Juvenile idiopathic arthritis patients with low inflammatory activity have increased adiposity
M-M Grönlund1, M Kaartoaho, A Putto-Laurila
1Department of Paediatrics, Turku University Hospital , Turku , Finland.
Insights
Juvenile idiopathic arthritis (JIA) patients, even with inactive disease, show increased adiposity and higher energy intake compared to healthy children. Disease subtype and activity levels do not influence body composition or nutritional biomarkers.
Area of Science:
- Pediatric Rheumatology
- Pediatric Endocrinology
- Nutritional Science
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition affecting children.
- Understanding the impact of JIA on growth, body composition, and nutrition is crucial for management.
- Previous research has not fully elucidated these effects, particularly in low disease activity states.
Purpose of the Study:
- To evaluate the anthropometric measurements, body composition, and nutritional status in children with JIA.
- To compare these parameters between JIA patients and healthy controls.
- To investigate the influence of JIA subtypes and disease activity on these health indicators.
Main Methods:
- A cross-sectional study involving 40 children with JIA (aged 3-10 years) and 40 age- and gender-matched healthy controls.
- Assessment included anthropometric measurements, body composition analysis, blood biomarkers (nutritional and inflammatory), and a 7-day food diary.
- The Childhood Health Assessment Questionnaire (CHAQ) was used to assess disease activity.
Main Results:
- JIA patients exhibited significantly higher central and peripheral adiposity (e.g., waist circumference, biceps skinfold) compared to controls.
- Obesity/overweight prevalence was higher in JIA patients (30% vs. 12.5%).
- JIA patients had a significantly higher daily energy intake, though nutritional biomarkers were comparable. Disease activity and subtype did not correlate with body composition or energy intake.
Conclusions:
- Children with JIA, even those with low disease activity, demonstrate increased adiposity and higher energy consumption than healthy peers.
- JIA disease subtype and current disease activity do not appear to be associated with altered body composition or nutritional status.
- These findings highlight the importance of monitoring body composition and nutritional intake in pediatric patients with JIA, irrespective of disease activity levels.
Objectives:
The aim of this study was to assess the effect of juvenile idiopathic arthritis (JIA), its subtypes and disease activity on anthropometric measurements, body composition, and nutritional parameters.
Method:
A cross-sectional cohort of 40 JIA patients, aged 3-10 years, was compared with 40 healthy children matched for age and gender. Concentrations of nutritional and inflammatory biomarkers in the blood, anthropometric measures, and clinical status were recorded and the parents filled in a 7-day food diary and completed the Childhood Health Assessment Questionnaire (CHAQ).
Results:
The JIA patients had low disease activity: 60% had inactive disease, the median CHAQ score was 0.125, and the median erythrocyte sedimentation rate (ESR) was 6 mm/h. Significantly higher values for central and peripheral adiposity were found in JIA patients compared with in healthy controls [waist circumference mean (SD) 55.9 (4.9) vs. 53.4 (3.7) cm, p < 0.0001, and biceps skinfold thickness 6.2 (2.3) vs. 5.3 (1.7) cm, p = 0.035, respectively], and obesity/overweight was more common (30% vs. 12.5%, p = 0.056, respectively) despite no differences in weight-for-height. The intake of energy (kcal/day) was significantly higher in the JIA patients (p = 0.036). The nutritional biomarkers were comparable in both groups. The JIA subtype and disease activity did not affect body composition, energy intake, or the nutritional biomarkers.
Conclusions:
Even JIA patients with low disease activity have a higher central and peripheral adiposity and a higher energy intake than their healthy peers. Neither disease subtype nor disease activity had any association with changes in body composition.
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