Plasma Fibrinogen Levels in Inflammatory Bowel Disease Patients Compared to a Control Group

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Inflammatory bowel disease (IBD) is comprised of two major disorders: ulcerative colitis and Crohn's disease. These disorders have distinct pathologic and clinical characteristics but their pathogenesis remains poorly understood. Some studies showed a relationship between IBD and thromboembolic disorders. The prevalence of thromboembolic disorders has been reported as 39% in autopsies. In addition, there is a relation between IBD and level of fibrinogen. This study was conducted to understand the relation between IBD and fibrinogen levels in Iranian patients.Methods: This cross-sectional study was performed in Ayatollah Kashani Hospital, Isfahan, Iran during 2010-2011. Hospitalized patients with a diagnosis of IBD according to Leonard Jones criteria were invited to participate in this study. Individuals who used anticoagulants, heparin, or oral contraceptive pills (OCPs), pregnancy women and patients with cancer were excluded. Venous blood samples were collected and fibrinogen levels were measured in the laboratory. Finally, the data was analyzed by SPSS18.Findings: : The mean ± SD levels of fibrinogen in the ulcerative colitis, Crohn's disease and control groups were 347.8 ± 11.7, 286.4 ± 88.5 and 346.6 ± 109.2, respectively. According to analysis of variance (ANOVA), a statistically significant difference existed between the three groups (P = 0.023).Conclusion: Based on the results of this study, serum fibrinogen levels in the ulcerative colitis group were not different from the control group. However, the levels in the Crohn's disease group were lower than the control group. Thus, further studies must be performed to precisely understand the relation between IBD and fibrinogen levels. 

Keywords


  1. D'Haens G, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, et al. A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis. Gastroenterology 2007; 132(2): 763-86.
  2. Friedmen S, Blumberg RS. Inflammatory bowel disease. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGrow-Hill; 2008. p. 1776-89.
  3. Loftus EV, Jr. Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. Gastroenterology 2004; 126(6): 1504-17.
  4. Webberley MJ, Hart MT, Melikian V. Thromboembolism in inflammatory bowel disease: role of platelets. Gut 1993; 34(2): 247-51.
  5. Solem CA, Loftus EV, Tremaine WJ, Sandborn WJ. Venous thromboembolism in inflammatory bowel disease. Am J Gastroenterol 2004; 99(1): 97-101.
  6. Papa A, Danese S, Grillo A, Gasbarrini G, Gasbarrini A. Review article: inherited thrombophilia in inflammatory bowel disease. Am J Gastroenterol 2003; 98(6): 1247-51.
  7. Souto JC, Martinez E, Roca M, Mateo J, Pujol J, Gonzalez D, et al. Prothrombotic state and signs of endothelial lesion in plasma of patients with inflammatory bowel disease. Dig Dis Sci 1995; 40(9): 1883-9.
  8. Chiarantini E, Valanzano R, Liotta AA, Cellai AP, Fedi S, Ilari I, et al. Hemostatic abnormalities in inflammatory bowel disease. Thromb Res 1996; 82(2): 137-46.
  9. van Bodegraven AA, Schoorl M, Linskens RK, Bartels PC, Tuynman HA. Persistent activation of coagulation and fibrinolysis after treatment of active ulcerative colitis. Eur J Gastroenterol Hepatol 2002; 14(4): 413-8.
  10. Ridker PM, Hennekens CH, Lindpaintner K, Stampfer MJ, Eisenberg PR, Miletich JP. Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction, stroke, and venous thrombosis in apparently healthy men. N Engl J Med 1995; 332(14): 912-7.
  11. Price DT, Ridker PM. Factor V Leiden mutation and the risks for thromboembolic disease: a clinical perspective. Ann Intern Med 1997; 127(10): 895-903.
  12. Over HH, Ulgen S, Tuglular T, Tezel A, Avsar E, Geyik G, et al. Thrombophilia and inflammatory bowel disease: does factor V mutation have a role? Eur J Gastroenterol Hepatol 1998; 10(10): 827-9.
  13. Novacek G, Miehsler W, Kapiotis S, Katzenschlager R, Speiser W, Vogelsang H. Thromboembolism and resistance to activated protein C in patients with inflammatory bowel disease. Am J Gastroenterol 1999; 94(3): 685-90.
  14. Koutroubakis IE, Sfiridaki A, Mouzas IA, Maladaki A, Kapsoritakis A, Roussomoustakaki M, et al. Resistance to activated protein C and low levels of free protein S in Greek patients with inflammatory bowel disease. Am J Gastroenterol 2000; 95(1): 190-4.
  15. Levine A, Lahav J, Zahavi I, Raz A, Dinari G. Activated protein C resistance in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 1998; 26(2): 172-4.
  16. Mahmood A, Needham J, Prosser J, Mainwaring J, Trebble T, Mahy G, et al. Prevalence of hyperhomocysteinaemia, activated protein C resistance and prothrombin gene mutation in inflammatory bowel disease. Eur J Gastroenterol Hepatol 2005; 17(7): 739-44.
  17. Vucelic B, Milicic D, Krznaric Z, Korac B, Sentic M, Hadzic N, et al. [Serum acute phase proteins for determining disease activity of ulcerative colitis and Crohn disease]. Acta Med Austriaca 1991; 18(4): 100-5.
  18. Rudra T, Motley R, Rhodes J. Does smoking improve colitis? Scand J Gastroenterol Suppl 1989; 170: 61-3.
  19. Tojo N, Miyagi I, Miura M, Ohi H. Recombinant human fibrinogen expressed in the yeast Pichia pastoris was assembled and biologically active. Protein Expr Purif 2008; 59(2): 289-96.
  20. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med 1987; 317(26): 1625-9.
  21. Sostegni R, Daperno M, Scaglione N, Lavagna A, Rocca R, Pera A. Review article: Crohn's disease: monitoring disease activity. Aliment Pharmacol Ther 2003; 17 Suppl 2: 11-7.
  22. Lotfi D. Evaluation of plasma Level protein S protein C and antithrombin III in patients with inflammatory bowel disease in Isfahan in 2009-2010. Isfahan: Isfahan University of Medical Sciences; 2010.