Background Atherosclerosis is a chronic inflammatory disease of the arteries. The clinical consequences of atherosclerosis are present in the adult population, however the beginning of atherosclerosis occurs in early childhood.
Objectives The aim of the study was to assess whether cardiovascular risk in patients with JIA is increased, as well as in patients with RA. We evaluated the lipid parameters as the traditional (classic) risk factors and new risk factors (homocysteine, fibrinogen, IL-6, IMT thickness) of cardiovascular risk in children with JIA compared with the control group.
The same parameters were assessed in groups of children with JIA stratified according to the disease activity, the disease duration and the form of the disease compared with the control group. Particular attention was paid to the assessment of cardiovascular risk factors in the group of children with JIA meeting the criteria for overweight and obesity.
Methods The study group comprised 60 children with JIA. The control group consisted of 25 children appropriately matched for age and sex.
In all patients were measured: height, weight, BMI and BMI percentile, IMT.
The analysis of total cholesterol, LDL cholesterol, HDL cholesterol, TG, homocysteine, fibrinogen, IL-6 were assessed in all examined children.
Results In children with JIA were found significantly lower: average body weight, height, BMI and BMI percentile compared to the corresponding mean values of the children of the control group. In children with JIA were found statistically higher concentrations of IL-6 compared with the control group. The average thickness of IMT observed in the group of children who were in the inactive phase was significantly higher than the mean values of IMT observed in children with a group of children in the active phase and the control group.The mean concentration of fibrinogen was significantly higher in the group of children in the active phase in relation to average fibrinogen levels observed in the group of children with the disease in the inactive phase and the control group. A positive correlation between IMT and body mass, BMI and BMI percentiles was found as well as between homocysteine and body weight and BMI. A negative correlation between the concentration of fibrinogen and HDL cholesterol was found. The IMT values in children with overweight and obesity were significantly higher compared with the IMT values in children without overweight and obesity. There were no statistically significant differences between the mean values of lipid parameters observed in the group of children with JIA and the control group. There were no statistically significant differences in the concentration of homocysteine, fibrinogen in children with JIA and the control group.
Conclusions The cardiovascular risk in children in the active phase of JIA may be higher in relation to the children in the inactive phase. In these groups of children higher concentrations of fibrinogen, IL-6 are observed. This assessment of IMT should be taken into consideration as a noninvasive method, especially in the group of children who are overweight and obese. Cardiovascular risk in this group may be higher than in the group of lean children.
The number of studies on cardiovascular risk factors in children with JIA is still small and their results often ambiguous, so further studies are needed to assess the cardiovascular risk in this group of children.
Jednacz E, Rutkowska Sak L. Mediators Inflamm. 2012;2012; 2012:714732
Disclosure of Interest None declared
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