Endothelial dysfunction in patients with ulcerative colitis

BACKGROUND: Human intestinal microvessels from chronically inflamed ulcerative colitis (UC) show microvascular endothelial dysfunction. Whether generalized endothelial dysfunction could associate with UC has not been explored yet. Our aim was to assess the endothelial function in the patients with different UC activity and to hypothesize about the relationship of endothelial function to activity-related extraintestinal complications (AREC) of UC. METHODS: Twelve patients with mild UC, 14 patients with moderate UC, 16 patients with severe UC, and 24 healthy subjects were included in the study. The activity of UC is calculated according to the Seo Index. Endothelial functions of the brachial artery were evaluated by using high-resolution vascular ultrasound. Endothelial-dependent dilatation (EDD) was assessed by establishing reactive hyperemia and endothelial-independent dilatation (EID) was determined by using sublingual isosorbide dinitrate. RESULTS: EDD was significantly worse in patients with severe UC as compared with patients with mild UC (8.7 +/- 1.6% versus 17.3 +/- 5.6%, P < 0.05) and even in patients with moderate UC as compared with patients with mild UC (13.1 +/- 3.2% versus 17.3 +/- 5.6%, P < 0.05). EDD was not significantly worse in patients with mild UC as compared with healthy subjects (17.3 +/- 5.6% versus 18.1 +/- 8.1%, P > 0.05). EID was significantly worse in patients with severe UC compared with patients with moderate UC (10.5 +/- 2.9% versus 13.4 +/- 3.7%, P < 0.05) and even in patients with mild UC compared with healthy subjects (20 +/- 6.7% versus 31.1 +/- 12.6%, P < 0.05). EDD and EID were significantly worse in patients with AREC compared with patients with no AREC (9.5 +/- 2.5% versus 14.9 +/- 5.1%, P < 0.05; 11.6 +/- 4.3% versus 16 +/- 6.1%, P < 0.05, respectively). CONCLUSIONS: Increased activity of UC is associated with significant endothelial dysfunction, which may relate to the pathophysiology of AREC of UC.