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Physical fitness in adolescent patients with familial Mediterranean fever
Inès Elhani1,2,3,4, Pascal Heydacker5,6, Anne-Sophie Tavernier5,6
1Department of General Pediatrics, Versailles Hospital, Versailles, France. Ines.elhani@aphp.fr.
Introduction:
Familial Mediterranean fever (FMF) is the most frequent monogenic auto-inflammatory disease worldwide responsible for episodes of fever, serositis and musculoskeletal symptoms. Inflammatory attacks are responsible for sedentary behavior and FMF patients may be at increased cardiovascular risk. Cardiorespiratory Fitness (CRF) and physical capacities during adolescence are associated with cardiovascular mortality in adulthood. In this study, we aimed to describe the physical fitness of FMF adolescents.
Methods:
A monocentric retrospective study at the Versailles Hospital between January 2020 and June 2023. All FMF patients over 14-year-old who had completed a routine physical test were included. Clinical and physical data including results of the 6-minute walking test, timed unipedal stance test, Ruffier-Dickson index, 30-seconds chair-stand test and sit-and-reach test were extracted from medical records. Results were compared with previously published normative reference values and criterion-referenced standards for healthy subjects.
Results:
Eighteen FMF patients (12 girls, 6 boys) were included. The median age was 16 years old [14-18]. Clinical history included joint symptoms (n = 11), chest pleuritis (n = 8), and leg pain (n = 11). Estimated VO2max was below the recommended thresholds in 13 patients, which predicts cardiovascular risk. Cardiovascular adaptation was poor in 11 patients. Low VO2max was associated with CRP > 5 mg/l on test day and history of joint symptoms.
Conclusion:
FMF patients displayed altered physical capacities compared to normative values of healthy subjects. History of musculoskeletal pain, systemic inflammation and sedentary behavior may participate in impaired physical abilities and promote cardiovascular diseases in adulthood. Specific exercise programs could benefit patients for disease control and cardiovascular risk reduction.
Insights
Adolescents with Familial Mediterranean Fever (FMF) show reduced physical fitness, potentially increasing cardiovascular risk. Early interventions with exercise programs may improve health outcomes for FMF patients.
Area of Science:
- Pediatrics
- Rheumatology
- Cardiology
Background:
- Familial Mediterranean Fever (FMF) is a prevalent monogenic auto-inflammatory disorder causing recurrent fever, serositis, and musculoskeletal symptoms.
- Chronic inflammation and associated sedentary behavior in FMF patients may elevate cardiovascular disease (CVD) risk.
- Adolescent cardiorespiratory fitness (CRF) is a critical predictor of adult cardiovascular mortality.
Purpose of the Study:
- To assess and characterize the physical fitness levels of adolescents diagnosed with FMF.
- To identify potential correlations between FMF clinical manifestations and physical capacity deficits.
Main Methods:
- A retrospective monocentric study included 18 FMF patients (age 14-18) who underwent routine physical assessments.
- Evaluated physical capacities included the 6-minute walking test, unipedal stance, Ruffier-Dickson index, chair-stand test, and sit-and-reach test.
- Results were benchmarked against normative data and criterion-referenced standards for healthy adolescents.
Main Results:
- FMF adolescents exhibited significantly impaired physical capacities compared to healthy peers.
- Low estimated VO2max, indicative of cardiovascular risk, was observed in 13 patients.
- Poor cardiovascular adaptation was noted in 11 patients, with low VO2max linked to elevated CRP and a history of joint symptoms.
Conclusions:
- FMF adolescents demonstrate reduced physical fitness, suggesting a potential for long-term cardiovascular complications.
- Musculoskeletal pain, systemic inflammation, and inactivity likely contribute to diminished physical abilities in FMF.
- Tailored exercise interventions are recommended to manage FMF, improve physical capacity, and mitigate cardiovascular risk.
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