title: Subclinical cardiovascular system changes in obese patients with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthritis (JIA) children and to investigate the influence of obesity into the early, subclinical changes in cardiovascular system in these patients.
  
  
  METHODS
  Fifty-eight JIA patients, aged median 13 years, were compared to 36 healthy controls. Traditional cardiovascular risk factors and inflammatory markers (hsCRP, IL-6, TNF α, adiponectin) were studied together with IMT (intima-media thickness), FMD (flow mediated dilation), and LVMi (left ventricle mass index) as surrogate markers of subclinical atherosclerosis.
  
  
  RESULTS
  Thirteen JIA children (22%) were obese and had increased systolic blood pressure, cholesterol, triglycerides, insulin, HOMA, hsCRP, and IL-6 compared to nonobese JIA and controls. FMD was decreased compared to nonobese JIA and controls, whereas IMT and LVMi were increased. In multivariate regression analysis, TNF α, SDS-BMI, and systolic blood pressure were independent predictors of early CV changes in JIA.
  
  
  CONCLUSIONS
  Coincident obesity is common in JIA children and is associated with insulin resistance, dyslipidemia, and increased levels of inflammatory markers leading to early changes in cardiovascular system. Thus, medical care of children with JIA should include strategies preventing cardiovascular disease by maintenance of adequate body weight.
authors.affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Bialystok, Waszyngtona 17 Street, 15-274 Białystok, Poland. bglowinska@poczta.onet.pl
authors.forename: Barbara
authors.initials: B
authors.lastname: Głowińska-Olszewska
authors.forename: Artur
authors.initials: A
authors.lastname: Bossowski
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Dobreńko
authors.forename: Andrzej
authors.initials: A
authors.lastname: Hryniewicz
authors.forename: Jerzy
authors.initials: J
authors.lastname: Konstantynowicz
authors.forename: Robert
authors.initials: R
authors.lastname: Milewski
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Łuczyński
authors.forename: Janina
authors.initials: J
authors.lastname: Piotrowska-Jastrzębska
authors.forename: Otylia
authors.initials: O
authors.lastname: Kowal-Bielecka
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000378:metabolism* / Q000503:physiopathology*; D050197:Atherosclerosis / Q000378:metabolism / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000378:metabolism / Q000503:physiopathology; D002648:Child; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000378:metabolism* / Q000503:physiopathology*
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