1
|
Patra PK, Banday AZ, Asghar A, Nisar R, Das RR, Reddy P, Bhattarai D. Vascular dysfunction in juvenile idiopathic arthritis: a systematic review and meta-analysis. Rheumatol Int 2023; 43:33-45. [PMID: 36469106 DOI: 10.1007/s00296-022-05255-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
We performed a systematic review and meta-analysis of studies evaluating vascular function in patients with JIA. Relevant literature published from 1st January 1965 to 1st March 2022 was searched systematically utilizing PubMed, Web of Science, and Embase databases. Observational studies were included-patients with JIA (classified according to the International League of Associations for Rheumatology criteria) were included as cases (study population) and age/sex-matched healthy participants as controls (comparator group). Outcome measures were differences in non-invasive parameters of vascular function. Online Population, Intervention, Comparison, Outcomes Portal was used for deduplication of studies and data extraction. Review Manager, Comprehensive Meta-analysis, and Meta-Essential softwares were used for data synthesis/analysis (encompassing data pooling and evaluation of heterogeneity and publication bias). Newcastle-Ottawa Scale and GRADEpro GDT software were utilized to assess study quality and certainty of evidence, respectively. Of 338 citations, 17 observational studies with 1423 participants (cases = 757, controls = 666) were included. Carotid intima-media thickness (CIMT) was higher [mean difference (MD) 0.02 mm {95% confidence interval (CI) 0.01-0.04}, p = 0.0006, I2 = 69%] in patients with JIA. Besides, decreased flow-mediated dilatation (FMD) [MD - 2.18% {95%CI - 3.69- - 0.68}, p = 0.004, I2 = 73%] was also observed. Results of studies assessing pulse wave velocity or arterial stiffness could not be pooled due to significant methodological variations. A 'very low' certainty of evidence suggests the presence of vascular dysfunction in JIA. Future longitudinal studies are required to determine whether altered CIMT and FMD in patients with JIA translate to an enhanced risk of (adverse) clinical cardiovascular events. PROSPERO (CRD42022323752).
Collapse
Affiliation(s)
- Pratap Kumar Patra
- Department of Pediatrics, Allergy Immunology Unit, All India Institute of Medical Sciences (AIIMS), Patna, 801105, India.
| | - Aaqib Zaffar Banday
- Rheumatology Division, Kashmir Clinics Group, Balgarden, Srinagar, India
- Clinical Immunology and Rheumatology Division, Department of Pediatrics, Khyber Medical Institute, Nowpora, Srinagar, India
| | | | - Rahila Nisar
- Department of Microbiology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Pakkiresh Reddy
- Department of Pediatrics, Allergy Immunology Unit, All India Institute of Medical Sciences (AIIMS), Patna, 801105, India
| | - Dharmagat Bhattarai
- Advanced Center for Immunology and Rheumatology, Om Hospital and Research Center, Katmandu, Nepal
| |
Collapse
|
2
|
Cafarotti A, Marcovecchio ML, Lapergola G, Di Battista C, Marsili M, Basilico R, Di Donato G, David D, Pelliccia P, Chiarelli F, Breda L. Kidney function and renal resistive index in children with juvenile idiopathic arthritis. Clin Exp Med 2022:10.1007/s10238-022-00898-x. [PMID: 36129558 DOI: 10.1007/s10238-022-00898-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is a common pediatric rheumatic disease. Renal manifestations have been rarely observed in JIA, although amyloidosis could be a renal complication in systemic JIA (sJIA). To investigate renal damage in JIA children and to establish the relationship with treatment. Blood urea nitrogen (BUN), creatinine, cystatin C (CysC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), urinary albumin excretion (UAE), estimated glomerular filtration