Digestive Diseases and Sciences

, Volume 56, Issue 1, pp 197–202 | Cite as

Intima-Media Thickness of the Common Carotid Artery Is Not Significantly Higher in Crohn’s Disease Patients Compared to Healthy Population

  • Efrat Broide
  • Andrei Schopan
  • Michael Zaretsky
  • Nimrod Alain Kimchi
  • Michael Shapiro
  • Eitan Scapa
Original Article



Patients with Crohn’s disease might have accelerated atherosclerosis due to: chronic systemic inflammation, metabolic changes or prolonged steroid treatment.


The aim of this study was to assess the risk of sub-clinical atherosclerosis in Crohn’s disease, by measuring the intima-media thickness and peak systolic velocity of the common carotid artery.


Fifty Crohn’s disease patients aged between 20 and 45 years were compared to 25 controls. Patients with a family history of cardiovascular diseases or a known risk for atherosclerosis were excluded. All participants underwent nutritional assessment. Carotid artery ultrasonography was performed and intima-media thickness and peak systolic velocity were measured, proximal to the common carotid bifurcation. Clinical data and laboratory parameters (hemoglobin, highly sensitive C-reactive protein, and plasma homocysteine) were determined.


No significant differences between the groups were found for intima-media thickness or peak systolic velocity. Multiple regression analysis revealed a positive correlation of intima-media thickness with older age. Peak systolic velocity was negatively associated with age.


Crohn’s disease patients do not have an increased risk for developing early atherosclerosis.


