Risk Factors to Pre-Clinical Atherosclerosis Evaluated by Carotid Intima-Media Thickness in Juvenile Idiopathic Arthritis: Descriptive Research

Abstract

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood. Cardiovascular morbidity and mortality are becoming important health problems for children with inflammatory rheumatic diseases. The aim of this study was to evaluate carotid intima-media thickness (CIMT) in children with JIA and to examine its association with JIA subtype, markers of inflammation, and early atherosclerosis. Material and Methods: We included 112 (50 boys and 62 girls) patients who have been followed by a diagnosis of JIA for at least 6 months and 54 healthy control subjects (32 girls and 22 males) who were matched with the patients age and gender. All children underwent a carotid artery. Inflammation markers were evaluated in the patient group. Cumulative drug doses, total disease duration (TDD), active disease duration (ADD) were calculated. All CIMT values were compared in patients, subgroups, and control groups, and their relationship with inflammation markers was investigated. Results: CIMT values in found that children with JIA were significantly higher than in healthy children. There was no difference between the disease subgroups in terms of CIMT. No relationship was found between CIMT measurements and atherosclerosis risk factors, drugs, erythrocyte sedimentation rate, white blood cell and C-reactive protein. A negative correlation was found between mean platelet volume (MPV) and right CIMT. A statistically significant positive correlation was detected between the right CIMT and TDD (r=0.221, p=0.022), and ADD (r=0.248, p=0.010). Conclusion: The study showed that the patients with JIA had more risks than healthy controls for cardiovascular disease (CVD) regardless of subgroup. We concluded early and aggressive therapies may be protective for CVD. Negative correlation was found between MPV and CIMT that is consistent with recently published literature, but there is need for further studies with a larger patient population.