Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. May 26, 2017; 9(5): 448-456
Published online May 26, 2017. doi: 10.4330/wjc.v9.i5.448
Markers of inflammation and cardiovascular disease in recently diagnosed celiac disease patients
Walter F Tetzlaff, Tomás Meroño, Martin Menafra, Maximiliano Martin, Eliana Botta, Maria D Matoso, Patricia Sorroche, Juan A De Paula, Laura E Boero, Fernando Brites
Walter F Tetzlaff, Tomás Meroño, Martin Menafra, Maximiliano Martin, Eliana Botta, Laura E Boero, Fernando Brites, Department of Clinical of Biochemistry, School of Pharmacy and Biochemistry, University of Buenos Aires, INFIBIOC, CONICET, Buenos Aires C1113AAD, Argentina
Maria D Matoso, Juan A De Paula, Service of Gastroenterology, Buenos Aires Italian Hospital, Buenos Aires C11000ABC, Argentina
Patricia Sorroche, Central Laboratory, Buenos Aires Italian Hospital, Buenos Aires C11000ABC, Argentina
Author contributions: Tetzlaff WF performed biochemical determinations, data collection and data analysis; Meroño T and Martin M analyzed the data; Menafra M, Botta E and Sorroche P performed the biochemical determinations; Matoso MD and De Paula JA contributed in the recruitment of patients and clinical studies; Boero LE and Brites F contributed equally in the design of research and revised the article critically for important intellectual content.
Supported by CONICET, No. PIP 11220110100516; and University of Buenos Aires, No. UBACyT 20020150100054BA.
Institutional review board statement: The study was reviewed and approved by the Ethical Committees from School of Pharmacy and Biochemistry, University of Buenos Aires.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: The technical appendix is available from the corresponding author laura.boero@hotmail.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Laura E Boero, PhD, Department of Clinical of Biochemistry, School of Pharmacy and Biochemistry, University of Buenos Aires, INFIBIOC, CONICET, Junín 956 (1113), Buenos Aires C1113AAD, Argentina. laura.boero@hotmail.com
Telephone: +54-11-59508654 Fax: +54-11-45083645
Received: November 24, 2016
Peer-review started: November 25, 2016
First decision: January 16, 2017
Revised: March 3, 2017
Accepted: April 6, 2017
Article in press: April 10, 2017
Published online: May 26, 2017
Abstract
AIM

To evaluate novel risk factors and biomarkers of cardiovascular disease in celiac disease (CD) patients compared with healthy controls.

METHODS

Twenty adult patients with recent diagnosis of CD and 20 sex, age and body mass index-matched healthy controls were recruited during a period of 12 mo. Indicators of carbohydrate metabolism, hematological parameters and high sensitive C reactive protein were determined. Moreover, lipoprotein metabolism was also explored through evaluation of the lipid profile and the activity of cholesteryl ester transfer protein and lipoprotein associated phospholipase A2, which is also considered a specific marker of vascular inflammation. The protocol was approved by the Ethic Committee from School of Pharmacy and Biochemistry, University of Buenos Aires and from Buenos Aires Italian Hospital, Buenos Aires, Argentina.

RESULTS

Regarding the indicators of insulin resistance, CD patients showed higher plasma insulin levels [7.2 (5.0-11.3) mU/L vs 4.6 (2.6-6.7) mU/L, P < 0.05], increased Homeostasis Model Assessment-Insulin Resistance [1.45 (1.04-2.24) vs 1.00 (0.51-1.45), P < 0.05] and lower Quantitative Sensitive Check index [0.33 (0.28-0.40) vs 0.42 (0.34-0.65), P < 0.05] indexes. Folic acid concentration [5.4 (4.4-7.9) ng/mL vs 12.2 (8.0-14.2) ng/mL, P < 0.01] resulted to be lower and High-sensitivity C reactive protein levels higher (4.21 ± 6.47 mg/L vs 0.98 ± 1.13 mg/L, P < 0.01) in the patient group. With respect to the lipoprotein profile, CD patients showed lower high density lipoprotein-cholesterol (HDL-C) (45 ± 15 mg/dL vs 57 ± 17 mg/dL, P < 0.05) and apo A-I (130 ± 31 mg/dL vs 155 ± 29 mg/dL, P < 0.05) levels, as well as higher total cholesterol/HDL-C [4.19 (3.11-5.00) vs 3.52 (2.84-4.08), P < 0.05] and apo B/apo A-I (0.75 ± 0.25 vs 0.55 ± 0.16, P < 0.05) ratios in comparison with control subjects. No statistically significant differences were detected in lipoprotein-associated lipid transfer protein and enzymes.

CONCLUSION

The presence and interaction of the detected alterations in patients with CD, would constitute a risk factor for the development of atherosclerotic cardiovascular disease.

Keywords: Inflammation, Cardiovascular disease, High density lipoprotein-cholesterol, Lipoproteins, Celiac disease

Core tip: Given that data about the presence of metabolic alterations and atherogenic risk factors in celiac disease are scarce and contradictory, we aimed to investigate carbohydrate metabolism, lipoprotein profile and inflammatory status in patients with celiac disease (CD). Patients presented higher insulin levels, Homeostasis Model Assessment-Insulin Resistance index, apo B/apo A-I ratio and High-sensitivity C reactive protein concentration, as well as lower Quantitative Sensitive Check index index, high density lipoprotein-cholesterol and apo A-I levels in comparison with sex and aged-matched healthy controls. Persistence of these alterations through long periods of time in a chronic pathologic condition, as it is the case with CD, would constitute a high risk of developing atherosclerotic cardiovascular disease.