title: Dyslipidaemia in juvenile dermatomyositis: the role of disease activity.
abstract: OBJECTIVE
  To evaluate the presence of dyslipidaemia in JDM and its possible risk factors.
  
  
  METHODS
  Twenty-ﬁve JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycaemia, insulin, antibodies and muscle enzymes. JDM scores were assessed: CMAS, MMT, DAS, MYOACT and MYTAX.
  
  
  RESULTS
  Abnormal lipid proﬁle was found in nine patients and four controls (36% vs. 16%, p=0.196). JDM patients demonstrated signiﬁcant higher levels of triglycerides (TG) [80(31-340) vs. 61(19-182) mg/dL, p=0.011] and higher frequency of abnormal levels of high density lipoproteins (HDL) (28% vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidaemia demonstrated signiﬁcant lower median of HDL levels [29(0-49) vs. 50(39-72) mg/dL, p=0.0005], higher frequency of low HDL levels (77% vs. 0%, p=0.0001), higher TG levels [128(31-340) vs. 69(46-138) mg/dL, p=0.011], and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) when compared to those without this condition. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid proﬁle. JDM with dyslipidaemia had higher ESR (26 vs. 1 4.5mm/1sthour, p=0.006), CRP (2.1 vs. 0.4mg/dL, p=0.01), DAS (6 vs. 2, p=0.008), MYOACT(0.13 vs. 0.01, p=0.012), MYTAX(0.06vs.0,p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidaemia. Positive correlations were detected between TG levels and CRP (r=0.697, p=0.001), DAS (r=0.610, p=0.001), MYOACT (r=0.661, p=0.001), MYTAX (r=0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body composition, lipodystrophy, anti-LPL antibodies, and treatment except by higher frequency of cyclosporine current use in patients with dyslipidaemia (33% vs. 0%, p=0.03).
  
  
  CONCLUSIONS
  Dyslipidaemia in JDM patients was characterised by increased levels of TG and low levels of HDL. Disease activity and cyclosporine use were the mainly factors associated to these abnormalities.
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Brazil. katia_kozu@hotmail.com
authors.forename: Katia T
authors.initials: KT
authors.lastname: Kozu
authors.forename: Clovis A
authors.initials: CA
authors.lastname: Silva
authors.forename: Eloisa
authors.initials: E
authors.lastname: Bonfá
authors.forename: Adriana M
authors.initials: AM
authors.lastname: Sallum
authors.forename: Rosa M R
authors.initials: RM
authors.lastname: Pereira
authors.forename: Vilma S
authors.initials: VS
authors.lastname: Viana
authors.forename: Eduardo
authors.initials: E
authors.lastname: Borba
authors.forename: Lucia M
authors.initials: LM
authors.lastname: Campos
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D001823:Body Composition; D002648:Child; D003882:Dermatomyositis / Q000453:epidemiology* / Q000276:immunology; D050171:Dyslipidemias / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007328:Insulin / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000276:immunology; D018482:Muscle, Skeletal / Q000201:enzymology; D009220:Myositis / Q000453:epidemiology* / Q000276:immunology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014280:Triglycerides / Q000097:blood
chemical_list: D001323:Autoantibodies; D007328:Insulin; D008075:Lipoproteins, HDL; D014280:Triglycerides