Gender-specific patterns of carotid atherosclerosis in patients with inflammatory bowel disease: a case-control study

Aim . To study the influence of sex on the ultrasound plaque morphology and the burden of atherosclerosis in patients with inflammatory bowel disease (IBD) and carotid atherosclerosis. Material and methods . This case-control study included 59 patients (28 women and 31 men) aged 40-64 years with IBD and carotid atherosclerosis. The control group (n=149, 56 women and 93 men) was recruited from a database of patients with carotid plaques. All patients underwent carotid duplex ultrasound to determine plaque echogenicity and measure the maximum height, total height, and total area of plaques. Results . The carotid plaque echogenicity was significantly lower in women with IBD compared to the control group (p=0,011). The maximum and total heights of carotid plaques, as well as the total area of carotid plaques, were higher in women with IBD compared to the control group (p=0,001; p=0,003; p=0,026, respectively). IBD in women was associated with a 4,14-fold increase in the odds ratio of hypoechoic carotid plaques (95% confidence interval: 1,11-15,5; p=0,035) after adjusting for age, obesity, smoking, hypertension, low-density lipoprotein cholesterol, triglyceride, glucose levels, and lipid-lowering therapy. Conclusion . Women with IBD had lower echogenicity of carotid plaques and higher carotid atherosclerosis burden scores compared with age-matched controls. IBD is associated with an increased probability of hypoechoic carotid plaques among women.