Agustos 2017
Inflamatuvar barsak hastaliklarinda lipid anormallikleri
Lipid abnormalities in inflammatory bowel disease
- Ana Sayfa
- Sayılar
- Agustos 2017
- Inflamatuvar barsak hastaliklarinda lipid anormallikleri...
Özet
Giris ve Amaç: Inflamatuvar barsak hastaliklari kronik inflamasyon ve aterosklerozda artisla karakterize hastaliklardir. Birçok çalismada inflamatuvar barsak hastaliklarinda kardiyovasküler hastaliklar için potansiyel neden olabilecek lipid anormallikleri arastirilmistir. Biz bu çalismamizda inflamatuvar barsak hastaliklarinda lipid parametreleri üzerinde etkisi olabilecek ilaç tedavisi, operasyon ve hastalik süresi gibi degiskenleri inceledik. Gereç ve Yöntem: Türkiye Yüksek Ihtisas Egitim ve Arastirma Hastanesi Inflamatuvar Barsak Hastaliklari Poliklinigi’nde Ocak 2016-Mart 2016 arasinda ardisik olarak takip ve tedavi edilen hastalar çalismaya alindi. Bulgular: Çalismaya toplam 138 hasta (ülseratif kolit: 71 hasta, Crohn: 67 hasta) alindi. Hastalarin yas ortalamasi 45 olup 47 kadin, 71 erkek hasta vardi. Total kolesterol ve düsük yogunluklu lipoprotein seviyeleri ülseratif kolit hastalarinda Crohn hastaligina göre anlamli olarak fazlaydi (sirasiyla p=0,003 ve p=0,001). Ülseratif kolitte proktit, sol kolon tutulumlu ve ekstensif tutulumlu hastalar arasinda total kolesterol, trigliserid, yüksek yogunluklu lipoprotein ve düsük yogunluklu lipoprotein seviyeleri arasinda fark yoktu. Crohn hastalarinda inflamatuvar, penetran ve striktüran fenotipler arasinda total kolesterol, trigliserid, yüksek yogunluklu lipoprotein ve düsük yogunluklu lipoprotein arasinda fark yoktu. Azatiyopürin ve mesalazin alan ve almayan hastalar arasinda bakilan lipid parametreleri için fark bulunmadi. Anti-tümör nekrozis faktör alan hastalarda ise total kolesterol ve düsük yogunluklu lipoprotein kolesterol seviyeleri anti-tümör nekrozis faktör almayan hastalara kiyasla anlamli olarak daha düsük izlendi (sirasiyla p=0,01 ve p=0,02). Hastalarin aldiklari ilaç tedavi süreleri ile total kolesterol, trigliserid, düsük yogunluklu lipoprotein ve yüksek yogunluklu lipoprotein seviyeleri arasinda korelasyon izlenmedi. Sonuç: Inflamatuvar barsak hastaliklarinda lipid anormallikleri üzerine etkili olabilecek ilaç, operasyon, hastalik fenotipi ve hastalik tutulum yeri gibi faktörlerin bilinmesi, ateroskleroz gibi potansiyel komplikasyonlarin önlenebilmesine olanak taniyabilir.
Abstract
Background and Aims: Chronic inflammation and increased atherosclerosis are main characteristic features of inflammatory bowel disease. Plasma lipid abnormalities in inflammatory bowel disease as a potential cause of cardiovascular disease has been examined in various studies. In this study, we have analyzed variables such as medication, operation history, and disease duration that can affect plasma lipid levels in inflammatory bowel disease. Materials and Methods: Consecutive inflammatory bowel disease patients who were followed and treated between January 2016-March 2016 in Türkiye Yüksek Ihtisas Training and Research Hospital Inflammatory Bowel Disease Polyclinic were included in the study. Results: Overall 138 patients (ulcerative colitis: 71 patients, Crohn’s disease: 67 patients) were analyzed. The median age of patients was 45 years old, and 91 were male while 47 were female. Levels of total cholesterol and low-density lipoprotein were significantly higher in ulcerative colitis than in Crohn’s disease (p = 0.003 and p = 0.001, respectively). Lipid parameters were not different among proctitis, distal colitis, and extensive colitis. Also, lipid parameters were not different between inflammatory, penetrant, and stricturing phenotypes in Crohn’s disease. Lipid parameters were not different among patients whether they received azathiopurine and 5-aminosalicylates. Total cholesterol and low-density lipoprotein levels were significantly lower in patients who received anti- tumor necrosis factor than in patients who did not receive anti- tumor necrosis factor (p=0.01 and p=0.02, respectively). Total cholesterol, triglyceride, high-density lipoprotein, and low-density lipoprotein levels were not correlated with medical treatment duration. Conclusion: For preventing atherosclerosis, it is important to be informed about medication, inflammatory bowel disease type, disease phenotype, and operation history, which can affect lipid levels in inflammatory bowel disease.
