Cardiovascular risk assessment in inflammatory bowel disease with metabolic dysfunction-associated steatotic liver disease

Sandra García-Mateo; Samuel J Martínez-Domínguez; Carla J Gargallo-Puyuelo; Beatriz Gallego; Erika Alfambra; María C Aso; Neus Martinez-Micaelo; Nuria Amigó; Javier Martínez-García; Pedro M Baptista; Borja Sanz; Sara Ballesta; Judith Espinosa; Carlos Tejero; Fernando Gomollón

doi:10.1016/j.medcli.2023.11.032

Cardiovascular risk assessment in inflammatory bowel disease with metabolic dysfunction-associated steatotic liver disease

Med Clin (Barc). 2024 Feb 28:S0025-7753(24)00004-6. doi: 10.1016/j.medcli.2023.11.032. Online ahead of print.

[Article in English, Spanish]

Authors

Affiliations

¹ Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain. Electronic address: sgarciamateo7@gmail.com.
² Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain.
³ Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain.
⁴ School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain.
⁵ School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain; Biosfer Teslab, Plaça del Prim 10, 2on 5a, 43201 Reus, Spain.
⁶ Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain; University of Zaragoza, Department of Multiscale in Mechanical and Biological Engineering, Spain.
⁷ Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain; CIBER Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
⁸ Department of Endocrinology, Manises Hospital, 46940 Valencia, Spain.
⁹ Department of Neurology, Lozano Blesa University Hospital, 50009 Zaragoza, Spain.
¹⁰ Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain.

PMID: 38423940
DOI: 10.1016/j.medcli.2023.11.032

Abstract

Background and aims: Inflammatory bowel disease (IBD) has been reported to increase the risk of early atherosclerosis even in young patients. Moreover, metabolic dysfunction-associated steatotic liver disease (MASLD), which has been linked to IBD, is a well-recognized but underdiagnosis entity related to cardiovascular risk. We analyze the impact of MASLD in IBD patients' cardiovascular risk through both advanced lipoprotein profile sorted by nuclear magnetic resonance spectroscopy, and carotid artery intima-media thickness (CIMT).

Methods: Cross-sectional cohort study which involves 941 IBD adult outpatients. Of them, 50 patients with IBD who met criteria for MASLD and 50 with IBD without MASLD, matched by sex and age were included. Alterations in CIMT were evaluated considering abnormal measures above the 75th percentile adjusted for sex and age. Specific advanced lipoprotein profile was also carried out.

Results: Most of the patients had an abnormal CIMT (58%). MASLD (OR=5.05, CI 95%=1.71-14.92) and female sex (OR=3.32, CI 95%=1.03-10) were significantly associated with CIMT alterations. Dense LDL particles (with high cholesterol composition in general cohort (OR=3.62, 95% CI=1.07-12.19) and high triglycerides density in young subgroup (OR=6.25, 95% CI=1.04-50) but not total LDL cholesterol were associated with CIMT alterations.

Conclusions: MASLD and female sex are associated with early atherosclerosis in IBD patients. Dense LDL particle in combination with vascular imaging findings should be evaluated as non-invasive tools in the management of cardiovascular risk in IBD patients.

Keywords: Cardiovascular risk; Carotid artery intima-media thickness; Dense LDL; Enfermedad hepática esteatósica asociada a disfunción metabólica; Enfermedad inflamatoria intestinal; Grosor íntima-media carotídeo; Inflammatory bowel disease; Metabolic disfunction-associated steatotic liver disease; Partículas de baja densidad; Riesgo cardiovascular.