rate (eGFR), and renal resistive index (RRI) were assessed in 49 JIA children (9 boys/40 girls, mean age 10.3 ± 3.8 years) and in 49 healthy controls (24 boys/25 girls, mean age 11.3 ± 3.4 years). Twenty-two JIA patients were on methotrexate (MTX) therapy (group A) and 27 on biologic drugs (group B). CysC and BUN (respectively, 0.8 ± 0.1 vs. 0.7 ± 0.1 mg/dl; 13.3 ± 2.9 vs. 11.7 ± 1.4 mg/dl) were higher (p ≤ 0.001) whereas creatinine and eGFR (respectively, 0.5 ± 0.1 vs. 0.6 ± 0.1 mg/dl; 99.2 ± 10.5 vs. 122.5 ± 19.8 ml/min/1.73 m2) were lower in JIA children as compared to controls (p < 0.001). UAE resulted higher in patients than in controls (p = 0.003). Mean RRI was higher in JIA children than controls (0.7 ± 0.04 vs. 0.6 ± 0.04; p < 0.001). Group B showed higher mean RRI than group A (0.7 ± 0.1 vs. 0.7 ± 0.04; p < 0.001). Associations were found between RRI and ESR, JADAS-27, disease state, BMI-SDS (p < 0.001), CRP (p = 0.003) and eGFR (p = 0.001). JIA children had reduced eGFR, increased UAE and higher RRI values, than controls. RRIs were higher in patients on biologic drugs than MTX group and were associated with inflammation indexes and disease state, suggesting a direct effect of the disease.
Collapse
Affiliation(s)
| | | | | | | | - Manuela Marsili
- Department of Paediatrics, University "G. d'Annunzio", Chieti, Italy
| | - Raffaella Basilico
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Giulia Di Donato
- Department of Paediatrics, University "G. d'Annunzio", Chieti, Italy
| | - Daniela David
- Department of Paediatrics, University "G. d'Annunzio", Chieti, Italy
| | | | | | - Luciana Breda
- Pediatric Rheumatology Unit, S.S. Annunziata Hospital, Via dei Vestini 5, Chieti, Italy.
| |
Collapse
|
3
|
Hypertension Predisposition and Thermoregulation Delays in Adolescents with Polycystic Ovary Syndrome: A Pilot Study. CHILDREN 2022; 9:children9030316. [PMID: 35327688 PMCID: PMC8946960 DOI: 10.3390/children9030316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder in which clinical, sonographic, and endophenotypic features have been underinvestigated or inconclusive, especially in the early stages of the disease (adolescence/young adulthood). Objective: This prospective pilot study focused on the differences of multiple physiological functions between Greek adolescent/young adult females suffering from PCOS and age- and body mass index (BMI)- matched healthy controls. Study design: Nineteen PCOS patients and eighteen healthy controls (aged 13 to 23 years) were studied for: (i) biochemical and hormonal dysfunction by measuring circulating glucose, insulin, and androgen levels; (ii) arterial stiffness with pulse wave analysis (PWA) by Sphygmocord; (iii) intima-media thickness (IMT) by ultrasound; (iv) heart rate variability (HRV) by Task Force Monitor; and (v) QT, QRS, QT, P, QRSD by electrocardiogram (ECG). Statistical analysis included Hedge’s g correction for small samples bias, and the results are shown using the Hedge’s g effect size and 95% CI, in line with precision medicine prerequisites. Results: Significant differences in pulse wave velocity (PWV) (g = 0.964 [0.296, 1.632]), subendocardial viability ratio (SEVR) carotid (g = −0.679 [−1.329, −0.030]), pulse pressure (PP) carotid (g = 0.942 [0.275, 1.608]), systolic pressure (SP) carotid (g = 0.785 [0.129, 1.440]), free-testosterone (g = 0.677 [0.042, 0.312]), and Delta4-androstenedione (g = 0.735 [0.097, 0.373]) were observed between PCOS patients and controls. No differences were detected in the remaining endocrine and PWA or ECG biomarkers. Conclusions: Our multidisciplinary approach showed early onset of vascular dysfunction, predisposition to hypertension, thermoregulation delays, and metabolic syndrome changes in adolescent/young adult PCOS.
