Risk of cardiovascular disease in inflammatory bowel disease.
Risk of cardiovascular disease in inflammatory bowel disease.
复制标题
DOI：
10.4291/wjgp.v5.i3.359
复制
发表时间：
2014-08-15
期刊：
影响因子：
--
通讯作者：
Jess, Tine
中科院分区：
文献类型：
--
作者：
Andersen, Nynne Nyboe;Jess, Tine
大量的科学证据支持炎症性肠病（IBD）和静脉血栓栓塞事件（由IBD相关高凝状态引起）之间的相关性，这一点已得到认可，目前在IBD患者的管理中实施了血栓预防治疗策略。相反，IBD患者发生动脉血栓栓塞性疾病（如缺血性心脏病、脑血管事件和肠系膜缺血）的风险仍不确定，且潜在风险增加的程度持续存在争议，研究中的风险估计不明确。炎症在动脉粥样硬化发病机制中的明显作用形成了生物学合理联系的基础; IBD患者的慢性全身性炎症增加了动脉粥样硬化的风险，从而增加了血栓形成事件的风险。此外，研究表明，IBD人群中动脉粥样硬化的传统风险因素（如肥胖、糖尿病和血脂异常）的负担较低，因此进一步加强了非传统风险因素的作用，如慢性炎症在两种疾病实体之间的联系。同样，IBD患者心血管疾病的死亡率仍受到质疑。目前综述的目的是对IBD和心血管疾病之间可能相关性的现有证据进行更新，并讨论传统和非传统危险因素。
Abundant scientific evidence supporting an association between inflammatory bowel disease (IBD) and venous thromboembolic events, caused by an IBD related hypercoagulability, is acknowledged and thromboprophylactic treatment strategies are now implemented in the management of IBD patients. In contrary, the risk of arterial thromboembolic disease, as ischemic heart disease, cerebrovascular events, and mesenteric ischemia in patients with IBD remains uncertain and the magnitude of a potentially increased risk is continuously debated, with ambiguous risk estimates among studies. The evident role of inflammation in the pathogenesis of atherosclerosis forms the basis of a biological plausible link; the chronic systemic inflammation in IBD patients increases the risk of atherosclerosis and thereby the risk of thrombotic events. Further, studies have shown that the burden of traditional risk factors for atherosclerosis, such as obesity, diabetes mellitus, and dyslipidemia is lower in IBD populations, thus further strengthen the role of non-traditional risk factors, as chronic inflammation in the linking of the two disease entities. Likewise, mortality from cardiovascular disease in IBD remains questioned. The aim of the current review is to give an up-date on the existing evidence of the possible association between IBD and cardiovascular disease and to discuss traditional and non-traditional risk factors.