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

Pediatr Rheumatol Online J. 2021 May 3;19(1):66. doi: 10.1186/s12969-021-00538-w.

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.

Keywords: Acute-phase proteins; Apolipoproteins; Cholesterol; Juvenile idiopathic arthritis.

MeSH terms

  • Acute-Phase Proteins / analysis*
  • Adolescent
  • Apolipoprotein A-I / blood*
  • Arthritis, Juvenile* / blood
  • Arthritis, Juvenile* / diagnosis
  • Arthritis, Juvenile* / epidemiology
  • Arthritis, Juvenile* / physiopathology
  • Biomarkers / analysis
  • Blood Sedimentation
  • Body Mass Index
  • Brazil / epidemiology
  • Child
  • Cholesterol, HDL / blood*
  • Cross-Sectional Studies
  • Dyslipidemias* / diagnosis
  • Dyslipidemias* / etiology
  • Female
  • Humans
  • Immunologic Tests / methods
  • Lipid Metabolism
  • Male
  • Nutritional Status
  • Patient Acuity

Substances

  • Acute-Phase Proteins
  • Apolipoprotein A-I
  • Biomarkers
  • Cholesterol, HDL