Analysis Of Dyslipidemia And Its Influencing Factors In Children With Juvenile Idiopathic Arthritis

Objective:To analyze the characteristics of dyslipidemia in children with juvenile idiopathic arthritis(JIA)and its relationship with inflammatory markers,proinflammatory cytokines and disease activity;to study the effect of antirheumatic drugs on dyslipidemia in children with JIA.Methods:Twenty-eight newly diagnosed children with JIA admitted to the Department of Rheumatology and Immunology,Children's Hospital of Zhejiang University School ofMedicine from October 2017 to October 2018 were enrolled prospectively.They weretreated with Anti-rheumatic drugs and followed up for 3 months.Twenty-eight healthy children with age and gender matching were collected as a control group.Peripheralvenous blood was collected to detect the levels of blood lipids(TG,TC,HDL-C,LDL-C),high-sensitivity C-reactive protein(hsCRP),erythrocyte sedimentation rate(ESR),and proin:flammatory cytokines(IL-2,IL-4,IL-6,IL-10,TNF-?,INF-?)in children with JIA before and 3 months after treatment.We also assessed disease activity(JADAS27),calculated arteriosclerosis index and recorded drug use.Then to analyze the characteristics of dyslipidemia in children with JIA before anti-rheumatic drug treatment,and the correlation with inflammatory index,proinflammatory cytokines and JADAS27;to compare the changes of experimental indicators such as blood lipid levels in children with JIA before and after treatment.Results:Compared with the healthy control group,children with JIA had elevated TG and LDL-C,decreased HDL-C,and increased arteriosclerosis index(P<0.01),while there was no significant difference in TC(p?0.677).TG was positively correlated with hsCRP,JADAS27,IL-6,IL-10(p<0.01 or 0.05);HDL-C was negative correlated with hsCRP,ESR,JADAS27,IL-2,IL-4,IL-6,IL-10(p<0.01 or 0.05);LDL-C was positively correlated with ESR and JADAS27(p<0.05).Twenty-one(75%)of the 28 children with JIA had dyslipidemia before antirheumatic drug treatment,and only seven(25%)children had dyslipidemia after treatment for 3 months,which had significant improvement(p<0.001).Among them,compared with before treatment,TG;LDL-C and arteriosclerosis index decreased(p<0.01),HDL-C increased significantly(p<0.001),and there was no significant difference in TC(p=0.231).At the same time,hsCRP,ESR,JADAS27,IL-6,IL-10 in children with JIA before antirheumatic drug treatment were significantly higher than those in healthy controls(p<0.001 or<0.01),and after treatment,except IL-10,indicators such as hsCRP,ESR,JADAS27,and IL-6 were all significantly decreased(p<0.01).Conclusion:There is obvious dyslipidemia in the early stage of JIA children,which is manifested by increased TG,LDL-C and decreased HDL-C.It is closely related to inflammatory factors,disease activity,IL-6 and other cytokines.After treatment with effective antirheumatic drugs,children with JIA have improved dyslipidemia as the inflammatory response decreases and disease activity improves.Antirheumatic drugs may improve dyslipidemia through its powerful anti-inflammatory and inhibition of overexpression of cytokines such as IL-6,then reduce the risk of cardiovascular disease.