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Previous issue date: 2016-03-03 / Introduction: The association betweenchangesin lipid metabolismand chronicinflammatory bowel diseasesis not well established. It is observed thatinflammatory markers which arepresent inCrohn's disease (CD) and inulcerative colitis(UC) are also presentin metabolicsituationsthat are characterized byatherogenicdyslipidemia. It ispossible to assumethat changes inlipid profilemay be associated withchronic inflammation,potentiallyaggravating theclinical situationand increasing the riskof cardiovascular diseases. Aim: This research aims to investigate the associationbetween patients? lipidprofile who areunderinflammatory bowel disease andtheactivity levelsof chronicinflammatory disease. Method: Cross-sectional studyof patients who are followedin the Inflammatory Bowel Disease(IBD)clinic ofS?o LucasHospital atPontif?ciaUniversidadeCat?licado Rio Grande do Sul. We have evaluateddemographic and anthropometric data,andbiochemicaltests (C-reactive protein, erythrocyte sedimentation rate, blood count andlipid profile). Patientswere classified accordingto the severity ofCrohn's diseaseregarding Harvey-Bradshaw index forinflammatory activity; in relation toulcerative colitis, the classification followedthe severity ofacuteoutbreakaccording toTrueloveandWitts. Results:The study involved 122 patients of both genders who are under chronic inflammatory bowel disease. The patients were divided into two groups: Crohn's disease (n = 64; 52.5%) and ulcerative colitis (n = 58; 47.5%). Their average age is 41.6 around 12.6 years and their body mass index(BMI) is 25 around 4.4 kg/m2. Concerning the laboratory markers which were evaluated, we have found that LDL-c was higher in UC when compared to LDL-c CD (110.0 +35.8 x 91.3?33.1 mg/dL; p= 0.006). Regarding Harvey-Bradshaw indexforinflammatory activity, 63.8% of CD patients have had mild disease activity and CRP was the only marker in correlation to the disease severity (p = 0. 027). In UC, the distribution of patients according to Truelove and Witts index showed that 63.2% of patients have had mild disease; while for markers lipid, HDL-c levels (p = 0.036) and total cholesterol (p = 0.028) were correlated to the disease severity. HDL-c was the only lipoproteins that have presented, in 67.6% of the sample,valuesbelow those recommended by the Brazilian Society of Cardiology. Conclusion:We have concludedthat in IBDpatients, it is clear that theLDL-cissignificantly higherinUC. TheHDL-c,in both diseases,has presentedlevels below recommended. Among CDpatients, those who werein moresevere inflammatorysituationhave presented significantlyhigher levelsof CRP whencomparedto UCpatients. In relation totheseverity of the disease, which is determinedbyHarvey-Bradshaw indexorCDandTrueloveandWittsforUC, patients from both groups havebehavedsimilarly. / Introdu??o: A associa??o entre altera??es no metabolismo lip?dico e doen?as inflamat?rias intestinais cr?nicas n?o est? bem estabelecida. Observa-se que marcadores inflamat?rios presentes na Doen?a de Crohn (DC) e na Retocolite Ulcerativa Inespec?fica (RCUI) tamb?m est?o presentes em situa??es metab?licas que se caracterizam por dislipidemias aterog?nicas. ? poss?vel supor que as altera??es no perfil lip?dico podem estar associadas a processos inflamat?rios cr?nicos, potencialmente, agravar a situa??o cl?nica e aumentar o risco de doen?as cardiovasculares. Objetivo: Verificar a associa??o entre o perfil lip?dico de pacientes com doen?a inflamat?ria intestinal e os n?veis de atividade da doen?a inflamat?ria cr?nica. M?todo: Estudo transversal de pacientes acompanhados no ambulat?rio de Doen?a Inflamat?ria Intestinal do Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Foram avaliados dados demogr?ficos, antropom?tricos e exames bioqu?micos (prote?na C reativa, velocidade de hemossedimenta??o, hemograma e perfil lip?dico). Os pacientes foram classificados quanto ? gravidade da Doen?a de Crohn de acordo com o ?ndice de atividade inflamat?ria de Harvey-Bradshaw e, na Retocolite Ulcerativa Inespec?fica, quanto ? gravidade do surto agudo segundo Truelove e Witts. Resultados: Participaram do estudo 122 pacientes de ambos os sexos com doen?a inflamat?ria intestinal cr?nica, divididos em dois grupos: doen?a de Crohn (n= 64; 52,5%) e retocolite ulcerativa inespec?fica (n= 58; 47,5%). M?dia de idade de 41,6 ?12,6 anos e m?dia de IMC de 25 ? 4,4kg/m2. Quanto aos marcadores laboratoriais avaliados, verificamos que o LDL-c mostrou-se mais elevado na RCUI quando comparado ao LDL-c da DC (110,0 +35,8 x 91,3?33,1 mg/dL; p= 0, 006). Em rela??o ao ?ndice de atividade inflamat?ria de Harvey-Bradshaw, 63,8% dos pacientes com DC apresentaram atividade leve da doen?a e a PCR foi o ?nico marcador que apresentou correla??o com a gravidade da doen?a (p= 0, 027). Na RCUI, a distribui??o dos pacientes conforme o ?ndice de Truelove e Witts demonstrou que 63,2% dos pacientes estavam com doen?a leve. Quanto aos marcadores lip?dicos, o HDL-c (p=0,036) e o colesterol total (p=0,028) apresentaram correla??o com a gravidade da doen?a. O HDL-c foi a ?nica das lipoprote?nas que apresentou valores abaixo dos recomendados pela Sociedade Brasileira de Cardiologia em 67,6% da amostra. Conclus?o: Podemos concluir que, em pacientes com DII, verifica-se que o LDL-c est? significativamente mais elevado na RCUI. O HDL-c em ambas as doen?as apresentou n?veis abaixo dos recomendados. Entre os pacientes com DC, os que se apresentam em situa??o inflamat?ria mais grave apresentaram valores significativamente mais elevados da PCR, quando comparados aos pacientes com RCUI. Em rela??o ? gravidade da doen?a determinada pelos ?ndices de Harvey-Bradshaw para DC e de Truelove e Witts para RCUI, os pacientes dos dois grupos comportaram-se de maneira semelhante.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6775 |
| Date | 03 March 2016 |
| Creators | Adorne, Elaine de Fatima |
| Contributors | Bodanese, Luiz Carlos |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 600, 600, 600, -8624664729441623247, -969369452308786627 |
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