Objectives To evaluate the association between gender, disease activity, body composition and bone mineral density in patients with juvenile idiopathic arthritis. Methods Our study was a cross-sectional study including Moroccan patients with juvenile idiopathic arthritis according to the International League of association of Rheumatology (ILAR) criteria, seen in rheumatology consultation or hospital. Sociodemographic and clinical data of the patients were collected. Bone mineral density of patients (BMD g/cm2) was measured by DXA X-ray Lunar Prodigy scanner. The disease activity was assessed by the number of painful joints (IA), swollen joint (SI), visual analogical scale measured by physician and patient vasP and VASp, biological markers of inflammation: the sedimentation rate (ESR) and C-reactive protein (CRP). BMD was measured in two sites: the lumbar spine (L1, L4) and the whole body. Lean and fat mass were measured by the same device in the whole body and expressed in grams. Results 33 patients were included, the mean of their age was 10±4.35 years old, with a male predominance (54.5%), the median of disease evolution was 2 (1 - 4.5) years. 24% had a systemic JIA, 27% had an oligoarticular JIA and 48% had a polyarticular JIA. The median of painful joints and synovial joint were respectively 3 (1-9) and 1 (0-3).The mean of DAS 28 was 5, 34±1.11 The mean of ESR was 37±18, with a median of CRP, VASP and VASp were respectively 20mg (10.5 to 40), 20 (10-50) and 20 (10-40). The median of BMD in the whole body, lumbar spine, lean mass and fat mass were respectively 0.720 g/cm2 (0700-0900) 0.620 g/cm2 (0530-0900), 20.49g (15.96-33.45) and 4.97g (3.63-15.09). We did not find a statistically significant association between gender and disease activity evaluated by the DAS28, articular index, synovial Index, VASP, VASp, ESR and CRP with p respectively at (p=0.79, p=0.068, p=0.75, p=0.75, p=0.71, p=0.80, p=0.73). There are also no statistically significant association between gender and lean body mass, fat mass, lumbar spineBMD or BMD of the whole body with p respectively at (p=0.39, p=0.99 p=0.29, p=0.65). Conclusions This study suggests that the gender of the patient does not influence the disease activity or body composition and BMD of patients. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5839
Objectives To evaluate the impact of morning stiffness duration reported by the patient on the evaluation of rheumatoid arthritis activity. Methods A multi- national cross-sectional study that included 1129 patients with rheumatoid arthritis according to the 1987 ACR criteria. The Quest-RA (Quantitative Standard monitoring of patients with Rheumatoid Arthritis)” Morocco study was inspired from the Finnish study, including public and private rheumatologists over a period from January 2008 to December 2010. A pre- questionnaire with Socio- demographic, clinical and paraclinical was completed by all patients. The duration of the Morning Stiffness (MS) was evaluated from the time of awakening patients until the maximum improvement in pain. Four groups were established according to the disease activity (DAS28 values in and MS). We conducted correlation analysis to establish the relationship between MS and disease activity based on DAS28. Linear regression analysis was used to identify the determinants of this relationship. The ROC curve was used to differentiate between active and inactive forms in the MS and the DAS28. Results The average age of our patients was 48.82±12.72 years with a female predominance (87.3%). The median disease duration was 6 years (3-12). The mean DAS28 was 4.93±1.68, the length of the MS averaged 29.95±19.16 min. A significant correlation was noted between the DAS28 (r =0.318) VAS tired (r =0.343) overall VAS (r =0.315) ESR (r =0.144) and the duration of the MS (all p<0.05). More than half of our patients were severe activity DAS28 (54%). Among this group, 71.5% had a sup MS 30 minutes (16 - 59min). The duration of MS in patients with severe activity was different from subjects in the other groups (p<0.0001). In univariate and multivariate analysis and adjusting for confounding factors, the DAS28 increased 8.6 10-2 when the duration of the MS increases a minute. The Roc curve is a threshold value of 16.50 with Specificity =0.57 and Sensibility =0.77. Conclusions Our study suggests that the MS reported by patients influences the disease activity assessed by the DAS28. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5567
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