Abstract 18185: Increased Intima-Media Thickness in Children With Polyarticular Juvenile Idiopathic Arthritis
Introduction: In adults, inflammatory arthritides are associated with increased cardiovascular disease and intermediate cardiovascular risk phenotypes. There are less data on cardiovascular risk in juvenile idiopathic arthritis (JIA), the most common pediatric arthritis. We investigated carotid and aortic intima-media thickness (IMT) in children with a well-defined JIA disease phenotype.
Hypothesis: In comparison to healthy controls, children with polyarticular JIA will have adverse intermediate CV risk phenotypes, with increased IMT and pulse-wave velocity (PWV).
Methods: Forty children with polyarticular JIA and disease duration of ≥ 6 months (mean 12.9 ± 3.34 years, 65% female) and 44 healthy controls (12.5 ± 3.3 years, 55% female) were recruited. Carotid and aortic images were accrued by B-mode ultrasonography and IMT measured by semi-automated edge-detection software, using standardized imaging and analysis protocols. Blood pressure (BP), carotid to femoral PWV, and pulse wave analysis (PWA) were measured using oscillometric and tonometry based methods. Clinical and demographic data, anthropometry, fasting lipids, glucose, and high sensitivity C-reactive protein (hsCRP) were obtained. Multivariate linear regression models were used to analyze cardiovascular parameters, adjusting for age, sex, body mass index, and BP.
Results: Children with JIA had increased mean and maximum aortic IMT compared to controls (0.55 vs. 0.51mm, p=0.021; and 0.61 vs. 0.60, p=0.012, respectively); findings were unchanged in multivariable analysis. There was some evidence of increased carotid IMT (0.52 vs. 0.5mm, p= 0.077). There were no differences in BP, PWV, PWA, hsCRP, fasting glucose, or standard lipid profile between JIA patients and controls.
Conclusions: This is the first study of aortic IMT in patients with JIA. In patients with polyarticular disease both aortic and carotid IMT were increased, indicative of adverse cardiovascular risk. In keeping with limited data from high risk children, aortic IMT may be a more discriminatory marker of early cardiovascular risk than carotid IMT. Longitudinal studies that incorporate aortic IMT are warranted.
Author Disclosures: G. Goldsmith: None. J.E. Munro: None. D. Zannino: None. J.D. Akikusa: None. R.C. Allen: None. J.A. Ellis: None. K.Y. Chen: None. J. Koleff: None. M. Cheung: None. D.P. Burgner: None.
- © 2016 by American Heart Association, Inc.