P008 Lipid profile disorders in children and adolescents with Juvenile Idiopathic Arthritis
Authors: Nasef Samah I , Abouzied Sara S I M , Elfiky Samar M , Zeiton A 
Published: November 2021

Abstract

Background
Dyslipidaemia is a well-recognized risk factor for cardiovascular diseases. Inflammation has been linked to alterations of the lipid profile and accelerated atherogenesis. Lipid profile disorders are one of the most studied problems in adult patients with rheumatoid arthritis. However, few studies addressed this problem in juvenile idiopathic arthritis patients. The objective is to describe the prevalence of dyslipidaemia in children and adolescents with Juvenile Idiopathic Arthritis.

Methods
One hundred patients diagnosed with JIA were included. Exclusion criteria were patients previously treated with lipid lowering drugs, history of familial dyslipidaemia, thyroid disease, and diabetes mellitus. Data obtained from the patients included age, gender, duration of disease and body mass index (BMI). Fasting lipid profiles included triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL) and high-density lipoprotein cholesterol (HDL). Fasting lipid profiles were measured after overnight fasting and consumption of normal diet for previous 2 days (without fat restriction). Normal values were considered according to reference values. Other laboratory tests included ESR, CRP, RF, and ANA. Disease activity was classified according to juvenile disease activity score (JADAS-27).

Results
The study included 100 JIA patients. Out of them, 78 patients were females, 51 patients had RF negative Polyarticular type, 20 patients had RF positive polyarticular type, 24 patients had systemic onset type and 5 patients had extended oligoarticular type. Mean age was 11.55 ± 4.02 years. Mean age at disease onset was 8.3 ± 1.5 years. Mean disease duration was 4.30 ± 1.7 years. Mean BMI was 22.3 ± 7.32 Kg/m2. Mean ESR was 31.24 ± 10.4 mm/h. Mean CRP level was 7.56 ± 4.61 mg/dl. About 20% of the patients had positive RF and about 8% had positive ANA. Twenty-six patients had active disease. Mean TC was 153.818 ± 29.8 mg/dl, mean HDL was 47.65 ± 16.8 mg/dl, mean LDL was 87.43 ± 28.1 and mean TG was 89.04 ± 26.1 mg/dl. The most common lipid abnormality was disturbed HDL, it was found in 40% patients followed by disturbed TG in 21% of patients. Abnormal TC was found in 15% of the patients and abnormal LDL was found in 12% of the patients. Active disease was significantly associated with abnormal TC, HDL, and TG levels (P = 0.03*), (P = 0.03*) and (P = 0.04*) respectively. No associations were found with ESR or CRP levels. Active disease is a significant risk factor for abnormal TG with increased risk of abnormal TG by 2.9 among cases with active disease than cases with inactive disease. The overall percent predicted was 73.8%.

Conclusion
Children and adolescents with JIA showed significant lipid profile abnormalities. Abnormal TC, HDL and TG are significantly associated with active disease. Active disease is a significant risk factor for abnormal TG. Therefore, we recommend monitoring lipid profile in JIA patients regularly to reduce the long-term risk of CVD.