有青少年皮肌炎病史的成人的临床状态和心血管风险特征

"Objective:
A pilot study of adults who had onset of juvenile dermatomyositis (JDM) in childhood, before current therapeutic approaches, to characterize JDM symptoms and subclinical cardiovascular disease.
Study Design:
Eight adults who had JDM assessed for disease activity and 8 healthy adults (cardiovascular disease controls) were tested for carotid intima media thickness and brachial arterial reactivity. Adults who had JDM and 16 age-, sex-, and body mass index-matched healthy metabolic controls were evaluated for body composition, blood pressure, fasting glucose, lipids, insulin resistance, leptin, adiponectin, proinflammatory oxidized high-density lipoprotein (HDL), and nail-fold capillary end row loops.
Results:
Adults with a history of JDM, median age 38years (24-44years) enrolled a median 29years (9-38years) after disease onset, had elevated disease activity scores, skin (7/8), muscle (4/8), and creatine phosphokinase (2/8). Compared with cardiovascular disease controls, adults who had JDM were younger, had lower body mass index and HDL cholesterol (P=.002), and increased intima media thickness (P=.015) and their brachial arterial reactivity suggested impairment of endothelial cell function. Compared with metabolic controls, adults who had JDM had higher systolic and diastolic blood pressure, P=.048, P=.002, respectively; lower adiponectin (P=.03); less upper arm fat (P=.008); HDL associated with end row loops loss (r=−0.838, P=.009); and increased proinflammatory oxidized HDL (P=.0037).
Conclusion:
Adults who had JDM, 29years after disease onset, had progressive disease and increased cardiovascular risk factors."