Enhanced atherogenesis and altered high density lipoprotein in patients with Crohn's disease

A chronic inflammatory state is a risk factor for accelerated atherogenesis. The aim of our study was to ex- plore whether Crohn's disease (CD), characterized by re- current inflammatory episodes, is also associated with acceleratedatherogenesis.In60CDpatientsand122matched controls, carotid intima media thickness (IMT), a validated marker for the burden and progression of atherosclerosis, was assessed ultrasonographically. Additional subgroup analyses, including plasma levels of acute phase reactants and HDL protein profiling, were performed in 11 consec- utive patients with CD in remission, 10 patients with active CD, and 15 healthy controls. Carotid IMT in patients with CD was increased compared with healthy volunteers: 0.71 (0.17) versus 0.59 (0.14) mm (P , 0.0001), respectively. In the subgroup analysis, HDL levels in controls and pa- tients in remission were identical ((1.45 (0.48) and 1.40 (0.46) mmol/l; P 5 0.797), whereas HDL during exacerba- tion was profoundly reduced: 1.02 (0.33) (P 5 0.022). HDL frompatientswithactiveCDandCDpatientsinremissionwas characterized by a reduced ability to attenuate oxidation compared with controls (P 5 0.008 and P 5 0.024 re- spectively). Patients with CD have increased IMT compared with matched controls, indicative of accelerated ath- erogenesis. The changes during CD exacerbation in terms of HDL concentration and composition imply a role for im- paired HDL protection in these patients.—van Leuven, S. I., R. Hezemans, J. H. Levels, S. Snoek, P. C. Stokkers, G. K. Hovingh, J. J. P. Kastelein, E. S. Stroes, E. de Groot, and D. W. Hommes. Enhanced atherogenesis and altered high density lipoprotein in patients with Crohn's disease. J. Lipid Res. 2007. 48: 2640-2646.