Relationship of dyslipoproteinemia features with arterial stiffness in young and middle-aged patients with ulcerative colitis

AIM: to study the features of dyslipoproteinemia and vascular wall elasticity in young and middle-aged patients with ulcerative colitis (UC). PATIENTS AND METHODS: the work was carried in the period from January 2021 to January 2025. The first stage included a retrospective and prospective analysis of 495 medical records of patients with UC, of which: 48 patients (group I) in the debut of UC with a UC activity index (Mayo index) of 6–9 points; 401 patients (Group II) from the regional registry of patients with IBD with a history of UC up to 10 years inclusive, with a moderate to severe course of the disease and who did not receive targeted immunosuppressants and genetically engineered biological drugs (GIBPS) until the time of retrospective analysis; 46 patients with UC (group III) with a disease duration of up to 5 years inclusive and who used in the anamnesis of GIBP (vedolizumab, infliximab, ustekinumab). As part of the second stage of the study, 3 study groups (I-1, I-2, and I-3) and a control group (K) were formed. The I-1 group included 40 patients from group I, the I-2 group included 80 patients from group II, and the I-3 group included 31 patients from group III, with a duration of UC of 5 years, in whom the appointment of biological therapy occurred in the first year after the manifestation of UC. The I-2 and I-3 groups included patients in clinical remission for at least 3 months before being included in the study. The I-2 group included 39 patients with a duration of UC up to 5 years inclusive (I-2.1) and 41 patients with a duration of UC 6–10 years inclusive (I-2.2). 160 people from practically healthy individuals who had no clinical or endoscopic signs of UC were selected for the control group K. The study included people under the age of 60. All study participants underwent a lipid profile study, volumetric sphygmography with determination of the cardiovascular vascular index CAVI (Cardio-Ankle Vascular Index). RESULTS: аs a result of the study, specific quantitative features of the components of the lipid profile in patients with UC were revealed, consisting in a lower level of atherogenic components: total cholesterol, low-density lipoprotein cholesterol (p < 0.001), against a background of a relatively higher amount of triglycerides ((p < 0.01), and low levels of high-density lipoprotein cholesterol (p < 0.001), as well as a higher atherogenicity index (p < 0.01), especially when the inflammatory process in the intestine is activated. When measuring the CAVI index, higher values of this indicator were recorded in the study groups than in the participants of the control group (p < 0.001). The maximum deviation of the CAVI index was found in the I-2.2 group (Me — 1.32, Q1–Q3: 1.06–1.58, rI-2.2 — K < 0.001), which included patients with UC experience from 6 to 10 years. CONCLUSION: the quantitative features of the lipid profile revealed during the study suggest the presence of special changes in the biochemistry of all lipid fractions in UC and possibly a higher need for them during the development of IBD. Further study of the biochemistry of lipoproteins and their genetic determination in patients with IBD is necessary.