Serum lipid profile in children with different subtypes of juvenile idiopathic arthritis
SUN Dong-Ming1, DING Yan2, ZHNAG Yong1, XIA Kun1
Department of Cardiology, Wuhan Children's Hospital/Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430016, China
Abstract Objective To study the serum lipid profile in children with different subtypes of juvenile idiopathic arthritis (JIA) during active and remission stages, as well as the long-term risk of atherosclerosis in children with JIA. Methods A total of 128 children newly diagnosed with active JIA were divided into oligoarticular JIA group with 48 children, polyarticular JIA group with 38 children, systemic JIA group with 22 children, and enthesitis-related JIA group with 20 children. According to the presence or absence of rheumatoid factor (RF), the polyarticular JIA group was further divided into RF-positive polyarticular JIA group with 15 children and RF-negative polyarticular JIA group with 23 children. A total of 45 children who underwent physical examination were randomly selected as healthy control group. The serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured and compared between groups. Blood lipid parameters were reexamined for 87 children in the remission stage after treatment and were compared with those in the active stage. Results Compared with the healthy control group, the systemic JIA group and the RF-positive polyarticular JIA group had a significant reduction in HDL-C and a significant increase in TG (P < 0.05) in the active stage, while there were no significant differences in TC and LDL-C (P > 0.05). There were no significant differences in blood lipid parameters between the other subtype JIA groups and the healthy control group (P > 0.05). The RF-positive polyarticular JIA group had a significant increase in plasma HDL-C from the active stage to the remission stage (P < 0.05), while the other subtype JIA groups had no significant changes in blood lipid parameters (P > 0.05). Conclusions Dyslipidemia may be observed in the active stage of children with systemic and RF-positive polyarticular JIA, with improvement in the remission stage of children with RF-positive polyarticular JIA. Further studies are needed to observe the long-term risk of atherosclerosis.
SUN Dong-Ming,DING Yan,ZHNAG Yong et al. Serum lipid profile in children with different subtypes of juvenile idiopathic arthritis[J]. CJCP, 2019, 21(6): 547-551.
SUN Dong-Ming,DING Yan,ZHNAG Yong et al. Serum lipid profile in children with different subtypes of juvenile idiopathic arthritis[J]. CJCP, 2019, 21(6): 547-551.
Hinks A, Marion MC, Cobb J, et al. Brief report:the genetic profile of rheumatoid factor-positive polyarticular juvenile idiopathic arthritis resembles that of adult rheumatoid arthritis[J]. Arthritis Rheumatol, 2018, 70(6):957-962.
[2]
Peckham H, Cambridge G, Bourke L, et al. Antibodies to cyclic citrullinated peptides in patients with juvenile idiopathic arthritis and patients with rheumatoid arthritis:shared expression of the inherently autoreactive 9G4 idiotype[J]. Arthritis Rheumatol, 2017, 69(7):1387-1395.
[3]
Hinks A, Bowes J, Cobb J, et al. Fine-mapping the MHC locus in juvenile idiopathic arthritis (JIA) reveals genetic heterogeneity corresponding to distinct adult inflammatory arthritic diseases[J]. Ann Rheum Dis, 2017, 76(4):765-772.
[4]
Gualtierotti R, Ughi N, Marfia G, et al. Practical management of cardiovascular comorbidities in rheumatoid arthritis[J]. Rheumatol Ther, 2017, 4(2):293-308.
[5]
Bohr AH, Pedersen FK, Nielsen CH, et al. Lipoprotein cholesterol fractions are related to markers of inflammation in children and adolescents with juvenile idiopathic arthritis:a cross sectional study[J]. Pediatr Rheumatol Online J, 2016, 14(1):61.
[6]
Marangoni RG, Hayata AL, Borba EF, et al. Decreased high-density lipoprotein cholesterol levels in polyarticular juvenile idiopathic arthritis[J]. Clinics, 2011, 66(9):1549-1552.
[7]
Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis:second revision, Edmonton, 2001[J]. J Rheumatol, 2004, 31(2):390-392.
Kavey RE, Allada V, Daniels SR, et al. Cardiovascular risk reduction in high-risk pediatric patients:a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research:endorsed by the American Academy of Pediatrics[J]. Circulation, 2006, 114(24):2710-2738.
[10]
Agca R, Heslinga SC, Rollefstad S, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders:2015/2016 update[J]. Ann Rheum Dis, 2017, 76(1):17-28.
[11]
Batún Garrido JA, Olán F, Hernández Núñez É. Dyslipidemia and atherogenic risk in patients with rheumatoid arthritis[J]. Clin Investig Arterioscler, 2016, 28(3):123-131.
[12]
Erum U, Ahsan T, Khowaja D, et al. Lipid abnormalities in patients with rheumatoid arthritis[J]. Pak J Med Sci, 2017, 33(1):227-230.
Szabó MZ, Szodoray P, Kiss E. Dyslipidemia in systemic lupus erythematosus[J]. Immunol Res, 2017, 65(2):543-550.
[15]
Kimak E, Zięba B, Duma D, et al. Myeloperoxidase level and inflammatory markers and lipid and lipoprotein parameters in stable coronary artery disease[J]. Lipids Health Dis, 2018, 17(1):71.
[16]
Schroeder LL, Tang X, Wasko MC, et al. Glucocorticoid use is associated with increase in HDL and no change in other lipids in rheumatoid arthritis patients[J]. Rheumatol Int, 2015, 35(6):1059-1067.
[17]
Filippatos TD, Derdemezis CS, Voulgari PV, et al. Effects of 12 months of treatment with disease-modifying anti-rheumatic drugs on low and highdensity lipoprotein subclass distribution in patients with early rheumatoid arthritis:a pilot study[J]. Scand J Rheumatol, 2013, 42(3):169-175.
[18]
Yeh KW, Lee CM, Chang CJ, et al. Lipid profiles alter from pro-atherogenic into less atherogenic and proinflammatory in juvenile idiopathic arthritis patients responding to anti TNF-α treatment[J]. PLoS One, 2014, 9(6):e90757.
[19]
Lee JL, Sinnathurai P, Buchbinder R, et al. Biologics and cardiovascular events in inflammatory arthritis:a prospective national cohort study[J]. Arthritis Res Ther, 2018, 20(1):171.
[20]
Roubille C, Richer V, Starnino T, et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis:a systematic review and meta-analysis[J]. Ann Rheum Dis, 2015, 74:480-489.
