2022;21(7):3333. (In Russ.). doi: 10.15829/1728-8800-2022-3333

9. Gabbiadini R, Dal Buono A, Mastrorocco E, Solitano V, Repici A, Spinelli A, Condorelli G, Armuzzi A.Atherosclerotic cardiovascular diseases in inflammatory bowel diseases: to the heart of the issue. Front. Cardiovasc. Med. 2023;10:1143293. doi: 10.3389/fcvm.2023.1143293

10. Хiao Y, Powell DW, Liu X, Li Q. Cardiovascular manifestations of inflammatory bowel diseases and the underlying pathogenic mechanisms. Am J Physiol Regul Integr Comp Physiol. 2023;325(2):R193–R211. doi: 10.1152/ajpregu.00300.2022

11. Mironova OIu, Isaikina MA, Khasieva SA. Аtherosclerosis and cardiovascular risk in patients with inflammatory bowel disease. Therapeutic Archive. 2021;93(12):1533–1538. (In Russ.). doi: 10.26442/00403660.2021.12.201225

12. Magruk MA, Mosikyan AA, Babenko AYu. Biomarkers associated with atherogenesis: current status and promising areas. Russian Journal of Cardiology. 2019;24(12):148–152. (In Russ.). doi: 10.15829/1560-4071-2019-12-148-152