Schenck S, Niewerth M, Sengler C, Trauzeddel R, Thon A, Minden K, Klotsche J
German Rheumatism Research Centre Berlin, a Leibniz Institute , Berlin , Germany.
Scand J Rheumatol. 2015;44(4):288-95. doi: 10.3109/03009742.2014.999351. Epub 2015 Mar 6.
To assess the prevalence of overweight in patients with juvenile idiopathic arthritis (JIA) between 2003 and 2012 and to determine correlates of overweight relevant to the change in the overweight rate.
Annual overweight prevalence was determined in the National Paediatric Rheumatological Database (NPRD) between 2003 and 2012. The prevalence of overweight in JIA was compared to representative data from Germany in 2005.
The median age of JIA patients was 11.5 years and the mean disease duration 4 years. Almost 50% of JIA patients had persistent oligoarthritis, followed by rheumatoid factor (RF)-negative polyarthritis (14%). The overweight prevalence decreased significantly from 14.2% in 2003 to 8.3% in 2012 [odds ratio (OR) 0.92, 95% confidence interval (CI) 0.89-0.95]. Higher levels of physical activity and less frequent treatment with high-dose glucocorticoids (GCs) were associated with decreasing overweight rates. Systemic JIA had the highest decrease in the overweight rate over time. Patients with JIA had an overweight rate comparable to that of children and adolescents in the general population. However, systemic JIA and enthesitis-related arthritis were more likely to be associated with overweight. The use of high-dose GCs, lower functional limitations, and a lower level (or lack) of participation in school sports were significant predictors of overweight in multivariable analyses.
The prevalence of overweight in JIA was comparable to the general population and decreased significantly over time. The decrease was associated with higher functional ability and JIA patients should be encouraged to be more physically active. The role of an elevated body mass index (BMI) in the long-term outcome of JIA needs to be addressed in future studies.
评估2003年至2012年间青少年特发性关节炎（JIA）患者超重的患病率，并确定与超重率变化相关的超重影响因素。
在2003年至2012年期间，通过国家儿科风湿病数据库（NPRD）确定年度超重患病率。将JIA患者的超重患病率与2005年德国的代表性数据进行比较。
JIA患者的中位年龄为11.5岁，平均病程为4年。近50%的JIA患者患有持续性寡关节炎，其次是类风湿因子（RF）阴性多关节炎（14%）。超重患病率从2003年的14.2%显著下降至2012年的8.3%[优势比（OR）0.92，95%置信区间（CI）0.89 - 0.95]。较高的身体活动水平和较少使用高剂量糖皮质激素（GCs）与超重率下降相关。随着时间推移，全身型JIA的超重率下降幅度最大。JIA患者的超重率与普通人群中的儿童和青少年相当。然而，全身型JIA和附着点炎相关关节炎更可能与超重有关。在多变量分析中，使用高剂量GCs、功能受限程度较低以及参与学校体育活动的水平较低（或缺乏）是超重的显著预测因素。
JIA患者的超重患病率与普通人群相当，且随时间显著下降。这种下降与较高的功能能力相关，应鼓励JIA患者增加身体活动。未来研究需要探讨体重指数（BMI）升高在JIA长期预后中的作用。