Collapse
|
4
|
Rodrigues WDR, Sarni ROS, Fonseca FLA, Araújo A, Len CA, Terreri MT. Biomarkers of lipid metabolism in patients with juvenile idiopathic arthritis: relationship with disease subtype and inflammatory activity. Pediatr Rheumatol Online J 2021; 19:66. [PMID: 33941215 PMCID: PMC8091710 DOI: 10.1186/s12969-021-00538-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To describe the biomarkers of lipid metabolism in children and adolescents with polyarticular and systemic JIA and to relate them to diseases subtypes, diseases activity markers, and nutritional status. METHODS A cross-sectional study including 62 JIA patients was performed. The following variables were evaluated: disease activity and medications used, body mass index, height for age (z-score), skin folds (bicipital, tricipital, subscapular and suprailiac), food intake based on three 24-h food recalls, lipid profile (total cholesterol (CT), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG) and non-HDL (N-HDLc), glycemia and insulin, erythrocyte sedimentation rate (ESR), ultrasensitive C-reactive protein (us-CRP) and apolipoproteins A-I and B (Apo A-I and Apo B). RESULTS Dyslipidemia was observed in 83.3% of the patients. Based on classical lipid profile, low HDL-c levels was the most frequently alteration observed. Inadequate levels of LDL-c, Apo B and NHDL-c were significantly more frequent in the systemic JIA subtype when compared to the polyarticular subtype (p = 0.017, 0.001 and 0.042 respectively). Patients on biological therapy had a better adequacy of Apo A-I concentrations. The ESR showed a negative correlation with Apo A-I level (r = - 0.25, p = 0.047). CONCLUSION We concluded that dyslipidemia is common in patients with JIA, especially in systemic subtype. The systemic subtype and an elevated ESR were associated with lower concentrations of Apo A-I, suggesting the participation of the inflammatory process.
Collapse
Affiliation(s)
- Wellington Douglas Rocha Rodrigues
- Department of Pediatrics, Universidade Federal de São Paulo, Rua Borges Lagoa, 802 - Vila Clementino, São Paulo, SP, CEP: 04038-001, Brazil
| | - Roseli Oselka Saccardo Sarni
- Department of Pediatrics, Universidade Federal de São Paulo, Rua Borges Lagoa, 802 - Vila Clementino, São Paulo, SP, CEP: 04038-001, Brazil
| | - Fernando Luiz Affonso Fonseca
- Department of Pediatrics, Universidade Federal de São Paulo, Rua Borges Lagoa, 802 - Vila Clementino, São Paulo, SP, CEP: 04038-001, Brazil
| | - Annelyse Araújo
- Department of Pediatrics, Universidade Federal de São Paulo, Rua Borges Lagoa, 802 - Vila Clementino, São Paulo, SP, CEP: 04038-001, Brazil
| | - Claudio Arnaldo Len
- Department of Pediatrics, Universidade Federal de São Paulo, Rua Borges Lagoa, 802 - Vila Clementino, São Paulo, SP, CEP: 04038-001, Brazil
| | - Maria Teresa Terreri
- Department of Pediatrics, Universidade Federal de São Paulo, Rua Borges Lagoa, 802 - Vila Clementino, São Paulo, SP, CEP: 04038-001, Brazil.
