Cardiovascular risks in patients with ulcerative colitis: The role of assessing the markers of systemic inflammation and metabolic activity of intestinal microbiota
Abstract. Studies indicate an increased risk of subclinical atherosclerosis and early cardiovascular events in patients with ulcerative colitis (UC). Increased cardiovascular risk (CVR) in UC patients is difficult to explain by traditional factors due to their limited prevalence. Systemic inflammation and disorder of metabolic activity of intestinal microbiota, in particular, short-chain fatty acids (SCFA) synthesis are considered in terms of the mechanisms underlying association of UC with pathological conditions of cardiovascular system.Bikbavova G.R., Livzan M.A., Lisyutenko N.S., Dranitsyn V.V., Mikhaleva L.V.
The aim: to study the role of systemic inflammation and metabolic activity of intestinal microbiota in the formation of CVR in UC patients.
Material and methods. The indexes of systemic inflammation SIRI, SII, AISI were determined and compared in 184 patients with UC, 17 of whom had coronary heart disease (CHD). Comparison groups included 20 patients with a combination of arterial hypertension and CHD and 20 practically healthy individuals. At the second stage of the study, the content of SCFAs in feces was assessed in 80 patients with UC, and a correlation analysis was performed to clarify the correlation between systemic inflammation and the content of SCFAs. Parametric and nonparametric statistical methods were used.
Results. In healthy individuals, the values of the SIRI, SII and AISI indexes were significantly lower than in other study participants. They were highest in patients with UC, while SII index was significantly higher in patients who had a combination of UC with coronary heart disease and arterial hypertension. In participants with UC, the content of SCFAs in feces was below the reference values. The acetate/propionate/butyrate ratio was 13.9:2.3:1. A negative correlation was fixed between the values of SIRI, SII and AISI with the content of SCFAs.
Conclusion. Probably, SII index can be considered as a laboratory marker for assessing CVR in case of UC, but additional studies are needed to confirm this. We have established an inverse relationship between the level of systemic inflammation and the metabolic activity of the intestinal microbiota in UC patients with a marked decrease in butyrate synthesis.
Keywords
ulcerative colitis
cardiovascular risk
systemic inflammation indices
short-chain fatty acids
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About the Authors
Galiya R. Bikbavova, MD, PhD (Medicine), associate professor, associate professor of the Department of hospital therapy, endocrinology, Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenina St.E-mail: galiya1976@mail.ru
ORCID: https://orcid.org/0000-0001-9252-9152. Scopus ID: 56612403500. eLibrary SPIN: 6103-6690
Maria A. Livzan, MD, Dr. Sci. (Medicine), professor, corresponding member of RAS, rector, head of the Department of faculty therapy and gastroenterology, Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenina St.
E-mail: rector@omsk-osma.ru
ORCID: https://orcid.org/0000-0001-6581-7017. Scopus ID: 24341682600. eLibrary SPIN: 1961-4082
Natalya S. Lisyutenko, MD, PhD (Medicine), associate professor of the Department of hospital therapy and endocrinology, Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenina St.
E-mail: n.labuzina@mail.ru
ORCID: https://orcid.org/0000-0003-4088-240X. Scopus ID: 57205695113. eLibrary SPIN: 1964-5202
Viktor V. Dranitsyn, MD, 1st year resident of the Department of oncology, radiation therapy of continuing professional education, Omsk state medical university of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenina St.
E-mail: viktordranicyn@list.ru
ORCID: https://orcid.org/0009-0001-6030-0131
Lyubov V. Mikhaleva, MD, physician at the Department of gastroenterology, Omsk Regional Clinical Hospital. Address: 644111, Omsk, 3 Berezovaya St.
E-mail: lyubov5.04@mail.ru
ORCID: https://orcid.org/0000-0003-0331-1640
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