[Early atherosclerosis changes in children with juvenile idiopathic arthritis].

UNLABELLED: Pathogenesis of the two diseases: juvenile idiopathic arthritis (JIA) and atherosclerosis are similar-they include increased inflammation markers, homocysteine and lipids levels, inflammatory cytokines. It seems to be important to look for new diagnostic methods to find atherosclerosis in early stage- ultrasonography of the carotid artery with intima-media thickness (IMT) measurement and serum homocysteine level. The aim of this study was assessment of preclinical markers of atherosclerosis--concentration of homocysteine and IMT
MATERIAL AND METHODS: The study group consists of 40 children with JIA (20 girls and 20 boys) aged 4-16 years; 32 children with oligoarthritis JIA and 8--polyarthritis JIA. Control group consists of 23 healthy children aged 3-17 years. We investigated serum levels of homocysteine, CRP, lipids and also IMT of the carotid artery. Children with JIA had statistically significant increase of IMT compare to control group (0.43 mm vs. 0.40 mm) and higher IMT in polyarthritis group compare to oligoarthritis children (0.46 mm vs. 0.43 mm). We also find statistically significant correlation between IMT and disease duration (p = 0.003, r = 0.45).
RESULTS: Children with JIA had also statistically significant increase of homocysteine level compare to control group (8.2 micromol/l vs. 6.05 micromol/l) and higher homocysteine level in polyarthritis group compare to oligoarthritis children (8.58 micromol/l vs. 7.88 micromol/l). We also find statistically significant correlation between IMT and homocysteine level (p = 0.02, r = 0.36).
CONCLUSIONS: There is accelerated atherosclerosis in JIA children that's why we need to find new methods to evaluate it in very early stage so we could help these patients to prevent its complication such as heart disease, stroke etc in the future.