| |
Collapse
|
5
|
Li DY, Zhang JY, Chen QJ, Liu F, Zhao Q, Gao XM, Li XM, Yang YN. MIF -173G/C (rs755622) polymorphism modulates coronary artery disease risk: evidence from a systematic meta-analysis. BMC Cardiovasc Disord 2020; 20:300. [PMID: 32560699 PMCID: PMC7304150 DOI: 10.1186/s12872-020-01564-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 06/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronary artery disease (CAD) remains one of the major causes of death in humans. Genetic testing may allow early detection and prevention of this disease. This study aimed to investigate the association between the macrophage migration inhibitory factor (MIF) -173G/C (rs755622) polymorphism and susceptibility to CAD based on a meta-analysis. METHODS We searched several databases to identify observational case-control studies investigating the association between the MIF -173G > C (rs755622) polymorphism and CAD risk published before July 30, 2019. Data were analyzed using the STATA software. RESULTS Six studies, comprising a total of 1172 CAD cases and 1564 controls evaluated for MIF polymorphisms, were included. The occurrence of CAD was found to be associated with the C allele of the MIF rs755622 SNP in the total population (C/G, OR = 1.489, 95% CI = 1.223-1.813). Further, MIF -173G/C polymorphism was significantly associated with CAD under the allelic model in the Asian (C/G, OR = 1.775, 95% CI = 1.365-2.309) and Caucasian (C/G, OR = 1.288, 95% CI 1.003-1.654) subgroups. The data showed that the risk of CAD was higher in the population carrying the C allele. CONCLUSIONS We found evidence of associations between MIF -173C/G and CAD susceptibility in the Asian and Caucasian populations.
Collapse
Affiliation(s)
- De-Yang Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Department one of coronary heart disease, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Jin-Yu Zhang
- Rehabilitation department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Qing-Jie Chen
- Department one of coronary heart disease, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Fen Liu
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Department one of coronary heart disease, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Qian Zhao
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Department one of coronary heart disease, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xiao-Ming Gao
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiao-Mei Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Department one of coronary heart disease, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Yi-Ning Yang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. .,Department one of coronary heart disease, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
| |
Collapse
|
6
|
Conkar S, Güven Yılmaz S, Koska İÖ, Berdeli A, Mir S. Evaluation of development of subclinical atherosclerosis in children with uveitis. Clin Rheumatol 2017; 37:1305-1308. [PMID: 28695435 DOI: 10.1007/s10067-017-3741-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/10/2017] [Accepted: 06/25/2017] [Indexed: 11/24/2022]
Abstract
Uveitis is a chronic inflammatory disease. Chronic inflammation has been shown to have a role in pathogenesis of atherosclerosis. Atherosclerosis is the most important risk factor of cardiovascular diseases and is shown to start as early as childhood. In this study, we investigated the presence of subclinical atherosclerosis in children with uveitis. Seventy five patients who were diagnosed as having uveitis in ophthalmology and pediatric rheumatology clinics were included in the study. Patients with hypertension, obesity, dyslipidemia, diabetes, and with history of early cardiovascular disease were excluded. Arterial stiffness, carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), and carotid artery intima-media thickness (cIMT) were measured for each patient. These measurements were compared with 50 healthy children with similar age and sex as controls. The mean age of patients in this study was 12.24 ± 2.69 years, and the mean age of controls was 11.32 ± 4.52 years. PWV and AIx values were higher in the patient group (p = 0.04, p = 0.03). cIMT levels were not different in patient and control groups. When patients were grouped as having uveitis for more than 5 years or not, patients with longer duration of uveitis had higher PWV, AIx, and cIMT levels (p values were 0.01, 0.02, and 0.04 respectively). Vascular functions deteriorate first with endothelial damage in children with uveitis and as disease continues, increase in cIMT is added. We think that for follow-up of the disease and evaluation of the treatment, non-invasive subclinical atherosclerosis markers should be used along with activation criteria of primary diseases.
Collapse
Affiliation(s)
- Seçil Conkar
- Department of Pediatric Nephrology, Ege University Faculty of Medicine, İzmir, Turkey.
