Association of disease activity and anti-rheumatic treatment in juvenile idiopathic arthritis with serum lipid profiles: A prospective study

Objectives: Patients with juvenile idiopathic arthritis (JIA) have abnormal serum lipid profiles. This study aimed to explore the association of disease activity and anti-rheumatic treatment with serum lipid profiles in a JIA cohort. Methods: Fifty-eight patients newly diagnosed with JIA who had not been treated with corticosteroids or disease-modifying anti-rheumatic drugs were enrolled. We measured their serum lipid profiles at baseline and 18 months later, and determined whether there were differences in lipid levels and atherogenic indices between patients who were in inactive disease and those who were not. For a case-control comparison at 18 months, control subjects from a population-based study cohort (NAHSIT study) were selected. Results: Thirty-one of the 58 patients achieved inactive disease status after 18-month treatment. In these patients, high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) levels increased significantly (p = 0.001 and p = 0.044); whereas the ratios of low-density lipoprotein cholesterol (LDL-C) to HDL-C and TC to HDL-C decreased with borderline significance (p = 0.066 and p = 0.080). The overall changes in HDL-C levels, LDL-C/HDL-C and TC/HDL-C ratio between baseline and 18 months were correlated with those in C-reactive protein levels (p = 0.005, p = 0.001, and p = 0.002, respectively). There were also significant differences among inactive, active and control subjects in HDL-C and TC levels (p = 0.021 and p = 0.013) but not in LDL, LDL-C/HDL-C, TC/HDL-C ratio, and triglyceride levels. Conclusions: Abnormal lipid levels and atherogenic indices were associated with disease activity in JIA and improved substantially following effective anti-rheumatic treatment. This improvement may reduce the risk of cardiovascular disease in JIA.