Vnitr Lek 2007, 53(10):1035-1039

Changes in lipid metabolism in patients in the active phase of Crohn's disease

V. Hrabovský^1,*, Z. Zadák², V. Bláha³, R. Hyšpler³, T. Karlík⁴

¹ Metabolická JIP, vedoucí MUDr. Vladimír Hrabovský, interního oddělení FN Ostrava-Poruba, přednosta doc. MUDr. Arnošt Martínek, CSc.

² Centrum pro vědu a výzkum Lékařské fakulty UK Hradec Králové, vedoucí prof. MUDr. Zdeněk Zadák, CSc.

³ Klinika gerontologická a metabolická Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Luboš Sobotka, CSc.

⁴ Ústav biochemie FN Ostrava-Poruba, přednosta prim. MUDr. Antonín Pohlídal, Ph.D.

Introduction:
Crohn's disease (CD) in its active period is accompanied by a decreased food intake and deterioration in water, mineral and metabolic balance. Lipid metabolism is known to be altered in many acute diseases, and hypocholesterolemia is a serious negative prognostic indicator. The causes of decreased serum cholesterol concentration are multiple. Simultaneous affection of both cholesterol synthesis and absorption has been reported in many sources. The changes in both the above processes can be quantified with the use of specific indicators of synthesis (cholesterol level) and absorption (sitosterol and campesterol levels).

Objective:
The objective of the study was to demonstrate changes in lipid metabolism in patients with active Crohn's disease, and to find out to what extent the above phenomenon is influenced by the affection of the process of cholesterol synthesis and/or absorption in the case of detected hypocholesterolemia.

Material and methods:
Total serum cholesterol, LDL- and HDL-cholesterol and triglyceride levels were measured on the 3rd, 14th and 28th day from admission in addition to admission analyses in 24 patients with acute manifestation of CD (CDAI - Cohn's disease activity index - over 150). Also measured were the concentrations of squalene, lathosterol, sitosterol and campesterol. The results were compared with a control sample of 100 voluntary blood donors. The obtained data was processed using the Sigma-stat 3.1 statistical software.

Results:
Decreased levels of all basic lipid metabolism parameters were detected. At the same time, a statistically significant decrease in the levels of lathosterol and camposterol was recorded. The decrease in sitosterol levels was insignificant and the level of squalene was higher than in the controls.

Conclusion:
Significant changes in lipid metabolism were demonstrated in the study in patients in active phase of Crohn's disease. Also detected was statistically significant hypocholesterolemia, with altered process of cholesterol synthesis and absorption.

Keywords: Crohn's disease; lipids; hypocholesterolemia; noncholesterol sterols

Received: February 5, 2007; Accepted: April 13, 2007; Published: October 1, 2007  Show citation