| | - Suzan Güven Yılmaz
- Departments of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey
| | - İlker Özgür Koska
- Department of Radiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Afig Berdeli
- Department of Pediatric Rheumatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Sevgi Mir
- Department of Pediatric Nephrology, Ege University Faculty of Medicine, İzmir, Turkey.,Department of Pediatric Rheumatology, Ege University Faculty of Medicine, Izmir, Turkey
| |
Collapse
|
7
|
Armbrust W, Bos GJFJ, Wulffraat NM, van Brussel M, Cappon J, Dijkstra PU, Geertzen JHB, Legger GE, van Rossum MAJ, Sauer PJJ, Lelieveld OTHM. Internet Program for Physical Activity and Exercise Capacity in Children With Juvenile Idiopathic Arthritis: A Multicenter Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2017; 69:1040-1049. [DOI: 10.1002/acr.23100] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 08/10/2016] [Accepted: 09/20/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Wineke Armbrust
- University of Groningen, University Medical Center Groningen, and Beatrix Children's Hospital; Groningen The Netherlands
| | - G. J. F. Joyce Bos
- University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Nico M. Wulffraat
- University Medical Center Utrecht and Wilhelmina Children's Hospital; Utrecht The Netherlands
| | - Marco van Brussel
- University Medical Center Utrecht and Wilhelmina Children's Hospital; Utrecht The Netherlands
| | - Jeannette Cappon
- Reade, Center for Rehabilitation and Rheumatology, Dr. Jan van Breemenstraat; Amsterdam The Netherlands
| | - Pieter U. Dijkstra
- University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Jan H. B. Geertzen
- University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - G. Elizabeth Legger
- University of Groningen, University Medical Center Groningen, and Beatrix Children's Hospital; Groningen The Netherlands
| | - Marion A. J. van Rossum
- Reade, Center for Rehabilitation and Rheumatology, Dr. Jan van Breemenstraat; Amsterdam The Netherlands
| | - Pieter J. J. Sauer
- University of Groningen, University Medical Center Groningen, and Beatrix Children's Hospital; Groningen The Netherlands
| | | |
Collapse
|
8
|
Ahmad HS, Othman G, Farrag SE, El-Hafez AA, Monir AA. Subclinical heart failure in juvenile idiopathic arthritis: a consequence of chronic inflammation and subclinical atherosclerosis. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2016. [DOI: 10.4103/1110-161x.181881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
|
9
|
Sozeri B, Atikan BY, Ozdemir K, Mir S. Assessment of vascular function in systemic onset juvenile idiopathic arthritis. Clin Rheumatol 2016; 35:1699-703. [DOI: 10.1007/s10067-016-3254-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 03/28/2016] [Accepted: 03/31/2016] [Indexed: 10/22/2022]
|
10
|
Evensen K, Aulie HA, Rønning OM, Flatø B, Russell D. Carotid Atherosclerosis in Adult Patients with Persistently Active Juvenile Idiopathic Arthritis Compared with Healthy Controls. J Rheumatol 2016; 43:810-5. [DOI: 10.3899/jrheum.150499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2015] [Indexed: 11/22/2022]
Abstract
Objective.Juvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatic disease in childhood. It is regarded as a systemic inflammatory disease with possible increased risk of cardiovascular disease (CVD). The aim of this study was to assess carotid intima-media thickness (IMT) and carotid stenosis as surrogate measures for CVD in adults with longterm active JIA and healthy age- and sex-matched controls.Methods.Seventy-five patients with JIA (age 28–45 yrs) with persistently active disease at least 15 years after disease onset were reexamined after a median of 29 years and compared with 75 matched controls. Patients and controls were examined by color duplex ultrasound of the carotid arteries to compare carotid IMT and carotid stenosis in the 2 groups.Results.Patients with JIA did not have increased carotid IMT values compared with the controls (mean ± SD: 0.56 mm ± 0.09 vs 0.58 mm ± 0.07, p = 0.289). Patients with a higher disease activity indicated by the Juvenile Arthritis Disease Activity Score value above the median value had increased carotid IMT compared with the patients with a lower value, but not statistically different compared with controls. No carotid stenoses were detected in patients or controls.Conclusion.We found similar carotid IMT values in adult patients with JIA and controls.
