Oxidation Rates of the Different Substrates During Exercise in Children and Adolescents With Juvenile Idiopathic Arthritis. Case-control Study and Cases Treated / Cases Not Treated With Anti-TNFα

Study Overview
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Brief Summary
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During exercise, energy comes mainly from carbohydrates and lipids. The relative contribution of lipids and glucose as energy substrates to exercise depends on the parameters of the exercise (duration, intensity and level of training) and the physiological conditions of the subject. Inflammatory diseases such as juvenile idiopathic arthritis (JIA) are treated, for the most severe forms, by biotherapies. These treatments target certain pro-inflammatory cytokines including TNFα. In adults with rheumatoid arthritis several studies have shown that treatment with anti-TNFα increases insulin sensitivity. There is no data on the oxidation of energy substrates during exercise in children and adolescents with AJI, nor on the impact of anti-TNFα treatments on the oxidation of energetic substrates in children. Investigators hypothesize that, compared to healthy children, children with JIA should exhibit altered oxidation of energy substrates at rest and submaximal physical exercise due to physical deconditioning and inflammation. In addition, those treated with anti-TNFα should have an oxidation profile of energy substrates at exercise different from that of patients not treated with anti-TNFα. Investigators also hypothesize that anti-TNFα treatments modify the contribution of energy chains (aerobic, anaerobic and anaerobic alactic) during the exercise.

Detailed Description
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Annual evaluation by Lipoxmax test and Wingate anaerobic test (WAnT) during 3 years or until the transition from pediatric to adult care. For healthy volunteer, only one lipaxmax and Wingate test.

Official Title
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Oxidation Rates of the Different Substrates During Exercise in Children and Adolescents With Juvenile Idiopathic Arthritis. Case-control Study and Cases Treated / Cases Not Treated With Anti-TNFα

Conditions
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Juvenile Idiopathic Arthritis

Intervention / Treatment
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* Other: anti-TNFα


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children with juvenile idiopathic arthritis Exclusion Criteria: active infection BMI > 25 Systemic corticosteroid within last 3 months

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: patients treated withTNF blockade<br>22 patients treated with TNF blockade | Other: anti-TNFα<br> <br> |
| Experimental: patients without TNF blockade<br>22 patients without TNF blockade | Other: anti-TNFα<br> <br> |
| Experimental: healthy subjects<br>22 matched healthy subjects by pubertal stage and sex | Other: anti-TNFα<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage variation of the maximal fat oxidative rate during an exercise between JIA and healthy children. Timing: |  | at day 1 (first test) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage variation of substrates oxidative crossing point during an exercise. |  | at day 1 | 
| Description of the contribution of energy systems during supra-maximal physical exercise | Description of the contribution of energy systems during supra-maximal physical exercise in patients with JIA according to JIA subtype, treatments, age, pubertal status, disease status | at day 1 (first test) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Juvenile idiopathic arthritis, fat oxidation, exercise