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Objective: To evaluate cognitive function in adult patients with juvenile idiopathic arthritis (JIA) and associated factors. Patients and methods: We performed a cross-sectional observational study of adult patients with JIA and a healthy control group (no inflammatory diseases) matched for age, gender, and educational level. Cognitive function was assessed using Wechsler Adult Intelligence Scale-III. The cognitive domains measured were attention/concentration, verbal function, visuospatial organization, working memory, and problem solving (Similarities). Other measures included clinical-epidemiological characteristics, comorbid conditions, and treatment. We performed a descriptive bivariate analysis and logistic regression to identify factors associated with visuospatial involvement. Results: The study population comprised 104 subjects (52 with JIA and 52 healthy controls). Patients with JIA had poorer results for visuospatial function, with a lower median scaled score on the Block Design test (5.

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Background25hydroxy-vitamin D not only plays a key role in calcium homeostasis, but also has antiinflammatory and immunomodulatory properties. Hypovitaminosis D prevalence in children suffering from Juvenile Idiopathic Arthritis (JIA) ranges from 6% to 30% according to different publications.ObjectivesEvaluate hypovitaminosis D prevalence in JIA pediatric patients in Spain and assess involved factors.MethodsObservational cross-sectional study in JIA Spanish patients from 4 to 15 years, monitored by a Pediatric Rheumatology Unit. Monoarticular forms and patients with other chronic diseases or receiving different treatments from those indicated for JIA were excluded.Anthropometric, clinical and treatment data were recorded. Bone metabolism parameters and validated diet (KIDMED) and exercise (PAQ-C/PAQ-A) questionnaires were obtained.Hypovitaminosis D was defined as 25hydroxy-vitamin D plasma levels lower than 30 ng/mlResults76 children participated. Their characteristics are included in table 1.The population's prevalence estimation of hypovytaminosis D in children with JIA was 16 - 35% (CI 95%).We found no relationship between 25 hydroxy-vitamin D levels and sex, JIA subtype neither duration or dose of systemic glucocorticoids.In bivariate analysis we found direct association between hypovitaminosis D and Body Mass Index percentile (BMIp) (p=0,05), received dose of prednisone (p=0,03) and clinical activity duration (p=0,04); and an inverse relationship with physical activity level (p=0,04).In multivariate analysis, relationship between hypovitaminosis D and BMIp (B 0,024; p 0,016) and with disease activity (B 0,015; p 0,01) were maintained. Moreover, we found an inverse association with biological disease-modifiying antirheumatic drugs (B-4,69; p 0,048), specifically with anti-tumoral necrosis factor α (antiTNFα) (B -4,7; p 0,042)ConclusionsHypovitaminosis D prevalence in our population is similar to previously described.JIA patients with higher BMIp have more hypovitaminosis D, as it has been reported in other inflammatory diseases.A direct relationship exists between inflammatory activity and vitamin D, but we need more studies to asses if one is cause or consecuence of the other.Patients treated with antiTNF have better plasma levels of 25 hydroxy-vitamin D, this can be explained because these drugs may increase 25 hydroxy-vitamin D levels or due to a better response to antiTNF of those patient with higher plasma levels of 25 hydroxy-vitamin D.References Nisar MK, Masood F, Cookson P, Sansome A, Östör AJ. What do we know about juvenile idiopathic arthritis and vitamin D? A systematic literature review and meta-analysis of current evidence. Clin Rheumatol 2013; 32:729–734.Santos-Antunes J, Corte-Real Nunes A, Lopes S, Macedo G. The Relevance of Vitamin D and Antinuclear Antibodies in Patients with Inflammatory Bowel Disease Under Anti-TNF Treatment: A Prospective Study. Inflamm Bowel Dis 2016;22:1101–1106.Ham M, Longhi MS, Lahiff C, Cheifetz A, Robson S, Moss AC. Vitamin D levels in adults with Crohn's disease ar...

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Objective: To identify factors associated with the higher proportion of fatty tissue and overweight/obesity observed in patients with juvenile idiopathic arthritis (JIA). Patients and methods: We performed a cross-sectional study of 80 JIA patients aged 4–15 years with 80 age- and sex-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry. The 27-joint Juvenile Arthritis Disease Activity score (JADAS27) was calculated. Two multivariate models were constructed to identify factors associated with overweight/obesity and fat mass index (FMI). Results: No differences were found between cases and controls in body mass index (BMI) or body composition. However, compared with controls, patients with a high inflammatory activity (JADAS27 > 4.2 for oligoarticular JIA or >8.5 for polyarticular disease) had higher values for BMI (p = 0.006); total fat mass (p = 0.003); FMI (p = 0.001); and fat in the legs (p = 0.001), trunk (p = 0.001), and arms (p = 0.002). The factors associated with overweight/obesity in patients were the duration of therapy with biological drugs, measured in months (OR [95% CI] = 1.12 [1.02–1.04]; p = 0.037), and physical activity (OR [95% CI] = 0.214 [0.07–0.68]; p = 0.010), while the factors associated with FMI were age (β [95% CI] = 0.30 [0.17–1.41]; p = 0.014), JADAS27 (β [95% CI] = 0.45 [0.16–1.08]; p = 0.009), and physical activity (β [95% CI] = −0.22 [−5.76 to 0.29]; p = 0.031). Conclusion: Our study revealed no differences between JIA patients with well-controlled disease and low disability and the healthy population in BMI or body composition. Furthermore, the association observed between inflammatory activity and adiposity could be responsible for poorer clinical course.