Yıldız Çisem, Küçükali Batuhan, Kutlar Merve, Belder Nuran, Karaçayır Nihal, Acun Büşra, Şenol Pelin Esmeray, Yayla Emine Nur Sunar, Yıldırım Deniz Gezgin, Bakkaloğlu Sevcan A
Department of Pediatric Rheumatology, Gazi University Faculty of Medicine, Besevler, Ankara, 06560, Turkey.
Department of Pediatric Rheumatology, Mersin City Hospital, Mersin, Turkey.
Eur J Pediatr. 2025 Mar 19;184(4):259. doi: 10.1007/s00431-025-06084-x.
Juvenile idiopathic arthritis (JIA) presents with diverse phenotypes and can lead to significant morbidity. Obesity, affecting 5 to 23% of JIA patients, may exacerbate disease activity and complicate management. This study evaluates the impact of body mass index (BMI) on disease activity and the influence of joint involvement on BMI in JIA patients. Between January 2012 and June 2024, 225 JIA patients were reviewed, with 173 ultimately included based on specific inclusion and exclusion criteria. Treatments followed the American College of Rheumatology (ACR) recommendations. Data on demographics, BMI, JADAS-27 scores, joint involvement, and laboratory parameters were analyzed, with statistical significance defined as p < 0.05. Among 173 JIA patients, significant increases in weight and height SDS were observed (p < 0.05). Obese patients at baseline had higher JADAS-27 scores at 6 months (p < 0.05). A positive correlation was found between initial JADAS-27 and final BMI SDS (r = 0.170, p < 0.05). Patients with hip involvement had lower BMI at diagnosis and at the first-year follow-up (p < 0.0001, p = 0.049), while knee involvement was linked to lower height SDS at the second year (p = 0.041).
Our study revealed that baseline obesity is a significant risk factor for poorer disease control at the 6-month follow-up in JIA patients. We also observed that effective treatment led to improvements in growth, particularly in patients with hip involvement, who initially had lower BMI values. These findings underscore the importance of monitoring BMI in JIA patients to optimize disease management and long-term outcomes.
• Overweight and obesity are prevalent in children with JIA, with reported rates ranging from 5 to 23% in various studies. • The relationship between BMI and disease activity in JIA remains controversial, with previous studies reporting conflicting results on whether BMI impacts disease remission or activity.
• Baseline obesity in juvenile idiopathic arthritis (JIA) patients is associated with worse disease activity during follow-up, particularly evident at the 6-month visit. • Patients with hip involvement had significantly lower BMI values, indicating a potential correlation with more severe disease. • Improved linear growth was observed in JIA patients during follow-up, indicating that effective treatment positively impacts growth despite the chronic nature of the disease.
幼年特发性关节炎（JIA）具有多种表型，可导致严重的发病情况。肥胖影响5%至23%的JIA患者，可能会加剧疾病活动并使管理复杂化。本研究评估了体重指数（BMI）对疾病活动的影响以及关节受累对JIA患者BMI的影响。在2012年1月至2024年6月期间，对225例JIA患者进行了评估，最终根据特定的纳入和排除标准纳入了173例。治疗遵循美国风湿病学会（ACR）的建议。分析了人口统计学、BMI、JADAS - 27评分、关节受累情况和实验室参数的数据，统计学显著性定义为p < 0.05。在173例JIA患者中，观察到体重和身高标准差得分显著增加（p < 0.05）。基线时肥胖的患者在6个月时JADAS - 27评分更高（p < 0.05）。发现初始JADAS - 27与最终BMI标准差得分之间存在正相关（r = 0.170，p < 0.05）。髋关节受累的患者在诊断时和第一年随访时BMI较低（p < 0.0001，p = 0.049），而膝关节受累与第二年身高标准差得分较低有关（p = 0.041）。
我们的研究表明，基线肥胖是JIA患者6个月随访时疾病控制较差的一个重要危险因素。我们还观察到有效治疗导致生长改善，特别是在最初BMI值较低的髋关节受累患者中。这些发现强调了在JIA患者中监测BMI以优化疾病管理和长期结局的重要性。
• JIA患儿中超重和肥胖较为普遍，不同研究报告的发生率在5%至23%之间。• JIA中BMI与疾病活动之间的关系仍存在争议，先前的研究在BMI是否影响疾病缓解或活动方面报告了相互矛盾的结果。
• 幼年特发性关节炎（JIA）患者的基线肥胖与随访期间更差的疾病活动相关，在6个月就诊时尤为明显。• 髋关节受累的患者BMI值显著较低，表明与更严重的疾病可能存在关联。• 在随访期间观察到JIA患者线性生长改善，表明尽管疾病具有慢性性质，但有效治疗对生长有积极影响。
