title: Effect of inflammatory activity and glucocorticoid [corrected] use on nutritional variables in patients with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To assess nutritional status in patients with juvenile idiopathic arthritis (JIA) and the influence of inflammatory activity and glucocorticoid use.
  
  
  METHODS
  One hundred sixteen patients were evaluated. Disease subtype and disease activity were defined by the attending physician, and the cumulative glucocorticoid dose was recorded from chart review. Percentiles of body mass index (BMI) and triceps skinfold (TSF) and the Z score for height were determined: low weight and low adiposity were diagnosed when BMI and TSF were below the 5th percentile. Short stature was defined by a Z score of height for age < -2. Serum concentration of insulin-like growth factor-I (IGF-I) was measured by radioimmunoassay.
  
  
  RESULTS
  The prevalences of low weight, low adiposity, and short stature were 16.4%, 20.7%, and 10.4%, respectively. Low IGF-I serum level was found in 14 patients (12.1%). The factors negatively associated with the Z score of height in multivariable regression analysis were disease duration (partial correlation coefficient -0.370, 95% confidence interval: -0.527 to -0.188; p < 0.001), erythrocyte sedimentation rate (ESR) (-0.357, -0.516 to -0.174; p < 0.001), and polyarticular or systemic disease subtype (-0.290, -0.459 to -0.100; p = 0.003), while there was no significant correlation with the cumulative dose of glucocorticoids (0.086, -0.111 to 0.277; p = 0.391). None of these variables was significantly correlated with the percentiles of BMI and TSF, albeit confidence intervals for these correlation coefficients were relatively large. Patients with a systemic or polyarticular disease subtype tended to present lower percentiles of BMI (p = 0.051).
  
  
  CONCLUSIONS
  Nutritional status is frequently compromised in patients with JIA. Duration and disease subtype and the ESR are factors independently associated with short stature. The cumulative dose of glucocorticoids was not independently associated with short stature or with other nutritional variables, although a relevant negative effect of glucocorticoid dose on BMI and TSF cannot be entirely excluded.
authors.affiliation: Division of Rheumatology, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, RS, Brazil.
authors.forename: Letícia
authors.initials: L
authors.lastname: Souza
authors.forename: Sandra Helena
authors.initials: SH
authors.lastname: Machado
authors.forename: Markus
authors.initials: M
authors.lastname: Bredemeier
authors.forename: João Carlos Tavares
authors.initials: JC
authors.lastname: Brenol
authors.forename: Ricardo Machado
authors.initials: RM
authors.lastname: Xavier
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D001827:Body Height; D015992:Body Mass Index; D002624:Chemistry, Clinical; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D009752:Nutritional Status
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007334:Insulin-Like Growth Factor I