Collapse
|
11
|
Obeid J, Nguyen T, Walker RG, Gillis LJ, Timmons BW. Circulating endothelial cells in children: role of fitness, activity, and adiposity. Med Sci Sports Exerc 2015; 46:1974-80. [PMID: 24561817 DOI: 10.1249/mss.0000000000000313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Circulating endothelial cells (CEC) are thought to be useful biomarkers of endothelial dysfunction and overall cardiovascular health. The extent to which CEC are influenced by fitness, physical activity, and adiposity in youth remains unknown, as they have seldom been examined in the pediatric population. This study assessed resting levels of CEC in boys and girls of different chronological and biological age and explored the relationship between these cells and aerobic fitness, physical activity, and adiposity. METHODS Seventy-five children (39 males; median [interquartile range], age = 14.4 [5.8]) completed two study visits. During the first visit, basic anthropometric data were collected and biological age was calculated. Peak mechanical power (Wpeak) was determined using the McMaster All-Out Continuous cycling test. Participants then wore an accelerometer over a 7-d period to assess habitual levels of moderate-to-vigorous physical activity. During visit 2, percent body fat (%BF) was assessed by dual-energy x-ray absorptiometry. A fasted blood sample was also collected from which concentrations of CEC, identified as CD31CD34CD45CD133, were quantified by flow cytometry. RESULTS No differences were seen in CEC by sex, chronological age, or biological age. The median (interquartile range) CEC concentration was 32.3 × 10 (63.0 × 10), representing 1.3% (2.7%) of collected peripheral blood mononuclear cells. CEC concentration was associated with Wpeak normalized to lean body mass (r = 0.36, P < 0.01) and time spent in moderate-to-vigorous physical activity (r = -0.27, P = 0.02). No relationship was observed between CEC and %BF. CONCLUSION Healthy children demonstrate relatively low concentrations of CECs. Because CEC represent a population of mature endothelial cells shed from the intima after irreversible damage, they may be more reflective of recent physical activity levels rather than fitness or level of adiposity.
Collapse
Affiliation(s)
- Joyce Obeid
- Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, ON, CANADA
| | | | | | | | | |
Collapse
|
12
|
Armbrust W, Bos JJFJ, Cappon J, van Rossum MAJ, Sauer PJJ, Wulffraat N, van Wijnen VK, Lelieveld OTHM. Design and acceptance of Rheumates@Work, a combined internet-based and in person instruction model, an interactive, educational, and cognitive behavioral program for children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2015; 13:31. [PMID: 26202161 PMCID: PMC4511536 DOI: 10.1186/s12969-015-0029-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) is a chronic rheumatic disease. Patients suffer daily discomforts such as pain, fatigue, stiffness, and mood disturbances. Their exercise capacity is decreased to a variable degree and physical activity levels may be impaired. To prevent long-term cardiovascular risks associated with JIA and medication, it is important to encourage physical activity. To achieve this we developed Rheumates@Work (R@W), a combined internet-based and in person instruction model, an interactive, educational, and cognitive behavioral program. The aim of this study is twofold: to describe the theoretical background and design of R@W based on Pender's Health Promotion Model, and to assess its acceptance. METHODS We enrolled 8 to 13-year-old JIA patients, from 3 outpatients clinics in The Netherlands, in R@W. Inclusion criteria were a low disease activity (VAS physician <20 mm), comprehension of the Dutch language and absence of relevant co-morbidity. We assessed acceptance by measuring the participants' commitment to the program, the level of interaction on patient's initiative (f.e. mails send by the patient), technical aspects and satisfaction. Commitment was defined as the percentage of participants that completed the assignments and how much encouragement the participants needed for this. Satisfaction was measured with an anonymous questionnaire concerning f.e. time investment and perceived benefits. Costs were monitored. RESULTS Of the 64 patients we enrolled, 23 boys and 41 girls, 93.8 % completed the program. Participant-initiated interaction was seen in 10.7 %, 24.7 % send a mail because of technical problems. Eighty-two percent of the participants and 99 % of the parents liked the program, and 85 % of the participants indicated that they had learnt something, or quite a lot. Development costs of the program were low. CONCLUSION The HPM is suitable for a behavioral intervention program such as R@W. Acceptance and satisfaction of R@W were high and the costs of the program were low. TRIAL NUMBER ISRCTN92733069.
