Intest Res.  2022 Oct;20(4):495-505. 10.5217/ir.2022.00017.

Abdominal aortic calcification in patients with inflammatory bowel disease: does anti-tumor necrosis factor α use protect from chronic inflammation-induced atherosclerosis?

• Mantaka A
• Galanakis N
• Tsetis D
• Koutroubakis IE

• KMID: 2535823
• DOI: http://doi.org/10.5217/ir.2022.00017

Abstract

Background/Aims
Abdominal aortic calcium (AAC) deposition has been suggested as a marker of early atherosclerosis. There is no published data on the evaluation of AAC in inflammatory bowel disease (IBD).
Methods
AAC was quantified by computed tomography or enterography scans performed in 98 IBD patients and 1:1 age and sex matched controls. AAC deposition was correlated with IBD characteristics, disease activity or severity parameters, laboratory tests and cardiovascular disease (CVD) risk factors.
Results
Moderate-severe grade of AAC was found in 35.7% of IBD patients compared to 30.6% of controls (P= 0.544). IBD with CVD and ulcerative colitis patients had significantly higher rates of more severe atherosclerotic lesions (P= 0.001 and P= 0.01, respectively). AAC deposition was similarly distributed in age groups ( < 45, 45–64, and ≥ 65 years) among patients and controls. Multivariate analysis after excluding CVD risk confounders for non-CVD patients found extensive disease (P= 0.019) and lifetime steroids (P= 0.04) as independent risk factors for AAC. Anti-tumor necrosis factor α (TNF-α) use was negatively associated with AAC deposition in non-CVD IBD patients (odds ratio, 0.023; 95% confidence interval, 0.001–0.594; P= 0.023).
Conclusions
More than one-third of IBD patients have moderate to severe AAC. Better control of inflammation with anti-TNF-α agents seems to protect IBD patients from ACC deposition and subsequent atherosclerosis.

Keyword

Abdominal aortic calcium; Atherosclerosis; Tumor necrosis factor-alpha; Crohn disease; Colitis, ulcerative

Figure

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  Fig. 1. Computed tomography of 3 inflammatory bowel disease patients with different grades of abdominal aortic calcium deposition. (A) Grade 1, minimal non-circumferential non-contiguous scattered arterial calcifications. (B) Grade 3, moderate non-circumferential non-contiguous calcifications of multiple arterial segments with >50% vessel wall calcification but without any completely concentric calcifications. (C) Grade 5, diffuse calcifications in multiple levels of completely concentric calcifications.

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