Dyslipidemia in patients with juvenile dermatomyositis / Dislipidemia em pacientes com dermatomiosite juvenil

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

04/09/2012

RESUMO

OBJECTIVE: To evaluate the presence of dyslipidemia in JDM and its possible risk factors. METHODS: 25 JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycemia, insulin, antibodies and muscle enzymes. The following JDM scores were assessed: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) and Myositis Intention to Treat Activity Index (MYTAX). RESULTS: Abnormal lipid profile was found in nine patients (36%) and four controls (16%) (p=0.196). JDM patients demonstrated significant higher levels of triglycerides (TG) [80 (31- 340) vs. 61 (19-182) mg/dL, p=0.011] and higher frequency of abnormal levels of high density lipoproteins (HDL) (28 vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidemia demonstrated significant lower median HDL levels compared to those without this condition [29 (0-49) vs. 50 (39-72) mg/dL, p=0.0005] and also had significant higher TG levels [128 (31- 340) vs. 69 (46-138) mg/dL, p=0.011]. Higher frequency of low HDL levels (77% vs. 0%, p=0.0001), and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) were observed in JDM patients with dyslipidemia. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid profile. JDM with dyslipidemia had higher ESR (26 vs 14.5mm/1sthour, p=0.006), CRP (2.1 vs 0.4mg/dL, p=0.006), DAS (6 vs. 2, p=0.008), MYOACT (0.13 vs. 0.01, p=0.012), MYTAX (0.06 vs. 0, p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidemia. Positive correlations were detected between TG levels and CRP (r=0.697, p=0.001), DAS (r=0.610, p=0.001), MYOACT (r=0.661, p=0.001), MYTAX (r=0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body mass index, body composition, lipodystrophy, anti-LPL antibodies, and treatment (current and cumulative doses of prednisone, methotrexate and hydroxichloroquine) (p>0.05), except by higher frequency of cyclosporine use in patients with dyslipidemia (33 vs. 0%, p=0.03). CONCLUSIONS: Dyslipidemia in JDM patients was characterized by increased levels of TG and low levels of HDL, and disease activity and cyclosporine use were the mainly factors associated to these metabolic abnormalities

ASSUNTO(S)

adolescent adolescente auto-antibodies auto-anticorpos child ciclosporina criança cyclosporine dermatomiosite dermatomyositis dislipidemia dyslipidemias

ACESSO AO ARTIGO

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