AB1110 Lipid abnormalities in children and adolescents with juvenile idiopathic arthritis jia

Abstract

BackgroundAtherosclerosis and its complications are known that one of the causes of lethality in rheumatic diseases. The risk of cardiovascular catastrophes increases not only with the prolongation of pathological process, but also in young patients, who are seropositive to rheumatoid factor and antinuclear antibodies in the early years of the disease.ObjectivesThe study of lipid blood spectrum in patients with JIA with the definition of its clinical significance for the course of the disease was conducted.Methods97 children (5–18 years) of patients with JIA were examined. The first group consisted of 38 children (39.2%) without symptoms of comorbidity, the second group, with signs of comorbidity, included 59 children (60.8%). The age of the debut of the disease in the fierst group was 6.3 years, and in the second group – 5.9 years. The duration of the disease at the time of the survey was 71 and 61 months. General clinical trials included the complex included autoantibodies, disease activity, drugs. Total cholesterol (TCh), triglycerides (TG), high density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, ApoA-I and lipoprotein-α were evaluated. The state of the blood coagulation system was also studied: fibrinogen of the blood, prothrombin index (PTI), thrombin time (TrT), active partial thrombin time, d-dimer, international normalised ratio.ResultsIt was established that the parameters of the lipid blood spectrum changed in the presence of an increase in the level of fibrinogen. Patients with comorbidity had higher rates of low-density lipoprotein cholesterol (2.55 mmol/L versus 3.16 mmol/L; p<0.03), TG (0.99 mmol/L versus 1.04 mmol/L, p<0.03); the coefficient of atherogeny (3,10 mmol/L versus 3.24 mmol/L, p<0.03).In the group of children with signs of comorbidity, there was a certain increase in the PTI and probable prolongation of the TrT (p<0.03), compared with the group without comorbid diseases. Children with JIA coagulation system parameters were also studied in a group of patients with signs of kidney damage. There is a probable increase in the PTI (p<0.05), which may indicate a predisposition to thrombosis.It was found that in children with JIA with the presence of atherogenic changes in the lipid blood spectrum, there are signs of the hypercoagulation with parameters of the PTI (89,70±0,74% vs. 94,05±3,11%, p<0,05); fibrinogen (3.55±0.25 vs. 3.96±0.21 g/L, p<0.05) and the level of d-dimer (0.25±0.08 units versus 0.82±0.13 units), p<0.01).Thus, in children with UIA, with signs of comorbidity, signs of hypercoagulation are established, especially in the presence of violations of the lipid profile of the blood. Regression analysis has shown that the greatest interaction exists between atherogenic dyslipidemia (the coefficient of atherogenicity) and d-dimer.ConclusionsThe obtained results confirm that the formation of comorbid pathology in children with JIA takes place against the backdrop of a close relationship between atherogenic changes in the lipid blood spectrum (the coe...

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