FEATURES OF THE BLOOD LIPID SPECTRUM IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS
Summary. Introduction. The main cause of premature mortality in rheumatoid arthritis (RA) in adults is atherosclerosis and its complications. The accelerated development of atherosclerosis in RA is promoted by the high immuno-inflammatory activity of the disease, as well as possible adverse reactions of antirheumatic therapy. An unfavorable atherogenic profile (high atherogenic index) is formed due to a decrease in high density lipoproteins (LP). The risk of cardiovascular accidents exists not only with a long course of the disease, but also in young patients, already at the first stages of the development of the disease. The purpose of the study was to determine the characteristics of the blood lipid spectrum in children with juvenile idiopathic arthritis (JIA), depending on the activity of the process, the characteristics of the course, and the treatment complex. Object and research methods. In 121 children 6–18 years old (32 boys, 89 girls) with oligoarthritis (18 people), polyarthritis (82 people) and uveitis-associated (21 people) JIA variants, the blood lipid spectrum was studied by the level of total cholesterol, triglycerides and cholesterol high density LP by the photometric method on a general-purpose photometer «CORMAY MULTI» (Poland), very low density LP cholesterol, low density LP cholesterol and atherogenic index were calculated. The results of the study. In children with JIA disorders in the blood lipid spectrum are noted in 20.0%, which are characterized by an increase in total cholesterol, low-density LP cholesterol, a decrease in high-density LP cholesterol, and a significant increase in atherogenic index (2.69±0.11 versus 1.42±0.05 in the control group; p<0.05). The most significant decrease in high density LP cholesterol and an increase in atherogenic index occur in the first year of the disease, and in the future, the ratio of atherogenic and antiatherogenic fractions of LP remains stable. The highest values of the atherogenic index were found in children with polyarthritis and uveitis-associated variants of JIA and the presence of positivity for ANA and RF. Conclusions. In children with JIA, as in adults, while maintaining the activity of the process, especially in individuals with polyarthritis and uveitis-associated variants of the disease and the presence of antibodies (ANA and RF), significant violations of the atherogenic blood lipid spectrum are detected. These children require special attention to control both the blood lipid spectrum and the formation of cardiovascular system disorders.
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