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Mediators of Inflammation
Volume 2013, Article ID 436702, 11 pages
Clinical Study

Subclinical Cardiovascular System Changes in Obese Patients with Juvenile Idiopathic Arthritis

1Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Bialystok, Waszyngtona 17 Street, 15-274 Białystok, Poland
2Department of Pediatrics and Developmental Disorders, Medical University of Bialystok, Waszyngtona 17 Street, 15-274 Białystok, Poland
3Department of Statistics and Medical Informatics, Medical University of Bialystok, Szpitalna 37 Street, 15-295 Białystok, Poland
4Department of Rheumatology and Internal Medicine, Medical University of Bialystok, M. Skłodowskiej-Curie 24A Street, 15-276 Białystok, Poland

Received 11 November 2012; Accepted 3 February 2013

Academic Editor: Eeva Moilanen

Copyright © 2013 Barbara Głowińska-Olszewska et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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, TNFα, 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, TNFα, 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.