Background Lipid metabolism disorders is one of the most studied problems in adult patients with rheumatic diseases in the world of rheumatology in connection with proven dyslipidemia in these patients, and raises the question of the genesis of atherosclerosis in the background of autoimmune disease.
Objectives To examine the state of lipid metabolism in children with rheumatic diseases.
Methods The survey included: the collection of family history, anthropometry, instrumental and laboratory examination, including the study of lipid profile (total lipids, total cholesterol, triglycerides, HDL, LDL, apolipoproteins: ApoA, ApoB, ApoE).
Results The study involved 96 children, suffering from rheumatic diseases - 54 children with juvenile idiopathic arthritis (JIA), 18 children with systemic lupus erythematosus (SLE) and 24 children with juvenile scleroderma (JS). Additionally it was examined 50 healthy children. Children with SLE found a significant increase in the content of total lipids, total cholesterol and triglycerides when compared with the control group (P<0.001). Children with JIA, there was a significant increase in total lipids and triglycerides (P<0.001) when compared with the control group. In children with JS found a significant increase in serum total lipids (P<0.05), as well as the reduction of HDL cholesterol (P<0.05) when compared with the control group. Increased levels of total lipids in serum>7.0 g/l are set at 61.1% of children with SLE, in 44.4% of patients with JIA and in 62.5% of JS. Elevated triglycerides >1.4 mmol/l were detected in 50% of children with SLE, 20.4% of patients with JIA and 25% of patients with JS. Elevated levels of total cholesterol >5.2 mmol/l is set at 16.7% of children with JIA, and reduced levels of HDL cholesterol <0.96 mmol/l was found in 29.6% of patients with JIA and in 25% of children with JS.
During the correlation analysis established a direct correlation between the level of total cholesterol in blood serum and disease duration (rs=0,71; P<0.01), as well as between the degree of disease activity and the content of total lipids (rs=0,63; P<0 01).
Apolipoprotein A is the major protein component of HDL. The significant (P 0.05) decrease in the concentration of ApoA patients clinical groups compared with the control group.
ApoA1 ratio and ApoB is a valuable indicator for assessing the atherogenic shift and the risk of cardiovascular disease. Normally ApoA1/ApoB >1 and is seen as a low atherogenic risk factor. Among children with rheumatic diseases indicator ApoA1/ApoB <1 is set at 16.7% of patients with SLE, in 14.8 patients with JIA and in 12.5% of patients with JS. An inverse correlation between the ratio ApoA1/ApoB and the concentration of serum cholesterol (rs=-0,31; P<0.01).
Apolipoprotein E (ApoE) is a part of the fat particles of chylomicrons and very low density lipoproteins, initiating their capture and removal of blood by interacting with specific cell surface receptor on the liver. The study established an elevated level of ApoE in the serum of children with rheumatic diseases compared to the control group. Established correlation (rs=0,37; P<0.05) between the content of ApoE and total cholesterol in the blood serum.
Conclusions For children suffering from rheumatic diseases characterized by atherogenic disorders of lipid metabolism.
Disclosure of Interest None declared