Collapse
Affiliation(s)
- Wineke Armbrust
- Department of Pediatric Rheumatology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands.
| | - Joyce J. F. J. Bos
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands
| | - Jeannette Cappon
- Amsterdam Center for Rheumatology and immunology Reade, location: Dr. Jan van Breemenstraat, Amsterdam, The Netherlands.
| | - Marion A.J. J. van Rossum
- Amsterdam Center for Rheumatology and immunology Reade, location: Dr. Jan van Breemenstraat, Amsterdam, The Netherlands
| | - Pieter J. J. Sauer
- University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, Groningen, The Netherlands
| | - Nico Wulffraat
- Department of Paediatric Immunology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
| | - Veera K. van Wijnen
- Department of Pediatric Rheumatology, University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, Groningen, The Netherlands
| | - Otto T. H. M. Lelieveld
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands
| |
Collapse
|
13
|
Jednacz E, Rutkowska-Sak L. Assessment of the body composition and parameters of the cardiovascular risk in juvenile idiopathic arthritis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:619023. [PMID: 25839035 PMCID: PMC4369879 DOI: 10.1155/2015/619023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/06/2014] [Accepted: 08/26/2014] [Indexed: 12/17/2022]
Abstract
The study was aimed to evaluate cardiovascular risk parameters, body mass index (BMI) centiles for sex and age, and body fat percentage using the electric bioimpedance method in children with juvenile idiopathic arthritis (JIA). 30 children with JIA participated in the study. A control group included 20 children. Patients were well matched for the age and sex. The body mass and body fat percentage were determined using the segmental body composition analyser; the BMI centiles were determined. All patients had the following parameters determined: lipid profile, hsCRP, homocysteine, and IL-6. The intima media thickness (IMT) was measured. Patients with JIA had significantly lower body weight, BMI, and the BMI centile compared to the control group. The IL-6 levels were significantly higher in patients with JIA compared to the control group. There were no differences between two groups with regard to the lipid profile, % content of the fat tissue, homocysteine levels, hsCRP, and IMT. Further studies are necessary to search for reasons for lower BMI and BMI centile in children with JIA and to attempt to answer the question of whether lower BMI increases the cardiovascular risk in these patients, similarly as in patients with rheumatoid arthritis (RA).
Collapse
Affiliation(s)
- Ewa Jednacz
- Paediatric Clinic of Rheumatology, Institute of Rheumatology, Spartanska 1, 02-637 Warsaw, Poland
| | - Lidia Rutkowska-Sak
- Paediatric Clinic of Rheumatology, Institute of Rheumatology, Spartanska 1, 02-637 Warsaw, Poland
| |
Collapse
|
14
|
Valdés-Alvarado E, Muñoz-Valle JF, Valle Y, Sandoval-Pinto E, García-González IJ, Valdez-Haro A, De la Cruz-Mosso U, Flores-Salinas HE, Padilla-Gutiérrez JR. Association between the -794 (CATT)5-8 MIF gene polymorphism and susceptibility to acute coronary syndrome in a western Mexican population. J Immunol Res 2014; 2014:704854. [PMID: 25105152 PMCID: PMC4106097 DOI: 10.1155/2014/704854] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 05/30/2014] [Accepted: 06/03/2014] [Indexed: 12/19/2022] Open
Abstract
The macrophage migration inhibitory factor (MIF) is related to the progression of atherosclerosis, which, in turn, is a key factor in the development of acute coronary syndrome (ACS). MIF has a CATT short tandem repeat (STR) at position -794 that might be involved in its expression rate. The aim of this study was to investigate the association between the -794 (CATT)5-8 MIF gene polymorphism and susceptibility to ACS in a western Mexican population. This research included 200 ACS patients classified according to the criteria of the American College of Cardiology (ACC) and 200 healthy subjects (HS). The -794 (CATT)5-8 MIF gene polymorphism was analyzed using a conventional polymerase chain reaction (PCR) technique. The 6 allele was the most frequent in both groups (ACS: 54% and HS: 57%). The most common genotypes in ACS patients and HS were 6/7 and 6/6, respectively, and a significant association was found between the 6/7 genotype and susceptibility to ACS (68% versus 47% in ACS and HS, resp., P = 0.03). We conclude that the 6/7 genotype of the MIF -794 (CATT)5-8 polymorphism is associated with susceptibility to ACS in a western Mexican population.
