Risco de doenças cardiovasculares em mulheres com retocolite ulcerativa, em remissão clínica, em resposta ao tratamento com aminossalicilato e azatioprina

Abstract

Ulcerative colitis (UC) is an inflammatory bowel disease, chronic, with involvement of the immune system. Chronic inflammatory disease have been associated with increased risk of cardiovascular disease (CVD) but few studies have assessed this risk in patients with UC and the influence of drug treatment. Thus, we evaluated the risk of development CVD in women with UC in clinical remission considering the drug treatment. 21 women with UC participated in this study, where 12 used aminosalicylates (ASA group) and 9 used azathioprine added to aminosalicylates (AZA+ASA group). The healthy control group was matched for age. We evaluated blood pressure, body composition and biochemical and immunological parameters. Compared the respective control group, the UC groups showed expansion of body fat and less lean body mass. Blood pressure, pro-inflammatory cytokines, nitric oxide, C reactive protein, erythrocyte sedimentation rate (ESR) and anti-oxidized LDL antibodies were higher in UC groups. Only AZA+ASA group showed increased of anti-inflammatory cytokines (IL-10 and TGF-). The Framingham scores showed higher risk of CVD in UC groups. UC groups were compared and women treated with azathioprine showed reduction of total protein, globulin, ESR and lymphocytes, with increased of IL-6, TNF, IL-10 and TGF-. Data suggest that women with UC in clinical remission have a higher risk for development of atherosclerosis and CVD when compared to the control group, while women treated with azathioprine seem more protected than that in isolated use of aminosalicylates, due the better regulation of the inflammatory process