Biomarkers of lipid metabolism in patients with juvenile idiopathic arthritis: relationship with disease subtype and inflammatory activity

Abstract

Background To describe the biomarkers of lipid metabolism in children and adolescents with polyarticular and systemic JIA and to relate them to diseases subtypes, diseases activity markers, and nutritional status. Methods A cross-sectional study including 62 JIA patients was performed. The following variables were evaluated: disease activity and medications used, body mass index, height for age (z-score), skin folds (bicipital, tricipital, subscapular and suprailiac), food intake based on three 24-h food recalls, lipid profile (total cholesterol (CT), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG) and non-HDL (N-HDLc), glycemia and insulin, erythrocyte sedimentation rate (ESR), ultrasensitive C-reactive protein (us-CRP) and apolipoproteins A-I and B (Apo A-I and Apo B). Results Dyslipidemia was observed in 83.3% of the patients. Based on classical lipid profile, low HDL-c levels was the most frequently alteration observed. Inadequate levels of LDL-c, Apo B and NHDL-c were significantly more frequent in the systemic JIA subtype when compared to the polyarticular subtype (p = 0.017, 0.001 and 0.042 respectively). Patients on biological therapy had a better adequacy of Apo A-I concentrations. The ESR showed a negative correlation with Apo A-I level (r = − 0.25, p = 0.047). Conclusion We concluded that dyslipidemia is common in patients with JIA, especially in systemic subtype. The systemic subtype and an elevated ESR were associated with lower concentrations of Apo A-I, suggesting the participation of the inflammatory process.

Changes in biomarkers of lipid in juvenile idiopathic arthritis and its association with various disease parameters: a 6-month follow-up study

“…Similar findings were found in the study done by Rodrigues et al in 2021 on changes in biomarkers of lipid metabolism in JIA and their association with inflammatory markers. 15 Also, in the study by Urban et al involving 25 children with JIA, they showed that HDL-C level was low along with raised homocysteine levels in children with JIA. 17 One of the highlights of the present study, which has not been pointed out in any of previous publications is lipid levels, particularly TC and TG, are higher in girls compared to boys.…”

“…Table 6 highlights the comparison between major findings on this aspect in previous publications and our study in a nutshell. [11][12][13][14][15][16] Our research work is one of the few in literature which assessed the clinical symptoms and the effect of alterations in complete blood counts, acute phase reactants and first line drugs on lipid profile in JIA patients.…”

Physical activity as a promising alternative for young people with juvenile idiopathic arthritis: Towards an evidence-based prescription

“…Accumulated lipids in vascular walls cause chronic inflammation, which favors the long-term advent of atherosclerosis. Children with JIA may thus be at increased risk of developing CVD in adulthood ( 37 , 38 ). Better characterization of the lipid profile in this patient population, focusing in particular on sphingolipids, seems a promising avenue.…”

Challenges in Implementing Cardiovascular Risk Scores for Assessment of Young People With Childhood-Onset Autoimmune Rheumatic Conditions

“…The systemic JIA phenotype was characterized by the most pronounced abnormalities, with CIMT increase correlating with age, BMI, blood pressure, disease activity, and corticosteroids use ( 63 ). A recent study exploring lipid abnormalities in JIA found them present in 83.3% of patients, with low HDL-cholesterol levels being the most common ( 64 ). Similarly, systemic JIA was associated more frequently with abnormal LDL-cholesterol and non-HDL-cholesterol, as well as apolipoprotein B levels.…”