Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Risk Factors to Pre-Clinical Atherosclerosis Evaluated by Carotid Intima-Media Thickness in Juvenile Idiopathic Arthritis: Descriptive Research
Juvenil İdiyopatik Artiritte Karotis İntima Media Kalınlığı ve Preklinik Ateroskleroz için Risk Faktörleri: Tanımlayıcı Araştırma
Mustafa ARMUTa, Ruhan DÜŞÜNSELb, Ayşenur PAÇ KISAARSLANb, Gonca KOÇc, Betül SÖZERİb, Ferhan ELMALId
aDepartment of Child Health and Diseases, Erciyes University Faculty of Medicine, Kayseri, Türkiye
bDivision of Pediatric Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
cDivision of Pediatric Radiology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
dDepartment of Biostatistics, Erciyes University Faculty of Medicine, Kayseri, Türkiye
Turkiye Klinikleri J Pediatr. 2023;32(1):26-35
doi: 10.5336/pediatr.2022-91466
Article Language: EN
Full Text
ABSTRACT
 Objective: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood. Cardiovascular morbidity and mortality are becoming important health problems for children with inflammatory rheumatic diseases. The aim of this study was to evaluate carotid intima-media thickness (CIMT) in children with JIA and to examine its association with JIA subtype, markers of inflammation, and early atherosclerosis. Material and Methods: We included 112 (50 boys and 62 girls) patients who have been followed by a diagnosis of JIA for at least 6 months and 54 healthy control subjects (32 girls and 22 males) who were matched with the patients age and gender. All children underwent a carotid artery. Inflammation markers were evaluated in the patient group. Cumulative drug doses, total disease duration (TDD), active disease duration (ADD) were calculated. All CIMT values were compared in patients, subgroups, and control groups, and their relationship with inflammation markers was investigated. Results: CIMT values in found that children with JIA were significantly higher than in healthy children. There was no difference between the disease subgroups in terms of CIMT. No relationship was found between CIMT measurements and atherosclerosis risk factors, drugs, erythrocyte sedimentation rate, white blood cell and C-reactive protein. A negative correlation was found between mean platelet volume (MPV) and right CIMT. A statistically significant positive correlation was detected between the right CIMT and TDD (r=0.221, p=0.022), and ADD (r=0.248, p=0.010). Conclusion: The study showed that the patients with JIA had more risks than healthy controls for cardiovascular disease (CVD) regardless of subgroup. We concluded early and aggressive therapies may be protective for CVD. Negative correlation was found between MPV and CIMT that is consistent with recently published literature, but there is need for further studies with a larger patient population.

Keywords: Mean platelet volume; carotid intima-media thickness; juvenile idiopathic arthritis; atherosclerosis
ÖZET
 Amaç: Juvenil idiyopatik artrit [juvenile idiopathic arthritis (JIA)] çocukluk çağının en sık görülen kronik romatizmal hastalığıdır. Kardiyovasküler morbidite ve mortalite inflamatuar romatizmal hastalıkları olan çocuklar için önemli sağlık sorunları hâline gelmektedir. Bu çalışmanın amacı, JIA'lı çocuklarda karotis intima-media kalınlığını (KİMK) değerlendirmek ve JIA alt tipi, inflamasyon belirteçleri ve erken ateroskleroz ile ilişkisini incelemektir. Gereç ve Yöntemler: Çalışmaya en az 6 aydır JIA tanısı ile takip edilen 112 (62 kız, 50 erkek) hasta ile yaş ve cinsiyet açısından hasta gruplarına benzer 54 (32 kız, 22 erkek) çocuk sağlıklı kontrol grubu olarak alındı. Tüm çocuklara, karotis arter ultrasonografi yapıldı, inflamasyon belirteçlerine bakıldı. İlaç kümülatif dozları, aktif hastalık süreleri [active disease duration (ADD)], toplam hastalık süreleri [total disease duration (TDD)] hesaplandı. Tüm KİMK değerleri hastalar, alt gruplar ve kontrol grubunda karşılaştırıldı ve inflamasyon belirteçleri ile ilişkisi araştırıldı. Bulgular: JIA'lı çocuklarda KİMK değerleri sağlıklı çocuklardan anlamlı yüksek saptandı. JIA alt grupları arasında KİMK değerleri açısından fark saptanmadı. Ateroskleroz risk faktörleri, ilaçlar, eritrosit sedimantasyon hızı, beyaz küre sayısı ve C-reaktif protein ile KİMK değerleri arasında ilişki saptanmadı. Ortalama trombosit hacmi (OTH) ile sağ KİMK arasında negatif korelasyon bulundu. Sağ KİMK ile TDD (r=0,221, p=0,022) ve ADD (r=0,248, p=0,010) arasında istatistiksel olarak anlamlı pozitif korelasyon saptandı. Sonuç: Çalışmamızda, alt gruptan bağımsız olarak JIA'lı hastaların kardiyovasküler hastalık (KVH) açısından sağlıklı kontrollere göre daha fazla risk taşıdığını gösterdik. Erken ve agresif tedavilerin KVH için koruyucu olabileceği sonucuna vardık. OTH ve KİMK arasında yakın zamanda yayımlanmış literatürle uyumlu negatif korelasyon bulundu ancak daha geniş hasta popülasyonu ile daha ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Ortalama trombosit hacmi; karotis intima-media kalınlığı; juvenil idiyopatik artrit; ateroskleroz
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-To send press releases or notifications through e-mail

-To generate a list for an event or competition

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-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

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