Grönlund M-M, Kaartoaho M, Putto-Laurila A, Laitinen K
Department of Paediatrics, Turku University Hospital , Turku , Finland.
Scand J Rheumatol. 2014;43(6):488-92. doi: 10.3109/03009742.2014.918171. Epub 2014 Sep 2.
The aim of this study was to assess the effect of juvenile idiopathic arthritis (JIA), its subtypes and disease activity on anthropometric measurements, body composition, and nutritional parameters.
A cross-sectional cohort of 40 JIA patients, aged 3-10 years, was compared with 40 healthy children matched for age and gender. Concentrations of nutritional and inflammatory biomarkers in the blood, anthropometric measures, and clinical status were recorded and the parents filled in a 7-day food diary and completed the Childhood Health Assessment Questionnaire (CHAQ).
The JIA patients had low disease activity: 60% had inactive disease, the median CHAQ score was 0.125, and the median erythrocyte sedimentation rate (ESR) was 6 mm/h. Significantly higher values for central and peripheral adiposity were found in JIA patients compared with in healthy controls [waist circumference mean (SD) 55.9 (4.9) vs. 53.4 (3.7) cm, p < 0.0001, and biceps skinfold thickness 6.2 (2.3) vs. 5.3 (1.7) cm, p = 0.035, respectively], and obesity/overweight was more common (30% vs. 12.5%, p = 0.056, respectively) despite no differences in weight-for-height. The intake of energy (kcal/day) was significantly higher in the JIA patients (p = 0.036). The nutritional biomarkers were comparable in both groups. The JIA subtype and disease activity did not affect body composition, energy intake, or the nutritional biomarkers.
Even JIA patients with low disease activity have a higher central and peripheral adiposity and a higher energy intake than their healthy peers. Neither disease subtype nor disease activity had any association with changes in body composition.
本研究旨在评估幼年特发性关节炎(JIA)及其亚型和疾病活动度对人体测量指标、身体成分和营养参数的影响。
选取40例年龄在3至10岁的JIA患者组成横断面队列,与40例年龄和性别相匹配的健康儿童进行比较。记录血液中营养和炎症生物标志物的浓度、人体测量指标及临床状况,同时家长填写7天食物日记并完成儿童健康评估问卷(CHAQ)。
JIA患者疾病活动度较低:60%的患者疾病处于非活动期,CHAQ评分中位数为0.125,红细胞沉降率(ESR)中位数为6mm/h。与健康对照组相比,JIA患者的中心性和外周性肥胖值显著更高[腰围均值(标准差)55.9(4.9)cm对53.4(3.7)cm,p<0.0001;肱二头肌皮褶厚度6.2(2.3)cm对5.3(1.7)cm,p = 0.035],尽管身高体重比无差异,但肥胖/超重更为常见(分别为30%对12.5%,p = 0.056)。JIA患者的能量摄入量(千卡/天)显著更高(p = 0.036)。两组的营养生物标志物具有可比性。JIA亚型和疾病活动度并未影响身体成分、能量摄入或营养生物标志物。
即使是疾病活动度较低的JIA患者,其中心性和外周性肥胖程度及能量摄入量也高于健康同龄人。疾病亚型和疾病活动度均与身体成分变化无关联。