Predictors of atherosclerosis development in children and adolescents with juvenile arthritis

Aim. To study the prevalence of metabolic disorders in children with juvenile arthritis.

Methods. A comprehensive clinical and laboratory examination of 82 children and adolescents aged 10-18 years with juvenile idiopathic arthritis and 50 healthy children of the control group was performed. All patients with juvenile arthritis received disease-modifying anti-rheumatic drugs and/or glucocorticoids (intraarticular injections or pulse therapy) and/or biologics.

Results. Complete clinical picture of metabolic syndrome (a combination of the two mandatory criteria - hypertension, glucose intolerance or dyslipidemia with increasing waist circumference above the 90th percentile) was found in 30 (36.5%) of 82 patients and was not found in any child from the control group (p <0.05). Such manifestations as dyslipidemia, abdominal obesity and hypertension, which correlate with disease activity and dose of glucocorticoids, were the most common. One-third of patients with juvenile arthritis had «intima-media» complex thickening and vascular wall structure disorders, which were associated with high disease activity, insulin resistance and other features of the metabolic syndrome.

Conclusion. Juvenile arthritis is associated with high prevalence of metabolic disorders, only partially (hypertension and carbohydrate metabolism disorders) associated with the glucocorticoid intake, but mostly mediated by high inflammatory disease activity.