Cardiovascular risk in juvenile idiopathic arthritis
Rheumatology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust and Musculoskeletal Research Group, Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. Rheumatology (Oxford, England)
(Impact Factor: 4.48).
03/2013; 52(7). DOI: 10.1093/rheumatology/ket106
JIA is the most common chronic inflammatory arthritis in children and young people. More than one-third of individuals have
persistent active disease into adulthood. In RA, there has been considerable interest in long-term cardiovascular outcomes.
Increased cardiovascular mortality and morbidity have been observed and consensus guidelines recommend annual cardiovascular
risk assessment for adults with RA. The increased risk is attributed to a higher prevalence of traditional cardiovascular
risk factors and the role of systemic inflammation in the acceleration of atherosclerosis. The long-term risk of cardiovascular
disease for individuals with JIA remains uncertain and guidance on risk assessment is not currently available. Given the potential
for longer disease duration, it is possible that cardiovascular risk in this group surpasses that observed in adult-onset
inflammatory arthritides. In this article, we consider the evidence for cardiovascular risk in JIA.
Available from: Lidia Rutkowska-Sak
- "But in a study with adult patients with JIA, who were in remission or with active disease, patients with JIA had significantly less body fat than healthy controls. Some researchers draw attention to the fact that JIA patients exhibit impaired nutrition and lower BMI values compared to healthy children[27,28]. Factors associated with this fact are not clearly determined, and they may be associated with an inflammatory process, secreted cytokines, absorption disturbances, effects of medicines, inadequate dietary intake, and physical activity limitation. "
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ABSTRACT: The study was aimed to evaluate cardiovascular risk parameters, body mass index (BMI) centiles for sex and age, and body fat percentage using the electric bioimpedance method in children with juvenile idiopathic arthritis (JIA). 30 children with JIA participated in the study. A control group included 20 children. Patients were well matched for the age and sex. The body mass and body fat percentage were determined using the segmental body composition analyser; the BMI centiles were determined. All patients had the following parameters determined: lipid profile, hsCRP, homocysteine, and IL-6. The intima media thickness (IMT) was measured. Patients with JIA had significantly lower body weight, BMI, and the BMI centile compared to the control group. The IL-6 levels were significantly higher in patients with JIA compared to the control group. There were no differences between two groups with regard to the lipid profile, % content of the fat tissue, homocysteine levels, hsCRP, and IMT. Further studies are necessary to search for reasons for lower BMI and BMI centile in children with JIA and to attempt to answer the question of whether lower BMI increases the cardiovascular risk in these patients, similarly as in patients with rheumatoid arthritis (RA).
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ABSTRACT: JIA is the most common chronic inflammatory arthritis in children and young people and an estimated one-third of individuals
will have persistent active disease into adulthood. There are a number of key differences in the clinical manifestations,
assessment and management of JIA compared with adult-onset arthritis. Transition and transfer to adult services present significant
challenges for many patients, their families and health care professionals. We describe key clinical issues relevant to adult
rheumatology health care teams responsible for ongoing care of these young people.
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