Crohn’s disease Atherosclerosis Intima-media thickness Peak systolic velocity 


Conflict of interest statement



  1. 1.
    Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part I. Circulation. 2003;108:1664–1672.CrossRefPubMedGoogle Scholar
  2. 2.
    Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part II. Circulation. 2003;108:1772–1778.CrossRefPubMedGoogle Scholar
  3. 3.
    Ripollés Piquer B, Nazih H, Bourreille A, et al. Altered lipid apolipoprotein profiles in inflammatory bowel disease: consequences on the cholesterol efflux capacity of serum using Fu5AH cell system. Metabolism. 2006;55:980–988.CrossRefPubMedGoogle Scholar
  4. 4.
    Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med. 2004;350:1387–1897.CrossRefPubMedGoogle Scholar
  5. 5.
    Tilg H. Inflammatory bowel diseases: meeting of the European Crohn’s Colitis Organization, 1–3 March 2007, Innsbruck, Austria. Expert Opin Ther Targets. 2007;11:853–856.CrossRefPubMedGoogle Scholar
  6. 6.
    Fiocchi C. Intestinal inflammation: a complex interplay of immune and nonimmune cell interactions. Am J Physio. 1997;273:G769–G775.Google Scholar
  7. 7.
    Hatoum OA, Binion DG. The vasculature and inflammatory bowel disease. Contribution to pathogenesis and clinical pathology. Inflamm Bowel Dis. 2005;11:304–313.CrossRefPubMedGoogle Scholar
  8. 8.
    Laroux FS, Grisham MB. Immunological basis of inflammatory bowel disease: role of the microcirculation. Microcirculation. 2001;8:283–301.PubMedGoogle Scholar
  9. 9.
    Talbot RW, Heppell J, Dozois PR, Beart RW Jr. Vascular complications of inflammatory bowel disease. Mayo Clin Proc. 1986;61:140–145.PubMedGoogle Scholar
  10. 10.
    Webbwerly MJ, Hart MT, Melikian V. Thromboembolism in inflammatory bowel disease: role of platelets. Gut. 1993;34:247–251.CrossRefGoogle Scholar
  11. 11.
    Van-Doornum S, McColl G, Wicks IP. An extraarticular feature of rheumatoid arthritis? Arthritis Rheum. 2002;46:862–873.CrossRefPubMedGoogle Scholar
  12. 12.
    Sattar N, McCarey DW, Capell H, McInness IB. Explaining how “high-grade” systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation. 2003;108:2957–2963.CrossRefPubMedGoogle Scholar
  13. 13.
    Roman MJ, Shanker BA, Davis A, et al. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med. 2003;349:2399–2406.CrossRefPubMedGoogle Scholar
  14. 14.
    Papa A, Danese S, Urgesi R, et al. Early atherosclerosis in patients with inflammatory bowel disease. Eur Rev Med Pharmacol Sci. 2006;10:7–11.PubMedGoogle Scholar
  15. 15.
    Maharshak N, Arbel Y, Bornstein NM, et al. Inflammatory bowel disease is not associated with increased intimal media thickening. Am J Gastroenterol. 2007;102:1050–1055.CrossRefPubMedGoogle Scholar
  16. 16.
    Dorn SD, Sandler RS. Inflammatory bowel disease is not a risk factor for cardiovascular disease mortality: results from a systematic review and meta-analysis. Am J Gasteroenterol. 2007;102:662–667.CrossRefGoogle Scholar
  17. 17.
    Papa A, Santoliquido A, Danese S, et al. Increased carotid intima–media thickness in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2005;22:839–846.CrossRefPubMedGoogle Scholar
  18. 18.
    Best WR. Predicting the Crohn’s disease activity index from the Harvey-Bradshaw Index. Inflamm Bowel Dis. 2006;12:304–310.CrossRefPubMedGoogle Scholar
  19. 19.
    Friedewald WT, Levy RI, Friedrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMedGoogle Scholar
  20. 20.
    Chambless LE, Heiss G, Folsom AR, et al. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the atherosclerosis risk in communities (ARIC) study. Am J Epidemiol. 1997;146:483–494.PubMedGoogle Scholar
  21. 21.
    Davis PH, Dawson JD, Riley WA, Lauer RM. Carotid intimal-medial thickness is related to cardiovascular risk factors measured from childhood through middle age. The muscattine study. Circulation. 2001;104:2815–2819.CrossRefPubMedGoogle Scholar
  22. 22.
    Kumeda Y, Inaba M, Goto H, et al. Increased thickness of the arterial intima-media detected by ultrasonography in patients with rheumatoid arthritis. Arthritis Rheum. 2002;46:1489–1497.CrossRefPubMedGoogle Scholar
  23. 23.
    Durga J, Verhoef P, Bots ML, Schouten E. Homocysteine and carotid intima-media thickness: a critical appraisal of the evidence. Atherosclerosis. 2004;176:1–19.CrossRefPubMedGoogle Scholar
