Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Eur J Pediatr. 2024 Feb;183(2):809-813. doi: 10.1007/s00431-023-05348-8. Epub 2023 Nov 28.
Despite the well-known role of obesity as risk factor for Juvenile Idiopathic Arthritis (JIA) severity, emerging but limited evidence suggested a similar role for underweight. We investigated the role of body mass index (BMI) across its full spectrum in a cohort of children with JIA.We retrospectively studied 113 children with JIA classified according to the International League of Association for Rheumatology (ILAR) criteria attending our Rheumatology Clinic. The patients underwent a comprehensive evaluation including both clinical and biochemical assessments. According to BMI Z-score, the cohort was divided into five groups as underweight, normal weight, overweight (OW), obesity (OB), and severe OB. Disease activity was calculated by Juvenile Arthritis Disease Activity Score 10 (JADAS-10) joint reduced count and relapses were defined according to Wallace criteria.The mean age of the cohort was 7.43 ± 4.03 years. The prevalence of underweight, normal weight, OW, OB, and severe OB was 7.2%, 54.1%, 10.8%, 17.1%, and 10.8%, respectively. Significant higher ferritin levels and erythrocyte sedimentation rate values were found in patients with severe OB and underweight compared to subjects belonging to normal weight, OW, and OB groups. A greater JADAS-10 score was observed in underweight patients and in those with severe OB than other groups. The relapse rate was higher in patients with severe OB and underweight compared to other groups. Conclusions: Both underweight and OB might negatively affect JIA course. Weight control is fundamental in children with JIA to avoid a more unfavourable course of the disease. What is Known: • Obesity represents a well-known risk factor for JIA severity. • The role of underweight in children with JIA is still poorly explored. What is New: • As observed in children with obesity, underweight young patients with JIA seem to experience a more severe JIA course. • Healthy lifestyle promotion in children with JIA is a crucial step in the management of the disease.
尽管肥胖是青少年特发性关节炎 (JIA) 严重程度的已知危险因素，但新兴的但有限的证据表明，体重过轻也有类似的作用。我们研究了 JIA 患儿全谱 BMI （身体质量指数）的作用。我们回顾性研究了 113 名根据国际风湿病联盟 (ILAR) 标准分类的 JIA 患儿。这些患者接受了全面评估，包括临床和生化评估。根据 BMI Z 分数，该队列分为五组：体重不足、正常体重、超重 (OW)、肥胖 (OB) 和严重肥胖 (OB)。疾病活动度通过青少年关节炎疾病活动评分 10 项 (JADAS-10) 关节减少计数计算，根据 Wallace 标准定义复发。该队列的平均年龄为 7.43±4.03 岁。体重不足、正常体重、OW、OB 和严重 OB 的患病率分别为 7.2%、54.1%、10.8%、17.1%和 10.8%。与属于正常体重、OW 和 OB 组的患者相比，严重 OB 和体重不足的患者铁蛋白水平和红细胞沉降率值显著更高。与其他组相比，体重不足的患者和严重 OB 的 JADAS-10 评分更高。与其他组相比，严重 OB 和体重不足的患者复发率更高。结论：体重不足和肥胖均可能对 JIA 病程产生负面影响。控制体重是 JIA 患儿的基础，以避免疾病病程更差。已知：肥胖是 JIA 严重程度的已知危险因素。体重不足在 JIA 患儿中的作用仍未得到充分探索。新发现：与肥胖患儿一样，体重不足的 JIA 年轻患者似乎经历了更严重的 JIA 病程。在 JIA 患儿中促进健康的生活方式是疾病管理的关键步骤。
