Clinical status and cardiovascular risk profile of adults with a history of juvenile dermatomyositis

Micah J. Eimer, Wendy J. Brickman, Roopa Seshadri, Rosalind Ramsey-Goldman, David D. McPherson, Beverly Smulevitz, Neil J. Stone, Lauren M. Pachman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

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 38 years (24-44 years) enrolled a median 29 years (9-38 years) 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, 29 years after disease onset, had progressive disease and increased cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)795-801
Number of pages7
JournalJournal of Pediatrics
Volume159
Issue number5
DOIs
StatePublished - Nov 2011

Keywords

  • BAR
  • BMI
  • BP
  • Blood pressure
  • Body mass index
  • Brachial arterial reactivity
  • CMH
  • CPK
  • CVD
  • CVD-C
  • Cardiovascular disease
  • Cardiovascular disease controls
  • Children's Memorial Hospital
  • Creatine phosphokinase
  • ERL
  • End row loops
  • HDL
  • HOMA-IR
  • High-density lipoprotein
  • Homeostasis model assessment of insulin resistance
  • IMT
  • Intima media thickness
  • JDM
  • Juvenile dermatomyositis
  • Met-C
  • Metabolic controls
  • TNF-a
  • Tumor necrosis factor-a
  • vWF:Ag
  • von Willebrand factor antigen

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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