Fatores relacionados com risco cardiovascular em indivíduos com doença Inflamatória Intestinal
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Data
2018-08-24
Autores
Biondi, Robertha Baccaro
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Biondi, R.B. Fatores relacionados com risco cardiovascular em indivíduos com Doença Inflamatória Intestinal. 2018. 48p. Dissertação (Mestrado). Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, 2018. Introdução: a incidência das doenças inflamatórias intestinais (DII), que compreendem principalmente a doença de Crohn (DC) e a retocolite ulcerativa idiopática (RCUI) aumentou nas últimas décadas. Evidências sugerem que, assim como observado em outras doenças inflamatórias, indivíduos com DII, podem apresentar maior risco de doenças cardiovasculares, uma vez que a inflamação crônica desempenha papel essencial na aterogênese. Objetivo: avaliar o risco cardiovascular de indivíduos com DC e RCUI. Metodologia: estudo transversal conduzido no periodo de abril 2016 a outubro de 2017 com indivíduos portadores de DC e RCUI atendidos no Ambulatório de DII do Hospital das Clínicas da Faculdade de Medicina de Botucatu (HC-FMB), comparado ao grupo controle. Foram avaliados dados como idade, sexo, índice de massa corporal, tabagismo, pressão arterial, atividade da doença, presença de comorbidades e tratamento medicamentoso, grau de espessamento medio-intimal das artérias carótidas (EMIC), presença de placa aterosclerótica nas artérias carótidas, escore de risco framingham (ERF), níveis séricos de proteína C reativa, perfil lipídico e glicemia. Foram utilizado o teste "t" de Student e o teste Mann-Whitney comparação dos grupos. Foram realizadas a regressão logística multivariada ou regressão linear múltipla para verificar quais fatores presentes nessa população explicam a presença de risco cardiovascular. Foi adotado o nível de significância de 5%. Resultados: foram avaliados 52 indivíduos no grupo DII e 37 no grupo controle. No grupo DII, 67,3% apresentavam RCUI e 32,7% DC, a maioria encontrava-se em remissão da doença (57,7%). Não houve diferença entre os grupos com relação ao sexo, idade, tabagismo, comorbidades, pressão arterial, índice de massa corporal, perfil lipídico e ERF. O grupo DII apresentou valores superiores de glicemia em jejum [95 (86,2 – 107,3) mg/dL vs. 86 (79 – 100) mg/dL, p= 0,041], maior média da EMIC (0,69 ± 0,12mm vs. 0,63 ± 0,12mm, p=0,031) e maior percentual de placa aterosclerótica (25% vs. 5,4%, p=0,032) em comparação ao grupo controle. A presença de DII, ajustada para idade, sexo, tabagismo, glicemia, LDL-colesterol, triglicérides e IMC, se associou a um maior risco de placa aterosclerótica em carótidas (OR: 6,45; IC 95%: 1,035-40,216; p<0,046). Conclusão: indivíduos com DII apresentam maior risco de placa aterosclerótica em carótidas e, consequentemente, maior risco de doenças cardiovasculares em comparação a indivíduos controles.
Biondi, R.B. Factors related to cardiovascular risk in individuals with Inflammatory Bowel Disease. 2018. 48p. Dissertation (Master’s). Botucatu Medical School, São Paulo State University, Botucatu, 2018. Introduction: The incidence of inflammatory bowel diseases (IBD), which encompass Crohn’s disease (CD) and ulcerative colitis (UC), has increased over the past decades. Considering that chronic inflammation plays an essential role in atherogenesis, studies have shown IBD may be associated with higher cardiovascular disease risk. Objective: The objective was to assess cardiovascular risk in CD or UC individuals. Methods: This cross-sectional study, conducted between April 2016 and October 2017, included CD or UC outpatients from the IBD outpatient clinic of Botucatu Medical School Hospital compared to a control group. Data collected included age, gender, body mass index, smoking status, arterial blood pressure, disease activity, presence of co-morbidities, ongoing medical treatment, carotid intima media thickness (CIMT), presence of carotid atherosclerotic plaque, Framingham risk score (FRS), serum C-reactive protein, lipid profile and glucose level. Groups were compared using the Student t test and Mann-Whitney test. Multivariate logistic regression or multiple linear regression analyses were performed with significance level at 5%. Results: 52 individuals in IBD group and 37 matched controls were included. In IBD group, 67.3% of the individuals had UC and 32.7% presented CD, the majority were in clinical disease remission (57.7%). No differences between groups were observed regarding gender, age, smoking status, co-morbidities, blood pressure, body mass index, lipid profile and FRS. In IBD individuals, fasting glucose levels [95 (86.2 – 107.3) mg/dL vs. 86 (79 – 100) mg/dL, p= 0.041], CIMT (0.69 ± 0.12mm vs. 0.63 ± 0.12mm, p=0.031) and atherosclerotic plaque percentage (25% vs. 5.4%, p=0.032) were higher compared to control group. Multivariate logistic regression showed IBD is associated with a 6.45-fold higher risk of carotid atherosclerotic plaque (OR: 6.45; 95% CI: 1.035-40.216; p<0.046). Conclusion: IBD individuals are at an increased risk of atherosclerosis and, consequently, an increased risk for cardiovascular diseases.
Biondi, R.B. Factors related to cardiovascular risk in individuals with Inflammatory Bowel Disease. 2018. 48p. Dissertation (Master’s). Botucatu Medical School, São Paulo State University, Botucatu, 2018. Introduction: The incidence of inflammatory bowel diseases (IBD), which encompass Crohn’s disease (CD) and ulcerative colitis (UC), has increased over the past decades. Considering that chronic inflammation plays an essential role in atherogenesis, studies have shown IBD may be associated with higher cardiovascular disease risk. Objective: The objective was to assess cardiovascular risk in CD or UC individuals. Methods: This cross-sectional study, conducted between April 2016 and October 2017, included CD or UC outpatients from the IBD outpatient clinic of Botucatu Medical School Hospital compared to a control group. Data collected included age, gender, body mass index, smoking status, arterial blood pressure, disease activity, presence of co-morbidities, ongoing medical treatment, carotid intima media thickness (CIMT), presence of carotid atherosclerotic plaque, Framingham risk score (FRS), serum C-reactive protein, lipid profile and glucose level. Groups were compared using the Student t test and Mann-Whitney test. Multivariate logistic regression or multiple linear regression analyses were performed with significance level at 5%. Results: 52 individuals in IBD group and 37 matched controls were included. In IBD group, 67.3% of the individuals had UC and 32.7% presented CD, the majority were in clinical disease remission (57.7%). No differences between groups were observed regarding gender, age, smoking status, co-morbidities, blood pressure, body mass index, lipid profile and FRS. In IBD individuals, fasting glucose levels [95 (86.2 – 107.3) mg/dL vs. 86 (79 – 100) mg/dL, p= 0.041], CIMT (0.69 ± 0.12mm vs. 0.63 ± 0.12mm, p=0.031) and atherosclerotic plaque percentage (25% vs. 5.4%, p=0.032) were higher compared to control group. Multivariate logistic regression showed IBD is associated with a 6.45-fold higher risk of carotid atherosclerotic plaque (OR: 6.45; 95% CI: 1.035-40.216; p<0.046). Conclusion: IBD individuals are at an increased risk of atherosclerosis and, consequently, an increased risk for cardiovascular diseases.
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Palavras-chave
doenças cardiovasculares, aterosclerose carotídea, espessura intima-media carotídea, doença de Crohn, colite ulcerativa, cardiovascular diseases, carotid artery diseases, carotid intima-media thickness, Crohn disease, ulcerative colitis