Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
1st Department of Paediatrics, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Rheumatology (Oxford). 2023 Nov 2;62(11):3526-3533. doi: 10.1093/rheumatology/kead272.
JIA is the most common type of arthritis in children and adolescents, causing joint damage, chronic pain and disability. Deconditioning is also prevalent in patients with JIA due to both inactivity and the disease progression, resulting in reduced cardiorespiratory fitness (CRF). We aimed to evaluate CRF of patients with JIA compared with healthy controls.
This is a systematic review and meta-analysis of studies using cardiopulmonary exercise testing (CPET) to examine differences in determinants of CRF between patients with JIA vs healthy controls. The primary outcome was peak oxygen uptake (VO2peak). Literature search involved PubMed, Web of Science and Scopus databases, manual search of article references and grey literature. Quality assessment was undertaken with Newcastle-Ottawa Scale.
From 480 literature records initially retrieved, eight studies (538 participants) were included in final meta-analysis. VO2peak was significantly lower in patients with JIA compared with controls [weighted mean difference (WMD): -5.95 ml/kg/min (95% CI -9.26, -2.65)]. Exercise duration and VO2peak (% predicted) were found to be significantly impaired in patients with JIA compared with controls [standardized mean difference: -0.67 (95% CI -1.04, -0.29) and WMD: -11.31% (95% CI -20.09, -2.53), respectively], while no significant differences were found in maximum heart rate.
VO2peak and other CPET variables were lower in patients with JIA compared with controls, indicating reduced CRF in the former. Overall, exercise programs for patients with JIA should be promoted as part of their treatment to improve physical fitness and reduce muscle atrophy.
CRD42022380833.
幼年特发性关节炎（JIA）是儿童和青少年中最常见的关节炎类型，可导致关节损伤、慢性疼痛和残疾。由于缺乏活动和疾病进展，JIA 患者也普遍存在身体不适，导致心肺适能（CRF）下降。我们旨在评估 JIA 患者与健康对照组的 CRF。
这是一项使用心肺运动测试（CPET）评估 JIA 患者与健康对照组之间 CRF 决定因素差异的系统评价和荟萃分析。主要结局为峰值摄氧量（VO2peak）。文献检索涉及 PubMed、Web of Science 和 Scopus 数据库、文章参考文献的手动搜索和灰色文献。使用纽卡斯尔-渥太华量表进行质量评估。
从最初检索到的 480 篇文献中，有 8 项研究（538 名参与者）纳入最终的荟萃分析。与对照组相比，JIA 患者的 VO2peak 明显较低[加权均数差（WMD）：-5.95ml/kg/min（95%CI-9.26，-2.65）]。与对照组相比，JIA 患者的运动时间和 VO2peak（%预测值）明显受损[标准化均数差：-0.67（95%CI-1.04，-0.29）和 WMD：-11.31%（95%CI-20.09，-2.53）]，而最大心率无显著差异。
与对照组相比，JIA 患者的 VO2peak 和其他 CPET 变量较低，表明前者的 CRF 降低。总体而言，应将 JIA 患者的运动计划作为其治疗的一部分加以推广，以提高他们的身体适应性并减少肌肉萎缩。
PROSPERO 注册号：CRD42022380833。
