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Conclusions: No statistically significant differences were seen in compar-ing CD patients with BMI�25 to those with BMI�25 when examiningtime to diagnosis or duration of disease of CD. This data is encouraging, asit suggests that gastroenterologists are unbiased when evaluating inflam-matory symptoms, and retain broad differential diagnoses in order toaccurately arrive at the correct disease pathology.
735
ANTI-INFLAMMATORY PROPERTIES OF STATINS IN THEDEXTRAN SODIUM SULFATE MOUSE MODEL OF COLITISJong H. Nam, M.D., Zaid Alnoah, M.M.S., Sreekant N. Murthy, Ph.D.*.Drexel University College of Medicine, Philadelphia, PA.
Purpose: HMG-CoA reductase inhibitors, or “statins”, have demonstratedanti-inflammatory effects in animal models of atherosclerosis in addition totheir lipid-lowering effects. The purpose of this experiment was to assessthe anti-inflammatory effects of statins in the dextran sodium sulfate (DSS)mouse model of colitis, a well-established murine model of colonic in-flammation.Methods: Eighteen 8-week old female Swiss-Webster mice were separatedinto three groups of 6. Colitis was induced in all animals by feeding 4%DSS solution ad libitum for 7 days. Following discontinuation of DSS,groups 1 and 2 received oral atorvastatin (60 mg/kg/day) and simvastatin(20 mg/kg/day), respectively, suspended in 0.75% methyl-cellulose for thenext 8 days. Group 3 served as control and received oral methyl-celluloseonly. A disease activity index (DAI) was determined on a daily basis for allanimals throughout the study, and consisted of a calculated score based onchange in body weight, stool consistency, and intestinal bleeding. The DAIis a well-characterized method of quantifying disease severity in this modeland is known to correlate well with histological healing. Parameters for theDAI were measured by an investigator who was blinded to the protocol. Allanimals were sacrificed on day 14. Colon lengths were measured as anadditional indicator of disease activity.Results: On day 15, the control group demonstrated a mean DAI of 1.94 �0.49. Group 1, in comparison, demonstrated a significantly lower meanDAI of 0.78 � 0.72 (P � 0.01). Group 2, likewise, demonstrated a muchlower mean DAI of 0.72 � 0.7 (P � 0.01). When colon lengths wereassessed, atorvastatin and simvastatin treated groups showed significantlygreater average colon lengths (6.83 � 0.21 and 7.33 � 0.95 cm, respec-tively) than that of the control group (6.15 � 0.54 cm; P � 0.05).Conclusions: Our data demonstrates the anti-inflammatory properties ofstatins in a murine model of colitis for the first time to our knowledge.Further investigation is clearly needed to elucidate the mechanism ofanti-inflammatory properties of statins.
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IRON DEFICIENCY ANEMIA AS A PRESENTATION OFPOUCHITISRafael J. Pastrana, M.D., Esther A. Torres, M.D., FACG*,Cynthia Rivera, M.P.H., Jesus Arroyo, M.D., Maria Vazquez, M.D.,Luis Flores, M.D. UPR School of Medicine, San Juan, PR, PuertoRico.