Collapse
Affiliation(s)
- Emmanuel Valdés-Alvarado
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio Q, Primer Piso, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
- Doctorado en Ciencias Biomédicas, Universidad de Guadalajara, Sierra Mojada 950, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
| | - José Francisco Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio Q, Primer Piso, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
| | - Yeminia Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio Q, Primer Piso, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
| | - Elena Sandoval-Pinto
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio Q, Primer Piso, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
- Doctorado en Ciencias Biomédicas, Universidad de Guadalajara, Sierra Mojada 950, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
| | - Ilian Janet García-González
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio Q, Primer Piso, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
- Doctorado en Genética Humana, Universidad de Guadalajara, Sierra Mojada 950, Colonia Independencia,
44350 Guadalajara, JAL, Mexico
| | - Angélica Valdez-Haro
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio Q, Primer Piso, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
- Doctorado en Genética Humana, Universidad de Guadalajara, Sierra Mojada 950, Colonia Independencia,
44350 Guadalajara, JAL, Mexico
| | - Ulises De la Cruz-Mosso
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio Q, Primer Piso, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
- Doctorado en Ciencias Biomédicas, Universidad de Guadalajara, Sierra Mojada 950, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
| | - Héctor Enrique Flores-Salinas
- IMSS, Centro Medico Nacional de Occidente, Belisario Dominguez 1000, Colonia Independencia, 44340 Guadalajara, JAL, Mexico
| | - Jorgé Ramón Padilla-Gutiérrez
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio Q, Primer Piso, Colonia Independencia, 44350 Guadalajara, JAL, Mexico
| |
Collapse
|
15
|
Głowińska-Olszewska B, Bossowski A, Dobreńko E, Hryniewicz A, Konstantynowicz J, Milewski R, Łuczyński W, Piotrowska-Jastrzębska J, Kowal-Bielecka O. Subclinical cardiovascular system changes in obese patients with juvenile idiopathic arthritis. Mediators Inflamm 2013; 2013:436702. [PMID: 23554546 PMCID: PMC3608356 DOI: 10.1155/2013/436702] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 02/03/2013] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthritis (JIA) children and to investigate the influence of obesity into the early, subclinical changes in cardiovascular system in these patients. METHODS Fifty-eight JIA patients, aged median 13 years, were compared to 36 healthy controls. Traditional cardiovascular risk factors and inflammatory markers (hsCRP, IL-6, TNF α, adiponectin) were studied together with IMT (intima-media thickness), FMD (flow mediated dilation), and LVMi (left ventricle mass index) as surrogate markers of subclinical atherosclerosis. RESULTS Thirteen JIA children (22%) were obese and had increased systolic blood pressure, cholesterol, triglycerides, insulin, HOMA, hsCRP, and IL-6 compared to nonobese JIA and controls. FMD was decreased compared to nonobese JIA and controls, whereas IMT and LVMi were increased. In multivariate regression analysis, TNF α, SDS-BMI, and systolic blood pressure were independent predictors of early CV changes in JIA. CONCLUSIONS Coincident obesity is common in JIA children and is associated with insulin resistance, dyslipidemia, and increased levels of inflammatory markers leading to early changes in cardiovascular system. Thus, medical care of children with JIA should include strategies preventing cardiovascular disease by maintenance of adequate body weight.
Collapse
Affiliation(s)
- Barbara Głowińska-Olszewska
- Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Bialystok, Waszyngtona 17 Street, 15-274 Białystok, Poland.
| | | | | | | | | | | | | | | | | |
Collapse
|