CARDIOVASCULAR RISK FACTORS IN JUVENILE IDIOPATHIC ARTHRITIS

This systematic bibliographical review has a purpose of summarizing the current data on the presence of main cardiovascular risk factors, including the metabolic syndrome (MS) components, in children and adolescents with juvenile idiopathic arthritis (JIA). PubMed was searched for the keywords as follows: “juvenile arthritis,” “rheumatoid arthritis” and “cardiovascular risk factors,” “metabolic syndrome,” “dyslipidemia,” “arterial hypertension,” “obesity.” Thus, 90 original studies, meta-analyses, case series and clinical guidelines were included for analysis. The Authors’ own publications previously published on the topic were also in the list. The connection between the cardiac disorders and the MS in childhood, in particular, with the development of cardiovascular complications in adulthood is shown. The diagnostic criteria for MS and the prevalence of the complete MS signs (obesity, arterial hypertension, dyslipidemia, disorders of carbohydrate metabolism and insulin resistance) both in the general population and among adults and children with chronic inflammatory joint diseases are discussed. In addition to the traditional ones, the specific risk factors for cardiovascular diseases in patients with JIA are also considered, such as: rheumatoid cachexia, high inflammatory activity of the disease, side effects of antirheumatic drugs etc. The pathogenesis of metabolic disorders in JIA and the tactics for managing patients with an emphasis on non-drug methods of treatment are discussed as well.