Metabolismo lipídico em pacientes com artrite idiopática juvenil dos subtipos poliarticular e sistêmico

• Ano de defesa: 2018
• Autor(a) principal: Rodrigues, Wellington Douglas Rocha [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Juvenile idiophatic arthritis; Dyslipidemias; Apoliprotein A-I; Apoliprotein B; Acute phase reactants; Artrite idiopática juvenil; Dislipidemias; Apoliproteína A-I; Apolipoproteína B; Reagentes de fase aguda
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6642649; https://repositorio.unifesp.br/handle/11600/52464

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in the pediatric population. Mortality due to disease activity and secondary infectious complications has decreased, however, this group of patients coexists chronically with the disease and presents, to a greater extent, early negative outcomes such as osteoporosis and late as cardiovascular diseases. Objective: To describe the biomarkers of lipid metabolism related to the cardiovascular risk of children and adolescents with JIA and to relate them to variables of the disease, lipid and glucose profile, nutritional status and food consumption. Methods: Cross-sectional study with 62 patients with JIA. The following were evaluated: disease activity and medications used, body mass index, height for age (z score), skin folds (bicipital, tricipital, subscapular and suprailiac), food consumption (24 hour recall), lipid profile (Total Cholesterol, low density lipoprotein - LDL, high density lipoprotein - HDL and triglycerides - TG and non-HDL), C-reactive protein, erythrocyte sedimentation rate (ESR), apolipoproteins AI and B Paraoxonase (PON). Statistical analysis: Exact Fischer, Chi-square, Mann-Whitney and Spearman correlation tests, p <0.05. Results: The mean duration of the disease was 5 years (± 3.4) and the active disease was observed in 33.9% of the patients. The prevalence of dyslipidemia in general was 62.9% when the lipid profile (CT, LDL-c, HDL-c, non-HDL-c and TG) and 82.3% were evaluated, including apolipoproteins (Apo AI and Apo B) altered. HDL-c and Apo A-I were the most frequent lipid profile changes. The low concentrations of Apo A-I were statistically more frequent in systemic JIA compared to polyarticular. Patients using biological agents showed better adequacy of Apo A-I concentrations. There was no significant correlation between us-CRP and variables related to lipid metabolism. However, HSV showed a negative correlation with Apo A-I levels (r = -0.25, p = 0.047). Conclusion: We conclude that dyslipidemia and alteration of lipid biomarkers are common in patients with JIA. The systemic form and the elevated HSV were associated with lower concentrations of Apo A-I suggesting the participation of the inflammatory process. In addition, the use of biological agents may be a protective factor for dyslipidemia.