TY - JOUR
T1 - Anxiety, depression, chronic inflammation and aortic stiffness in Crohn's disease: The brain^gut^ vascular axis
AU - Tuttolomondo, Antonino
AU - Pinto, Antonio
AU - Cottone, Santina
AU - Geraci, Giulio
AU - Rapisarda, Fabio
AU - Di Raimondo, Domenico
AU - Castellino, Pietro
AU - Lentini, Paolo
AU - Xourafa, Anastasia
AU - Riguccio, Gaia
AU - Granata, Antonio
AU - Rizzo, Renata
AU - Pellegriti, Alfredo
AU - Inserra, Gaetano
AU - Rapisarda, Francesco
AU - Fatuzzo, Pasquale
AU - Gaudio, Agostino
AU - Malatino, Lorenzo
AU - Rizzo, Renata
AU - Zanoli, Luca
AU - Scrivo, Barbara
AU - Torres, Daniele
AU - Inserra, Gaetano
AU - Riguccio, Giorgia
PY - 2020
Y1 - 2020
N2 - Background: Patients with Crohn's disease have an increased aortic stiffness, a known cardiovascular risk factor. Anxiety, a key factor of the brain-gut axis in patients with Crohn's disease, is implicated in the pathogenesis and progression of the disease, and is linked with aortic stiffening in other clinical settings. Objectives: Considering that depression is frequently linked to anxiety in Crohn's disease, we performed a mediation analysis to reveal the potential link between anxiety, depression and aortic stiffness in these patients. Methods: Multicentre observational cross-sectional study of 86 consecutive patients with Crohn's disease and 86 matched control individuals. The connections between anxiety, depression, disease duration, aortic pulse wave velocity (aPWV), brachial and central SBP were tested using partial least squares structural equations modelling. Results: In patients with Crohn's disease, anxiety (path coefficient: 0.220, P = 0.01) and disease duration (path coefficient: 0.270, P = 0.02) were associated with aPWV that in turn was associated with brachial SBP (path coefficient: 0.184, P = 0.03). These associations were even stronger in patients with active disease. The connection between anxiety and aPWV was in part mediated by central SBP (indirect effect: 0.090, P = 0.01; indirect-to-total effect ratio: 41%) as well as, in a pilot substudy, by sympathetic hyperactivity. Anxiety and depression were highly correlated in patients with Crohn's disease. Consequently, results were confirmed when anxiety was substituted by depression. Conclusion: The connections of anxiety, depression and chronic inflammation with aPWV and SBP could suggest the first evidence of a brain-gut-vascular axis and new potential targets for therapy in patients with Crohn's disease.
AB - Background: Patients with Crohn's disease have an increased aortic stiffness, a known cardiovascular risk factor. Anxiety, a key factor of the brain-gut axis in patients with Crohn's disease, is implicated in the pathogenesis and progression of the disease, and is linked with aortic stiffening in other clinical settings. Objectives: Considering that depression is frequently linked to anxiety in Crohn's disease, we performed a mediation analysis to reveal the potential link between anxiety, depression and aortic stiffness in these patients. Methods: Multicentre observational cross-sectional study of 86 consecutive patients with Crohn's disease and 86 matched control individuals. The connections between anxiety, depression, disease duration, aortic pulse wave velocity (aPWV), brachial and central SBP were tested using partial least squares structural equations modelling. Results: In patients with Crohn's disease, anxiety (path coefficient: 0.220, P = 0.01) and disease duration (path coefficient: 0.270, P = 0.02) were associated with aPWV that in turn was associated with brachial SBP (path coefficient: 0.184, P = 0.03). These associations were even stronger in patients with active disease. The connection between anxiety and aPWV was in part mediated by central SBP (indirect effect: 0.090, P = 0.01; indirect-to-total effect ratio: 41%) as well as, in a pilot substudy, by sympathetic hyperactivity. Anxiety and depression were highly correlated in patients with Crohn's disease. Consequently, results were confirmed when anxiety was substituted by depression. Conclusion: The connections of anxiety, depression and chronic inflammation with aPWV and SBP could suggest the first evidence of a brain-gut-vascular axis and new potential targets for therapy in patients with Crohn's disease.
KW - Arterial stiffness
KW - Inflammation
KW - Inflammatory bowel disease
KW - Pulse wave velocity.
KW - Arterial stiffness
KW - Inflammation
KW - Inflammatory bowel disease
KW - Pulse wave velocity.
UR - http://hdl.handle.net/10447/437632
M3 - Article
VL - 38
SP - 2008
EP - 2017
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
ER -