Dynamics of blood lipid spectrum indicators in children with juvenile idiopathic arthritis taking into account basic therapy

  • Ludmila Bogmat MD, PhD, Professor, Head of the Department of rheumatology and comorbid conditions, State Institution «Institute for the Health of Children and Adolescents of the National Academy of Medical Sciences of Ukraine», MD, Professor of pediatric department № 2, V. N. Karazin Kharkiv National University
  • Viktoria Nikonova senior researcher, Department of rheumatology and comorbid conditions, SI «Institute for Children and Adolescents Health Care of the NAMS of Ukraine»
  • Natalya Shevchenko MD, PhD, Professor, head of pediatric department № 2, V. N. Karazin Kharkiv National University, MD, leading research worker of Department of rheumatology and comorbid conditions State Institution «Institute for the Health of Children and Adolescents of the National Academy of Medical Sciences of Ukraine»
  • Tetiana Holovko PhD, associate professor, department of pediatric № 2, V. N. Karazin Kharkiv National University
  • Irina Bessonova senior researcher, department of rheumatology and comorbid conditions, SU «Institute for Children and Adolescents Health Care at the National Academy of Medical Sciences of Ukraine», Associate Professor at the Department of Pediatrics V. N. Karazin Kharkiv National University https://orcid.org/0000-0002-8473-8365
Keywords: juvenile idiopathic arthritis, lipid spectrum, therapy, children

Abstract

Summary. In patients with rheumatoid arthritis, the risk of cardiovascular disease associated with atherosclerosis, is significantly increased compared to the general population. Studies of a cohort of children and young adults indicated that the atherosclerotic process usually begins long before its clinical manifestation, and the degree of vascular changes is associated with both the number of risk factors and their severity. The use of basic drugs in rheumatic patients contributed to a decrease in cardiovascular mortality, mainly due to the elimination of the activity of the process, which itself is an inducer of the onset and progression of atherosclerosis. The aim of the study was to establish the nature of changes in the blood lipid spectrum in children with juvenile idiopathic arthritis under the influence of basic therapy. Object and methods. We examined 85 children (8–18 years old) with juvenile idiopathic arthritis and oligo- (61.5 %) and polyarticular (38.5 %) variants of the disease, twice, with an interval of one year. The parameters of the blood lipid spectrum were determined by the level of: total cholesterol, triglycerides, high density lipoproteins, atherogenic coefficient by the enzymatic method on an automatic biochemical analyzer-photometer A25, low lipoproteins  and very low density cholesterol by calculation method. Research results. Analysis of the lipid profile in the group as a whole showed that patients with juvenile idiopathic arthritis had significantly higher total cholesterol values (p < 0.05), a tendency to an increase in the level of triglycerides, low lipoproteins and very low density cholesterol, which led to an increase in the atherogenic coefficient level. When analyzing the lipid spectrum of blood after a year, a tendency towards a decrease in the level of atherogenic and an increase in antiatherogenic fractions of the lipid spectrum with normalization of atherogenic coefficient was noted. In the group of patients receiving monotherapy with methotrexate, no significant changes in the lipid spectrum of blood were observed after one year. Against the background of combined basic therapy, the blood lipid spectrum normalizes, namely, a decrease in total cholesterol, an increase in high density lipoproteins of cholesterol, a decrease in the level of low density cholesterol (p < 0.05), triglycerides and very low density cholesterol and, as a consequence, significant decrease in atherogenic coefficient (p < 0.01). Conclusions. The dynamics of changes in blood lipid spectrum indicators in children with juvenile idiopathic arthritis confirms the need to use combined basic therapy not only to control the activity of main pathological process, but also to prevent the development of atherogenic dyslipoproteinemias.

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Author Biographies

Ludmila Bogmat, MD, PhD, Professor, Head of the Department of rheumatology and comorbid conditions, State Institution «Institute for the Health of Children and Adolescents of the National Academy of Medical Sciences of Ukraine», MD, Professor of pediatric department № 2, V. N. Karazin Kharkiv National University

Yubileiny avenue, 52 A, Kharkіv, Ukraine, 61118

Svobody Sq., 4, Kharkіv, Ukraine, 61022

 

Viktoria Nikonova, senior researcher, Department of rheumatology and comorbid conditions, SI «Institute for Children and Adolescents Health Care of the NAMS of Ukraine»

Yubileiny avenue, 52 A, Kharkіv, Ukraine, 61118

Natalya Shevchenko, MD, PhD, Professor, head of pediatric department № 2, V. N. Karazin Kharkiv National University, MD, leading research worker of Department of rheumatology and comorbid conditions State Institution «Institute for the Health of Children and Adolescents of the National Academy of Medical Sciences of Ukraine»

Svobody Sq., 4, Kharkіv, Ukraine, 61022

Yubileiny avenue, 52 A, Kharkіv, Ukraine, 61118

Tetiana Holovko, PhD, associate professor, department of pediatric № 2, V. N. Karazin Kharkiv National University

Svobody Sq., 4, Kharkiv, Ukraine, 61022

Irina Bessonova , senior researcher, department of rheumatology and comorbid conditions, SU «Institute for Children and Adolescents Health Care at the National Academy of Medical Sciences of Ukraine», Associate Professor at the Department of Pediatrics V. N. Karazin Kharkiv National University

Health Care at the National Academy of Medical Sciences of Ukraine», Yubileiny

Svobody Sq., 4, Kharkiv, Ukraine, 61022

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Published
2021-06-30
How to Cite
Bogmat, L., Nikonova, V., Shevchenko, N., Holovko, T., & Bessonova , I. (2021). Dynamics of blood lipid spectrum indicators in children with juvenile idiopathic arthritis taking into account basic therapy. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine&quot;, (42). https://doi.org/10.26565/2313-6693-2021-42-02