İlyas TENLİK, Fatih SAYGILI, Özlem AKDOĞAN, Ertuğrul KAYAÇETİN, Zeki Mesut Yalın KILIÇ, Mahmut YÜKSEL, Yasemin ÖZDERİN ÖZİN, İsmail Hakkı KALKAN, MUSTAFA KAPLAN, Muhammet Yener AKPINAR

İnflamatuvar barsak hastalıklarında lipid anormallikleri

Giriş ve Amaç: İnflamatuvar barsak hastalıkları kronik inflamasyon ve aterosklerozda artışla karakterize hastalıklardır. Birçok çalışmada inflamatuvar barsak hastalıklarında kardiyovasküler hastalıklar için potansiyel neden olabilecek lipid anormallikleri araştırılmıştır. Biz bu çalışmamızda inflamatuvar barsak hastalıklarında lipid parametreleri üzerinde etkisi olabilecek ilaç tedavisi, operasyon ve hastalık süresi gibi değişkenleri inceledik. Gereç ve Yöntem: Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi İnflamatuvar Barsak Hastalıkları Polikliniği’nde Ocak 2016-Mart 2016 arasında ardışık olarak takip ve tedavi edilen hastalar çalışmaya alındı. Bulgular: Çalışmaya toplam 138 hasta (ülseratif kolit: 71 hasta, Crohn: 67 hasta) alındı. Hastaların yaş ortalaması 45 olup 47 kadın, 71 erkek hasta vardı. Total kolesterol ve düşük yoğunluklu lipoprotein seviyeleri ülseratif kolit hastalarında Crohn hastalığına göre anlamlı olarak fazlaydı (sırasıyla p=0,003 ve p=0,001). Ülseratif kolitte proktit, sol kolon tutulumlu ve ekstensif tutulumlu hastalar arasında total kolesterol, trigliserid, yüksek yoğunluklu lipoprotein ve düşük yoğunluklu lipoprotein seviyeleri arasında fark yoktu. Crohn hastalarında inflamatuvar, penetran ve striktüran fenotipler arasında total kolesterol, trigliserid, yüksek yoğunluklu lipoprotein ve düşük yoğunluklu lipoprotein arasında fark yoktu. Azatiyopürin ve mesalazin alan ve almayan hastalar arasında bakılan lipid parametreleri için fark bulunmadı. Anti-tümör nekrozis faktör alan hastalarda ise total kolesterol ve düşük yoğunluklu lipoprotein kolesterol seviyeleri anti-tümör nekrozis faktör almayan hastalara kıyasla anlamlı olarak daha düşük izlendi (sırasıyla p=0,01 ve p=0,02). Hastaların aldıkları ilaç tedavi süreleri ile total kolesterol, trigliserid, düşük yoğunluklu lipoprotein ve yüksek yoğunluklu lipoprotein seviyeleri arasında korelasyon izlenmedi. Sonuç: İnflamatuvar barsak hastalıklarında lipid anormallikleri üzerine etkili olabilecek ilaç, operasyon, hastalık fenotipi ve hastalık tutulum yeri gibi faktörlerin bilinmesi, ateroskleroz gibi potansiyel komplikasyonların önlenebilmesine olanak tanıyabilir.

Anahtar Kelimeler:

Ateroskleroz, inflamatuvar barsak hastalığı, lipid

Lipid abnormalities in inflammatory bowel disease

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 İhtisas 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.

Keywords:

Atherosclerosis, inflammatory bowel disease, lipid,

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