  24. 24.
    Alkaabi JK, Ho M, Levison R, Pullar T, Belch JJ. Rheumatoid arthritis and macrovascular disease. Rheumatology. 2003;42:292–297.CrossRefPubMedGoogle Scholar
  25. 25.
    Park YB, Ahn CW, Choi HK, et al. Atherosclerosis in rheumatoid arthritis: morphologic evidence obtained by carotid ultrasound. Arthritis Rheum. 2002;46:1714–1719.CrossRefPubMedGoogle Scholar
  26. 26.
    Paoletti R, Gotto A, Hajjar DP. Inflammation in atherosclerosis and implications for therapy. Circulation. 2004;109(Suppl III):III-20–III-26.CrossRefGoogle Scholar
  27. 27.
    Jousilahti P, Salomaa V, Rasi V, Vahtera E, Palosuo T. The association of c-reactive protein, serum amyloid and fibrinogen with prevalent coronary heart disease–baseline findings of the PAIS project. Atherosclerosis. 2001;156:451–456.CrossRefPubMedGoogle Scholar
  28. 28.
    Grip O, Svensson PJ, Lindgren S. Inflammatory bowel disease promotes venous thrombosis earlier in life. Scand J Gastroenterol. 2000;6:619–623.CrossRefGoogle Scholar
  29. 29.
    Feigin VL, Anderseon CS, Mhurchu CN. Systemic inflammation, endothelial dysfunction, dietary fatty acids and micronutrients as risk factors for stroke: a selective review. Cerebrovasc Dis. 2002;113:219–224.CrossRefGoogle Scholar
  30. 30.
    Oldenburg B, Fijnheer R, van der Griend R, vanBerge-Henegouwen GP, Koningsberger JC. Homocysteine in inflammatory bowel disease: a risk factor for thromboembolic complications? Am J Gastroenterol. 2000;95:2825–2830.CrossRefPubMedGoogle Scholar
  31. 31.
    Hudson M, Hutton RA, Wakefield AJ, Sawyerr AM, Pounder RE. Evidence for activation of coagulation in Crohn’s disease. Blood Coagul Fibrinolysis. 1992;3:773–778.CrossRefPubMedGoogle Scholar
  32. 32.
    Souto JC, Martínez E, Roca M, et al. Prothrombotic state and signs of endothelial lesion in plasma of patients with inflammatory bowel disease. Dig Dis Sci. 1995;40:1883–1889.CrossRefPubMedGoogle Scholar
  33. 33.
    Younes-Mhenni S, Derex L, Berruyer M, et al. Large-artery stroke in a young patient with Crohn’s disease. Role of vitamin B6 deficiency-induced hyperhomocysteinemia. J Neurol Sci. 2004;221:113–115.CrossRefPubMedGoogle Scholar
  34. 34.
    Danese S, Sgambato A, Papa A, et al. Homocysteine triggers mucosal microvascular activation in inflammatory bowel disease. Am J Gastroenterol. 2005;100:886–895.CrossRefPubMedGoogle Scholar
  35. 35.
    Stühlinger MC, Oka RK, Graf EE, et al. Endothelial dysfunction induced by hyperhomocysteinemia: role of asymmetric dimethylarginine. Circulation. 2003;108:933–938.CrossRefPubMedGoogle Scholar
  36. 36.
    Cattaneo M. Hyperhomocysteinemia, atherosclerosis and thrombosis. Thromb Haemost. 1999;81:165–176.PubMedGoogle Scholar
  37. 37.
    The Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke. JAMA. 2002;288:2015–2023.CrossRefGoogle Scholar
  38. 38.
    Bernstein CN, Wajda A, Blanchard JF. The incidence of arterial thromboembolic diseases in inflammatory bowel disease: a population-based study. Clin Gastroenetrol Hepatol. 2008;6:41–45.CrossRefGoogle Scholar
  39. 39.
    Mutlu B, Ermeydan CM, Enc F, et al. Acute myocardial infarction in a young woman with severe ulcerative colitis. Int J Cardiol. 2002;83:183–185.CrossRefPubMedGoogle Scholar
  40. 40.
    Sandrock M, Hansel J, Schulze J, et al. Sequentially based analysis versus image based analysis of intima media thickness in common carotid arteries studies—do major IMT studies underestimate the true relations for cardio- and cerebrovascular risk? Cardiovasc Ultrasound. 2008;6:32.CrossRefPubMedGoogle Scholar
  41. 41.
    Hrabovsky V, Zadák Z, Bláha V, Hypsler R, Karlík T. Changes in lipid metabolism in patients in the active phase of Crohn’s disease. Vnitr Lek. 2007;3:1035–1039.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Efrat Broide
    • 1
    • 3
  • Andrei Schopan
    • 1
    • 3
  • Michael Zaretsky
    • 2
    • 3
  • Nimrod Alain Kimchi
    • 1
    • 3
  • Michael Shapiro
    • 1
    • 3
  • Eitan Scapa
    • 1
    • 3
  1. 1.Institute of Gastroenterology, Liver Diseases and NutritionAssaf Harofeh Medical CenterZerifinIsrael
  2. 2.Vascular LaboratoryAssaf Harofeh Medical CenterZerifinIsrael
  3. 3.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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