Purpose: Ileal pouch with anal anastomosis (IPAA) has become thesurgical procedure of choice in Ulcerative Colitis (UC) patients. Among itsdescribed complications are pouchitis (40%), strictures (30%), small bowelobstruction (10%), pelvic sepsis (�5%), and urinary and sexual dysfunc-tions (�5%). Few studies have described the prevalence of anemia afterIPAA but no conclusive findings have been reported at present. Anemiamay serve as a follow up screening tool for pouchitis surveillance. Thisstudy sought (1) to determine the prevalence and cause of anemia inpatients undergoing IPAA for UC, and (2) to correlate anemia with com-plications after IPAA.Methods: The study was approved by the IRB of the UPR. Informedconsent was obtained from all study participants. Patients with diagnosis ofUC by clinical, histological, endoscopic, radiological, or surgical/patho-
logical criteria who had undergone IPAA were recruited from the UPR IBDand Faculty clinics and GI Research Unit. Pertinent demographics andmedical data were obtained. Blood serum samples were obtained from thesubjects to establish the presence of anemia by standard hematologicalvalues. Those patients found with anemia were further evaluated withserum levels of iron, ferritin, transferrin, folate, vitamin B-12, erythropoi-etin, total iron binding capacity, reticulocyte counts, peripheral smears, andbone marrow aspirates. Data analysis was performed with EPI Info VersionV 6.0.Results: A total of 16 subjects were included. Mean age was 37.0 � 14.7years. Male to female ratio was 1:1.6. Average Hemoglobin/ Hematocritlevels were 11.7 � 2.7/35.5 � 7.25 gm/dl. Mean follow up was 2 yearsafter surgery. Iron deficiency anemia was identified in 62.5% (10/16) ofstudy subjects, of which only 63.6% (7/11) had clinical, endoscopic, orhistologic evidence of pouchitis. Four of the patients without anemia hadevidence of pouchitis (36.4%).
Results
Anemian�10
No Anemian�6
Pouchitis n�11 7 (43.8%) 4 (25%)No Pouchitis n�5 3 (18.7%) 2 (12.5%)
Conclusions: A trend suggesting that iron deficiency anemia may be acomplication of IPAA and a presenting clinical sign of pouchitis wasobserved. A larger number of patients is needed to confirm these findings.Hemoglobin and Hematocrit levels may be considered as a surveillancetool in patients with IPAA.
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PRIOR AMINOSALICYLATE USE AND THE DEVELOPMENTOF COLORECTAL CANCER IN INFLAMMATORY BOWELDISEASE (IBD): A LARGE BRITISH EPIDEMIOLOGICALSTUDYT.P. van Staa, M.D., Ph.D., T. Card, M.Sc., M.R.C.P.,H.G.M. Leufkens, Ph.D., R.F. Logan, M.Sc., F.R.C.P.*. Procter &Gamble Pharmaceutical, Egham, United Kingdom; Utrecht Institute forPharmaceutical Sciences, Utrecht, Netherlands and Division ofEpidemiology and Public Health, University of Nottingham, Nottingham,United Kingdom.
Purpose: The objective of this study was to evaluate the risk of colorectalcancer (CRC) in patients using aminosalicylates (5-ASA) for IBD.Methods: The medical records of general practitioners (GPs) in the UK(from the General Practice Research Database) were used. This databasehas been previously demonstrated to be a representative sample of thegeneral population of England and Wales. The study population consistedof either users of mesalazine, balsalazide, olsalazine, or sulfasalazine witha history of IBD. In a nested case-control analysis, each incident CRC casewith any exposure to 5-ASA within 6 months of the CRC diagnosis wasmatched by age, sex, and calendar time to six control patients who werealso exposed in that period. Patients were then classified according toregularity of use. Regular users were those who had received six or more5-ASA prescriptions in the 12 months before. The analysis was controlledfor history of colorectal polyps, use of NSAIDs, paracetamol, aspirin, oraland rectal corticosteroids and disease-modifying agents, IBD duration,prior hospitalisation and number of GP visits for IBD symptoms. Addi-tional data on the extent and activity of IBD in this population will becollected.Results: The study population included 18 969 patients, of whom 100patients had developed CRC. Most of these cases had a history of ulcerativecolitis (76 patients). In the nested case-control analysis, regular users werefound to have a decreased risk of CRC compared to irregular users (crudeOR 0.67 [0.44–1.03]; adjusted OR 0.54 [0.35–0.86]). The adjusted OR inpatients with regular use for � 2 years was 0.61 [0.32–1.16] and 0.51[0.30–0.87] with use � 2 years. Regular users of sulfasalazine with 6 to 12
S244 Abstracts AJG – Vol. 98, No. 9, Suppl., 2003