title: Changes in vascular function and structure in juvenile idiopathic arthritis.
abstract: OBJECTIVE
  Chronic inflammatory diseases in adults have been associated with increased cardiovascular risk and impaired vascular function. We aimed to assess the presence of early vascular dysfunction in patients with juvenile idiopathic arthritis (JIA) and investigate the role of inherent inflammatory process of JIA in vascular health.
  
  
  METHODS
  Thirty patients with JIA (age range 7-18 years) were compared to 33 age- and sex-matched controls. Endothelial function (brachial artery flow-mediated dilation [FMD]), carotid intima-media thickness (IMT), and arterial stiffness were examined. Endothelial inflammation was assessed by intercellular adhesion molecule 1 (ICAM-1) and P-selectin measurements.
  
  
  RESULTS
  Patients with JIA showed decreased FMD compared to controls (P = 0.001), independent of age (P = 0.9 among age subgroups). Baseline differences in erythrocyte sedimentation rate, ICAM-1, and glucose between the 2 groups accounted for the difference in FMD. The presence of systemic JIA was associated with greater IMT compared to patients with oligoarticular disease, polyarticular disease, or controls (P = 0.014, P = 0.069, and P = 0.046, respectively). The difference in IMT between systemic versus oligoarticular/polyarticular JIA was attributed to the following risk factors: age, body mass index, blood pressure, disease activity, and corticosteroids use. There were no differences in arterial stiffness indices between JIA patients and controls or between patients with systemic versus nonsystemic disease.
  
  
  CONCLUSIONS
  Endothelial function is impaired in patients with JIA at a very young age, while IMT is increased only in the presence of systemic JIA. Vascular dysfunction may be partly attributed to the effects of disease-related characteristics (inflammation, disease activity, and medications).
authors: Child Health Department, University of Ioannina, Ioannina, Greece. anvlahos@uoi.gr
authors: Antonios P
authors: AP
authors: Vlahos
authors: Paraskevi
authors: P
authors: Theocharis
authors: Aris
authors: A
authors: Bechlioulis
authors: Katerina K
authors: KK
authors: Naka
authors: Konstantinos
authors: K
authors: Vakalis
authors: Nikolaos D
authors: ND
authors: Papamichael
authors: Sapfo
authors: S
authors: Alfantaki
authors: Konstantina
authors: K
authors: Gartzonika
authors: Anestis
authors: A
authors: Mavridis
authors: Lampros K
authors: LK
authors: Michalis
authors: Antigoni
authors: A
authors: Siamopoulou
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001171:Arthritis, Juvenile / Q000150:complications* / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D006115:Greece; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D016014:Linear Models; D008297:Male; D008365:Manometry; D019007:P-Selectin / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D018608:Ultrasonography, Doppler; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D019007:P-Selectin; C546937:SELP protein, human; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein