Aaida Samad1,2, Matthew L Stoll1,2, Idit Lavi1,2, Joyce J Hsu1,2, Vibeke Strand1,2, Thomas N Robinson1,2, Elizabeth D Mellins1,2, Devy Zisman. 1. From the School of Medicine, Case Western Reserve University, Cleveland, Ohio; Department of Pediatrics, Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Medicine and Department of Pediatrics, and divisions of Allergy, Immunology and Rheumatology, and Human Gene Therapy, and General Pediatrics, Stanford University, Palo Alto, California, USA; Department of Rheumatology and the Department of Community Medicine and Epidemiology, Carmel Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. 2. A. Samad, BA, Case Western Reserve University School of Medicine; M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, Division of Rheumatology, University of Alabama at Birmingham; I. Lavi, MA, Department of Community Medicine and Epidemiology, Carmel Medical Center; J.J. Hsu, MD, Department of Pediatrics, Division of Allergy, Immunology and Rheumatology, Stanford University; V. Strand, MD, MACR, FACP, Department of Medicine, Division of Immunology and Rheumatology; T.N. Robinson, MD, Departments of Pediatrics and Medicine, Division of General Pediatrics; E.D. Mellins, MD, Department of Pediatrics, divisions of Human Gene Therapy and Allergy, Immunology and Rheumatology, Program in Immunology, Stanford University; D. Zisman, MD, Department of Rheumatology, Carmel Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion.
Abstract
OBJECTIVE: Adult patients with psoriatic arthritis are at increased risk for obesity and metabolic syndrome, but data regarding adiposity in children with juvenile psoriatic arthritis (JPsA) are limited. Our study assessed adiposity in children with JPsA in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry. METHODS: Patients with JPsA in the CARRA registry were divided into nonoverweight and overweight groups using recommendations from the US Centers for Disease Control, and differences in demographic and clinical characteristics between groups at baseline and after 1-year followup were assessed using chi-square test, Fisher's exact test, T test, or Mann-Whitney U test, as appropriate. The prevalence of overweight status in the JPsA registry patients was compared to rheumatoid factor-positive and -negative polyarticular juvenile idiopathic arthritis (RF+polyJIA; RF-polyJIA) registry cohorts and the US pediatric population, using a chi-square goodness-of-fit test. RESULTS: Overweight children represented 36.3% of this JPsA cohort (n = 320). Compared to nonoverweight children, they were significantly older at symptom onset and rheumatologist's first assessment, and scored significantly worse on patient/physician outcome measures. At 1-year followup, changes in body mass index were not associated with changes in clinical features or outcome measures. The prevalence of overweight and obesity in patients with JPsA was significantly higher than in RF+polyJIA patients, RF-polyJIA patients, and the US pediatric population. CONCLUSION: In this registry, almost 1 in 5 patients with JPsA were obese and more than one-third were overweight. This is significantly more than expected compared to the US pediatric population, and appropriate longterm followup of this JPsA subgroup is warranted.
OBJECTIVE: Adult patients with psoriatic arthritis are at increased risk for obesity and metabolic syndrome, but data regarding adiposity in children with juvenile psoriatic arthritis (JPsA) are limited. Our study assessed adiposity in children with JPsA in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry. METHODS:Patients with JPsA in the CARRA registry were divided into nonoverweight and overweight groups using recommendations from the US Centers for Disease Control, and differences in demographic and clinical characteristics between groups at baseline and after 1-year followup were assessed using chi-square test, Fisher's exact test, T test, or Mann-Whitney U test, as appropriate. The prevalence of overweight status in the JPsA registry patients was compared to rheumatoid factor-positive and -negative polyarticular juvenile idiopathic arthritis (RF+polyJIA; RF-polyJIA) registry cohorts and the US pediatric population, using a chi-square goodness-of-fit test. RESULTS: Overweight children represented 36.3% of this JPsA cohort (n = 320). Compared to nonoverweight children, they were significantly older at symptom onset and rheumatologist's first assessment, and scored significantly worse on patient/physician outcome measures. At 1-year followup, changes in body mass index were not associated with changes in clinical features or outcome measures. The prevalence of overweight and obesity in patients with JPsA was significantly higher than in RF+polyJIApatients, RF-polyJIA patients, and the US pediatric population. CONCLUSION: In this registry, almost 1 in 5 patients with JPsA were obese and more than one-third were overweight. This is significantly more than expected compared to the US pediatric population, and appropriate longterm followup of this JPsA subgroup is warranted.
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Keywords:
BODY MASS INDEX; CHILDHOOD OBESITY; JUVENILE IDIOPATHIC ARTHRITIS; PEDIATRIC RHEUMATOLOGY; PSORIATIC ARTHRITIS