Evaluation of Lipodystrophy and cardiovascular risk in children and adolescents with Juvenile Dermatomyositis

• Grant number: 19/14715-8
• Support Opportunities: Regular Research Grants
• Start date: March 01, 2020
• End date: February 28, 2023
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Claudio Arnaldo Len
• Grantee: Claudio Arnaldo Len
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated researchers: David Carlos Shigueoka ; Fabiana de Carvalho Silva ; Liana Soido Teixeira e Silva ; Liete Maria Liarte Figueiredo Zwir ; Maria Teresa de Sande e Lemos Ramos Ascensão Terreri ; Roseli Oselka Saccardo Sarni ; Simone Guerra Lopes da Silva

Abstract

Juvenile dermatomyositis (JDM) is the most common chronic idiopathic inflammatory myopathy in childhood, manifesting as a chronic inflammatory process of striated musculature and of skin. Acquired lipodystrophy is related to infections, antiretroviral therapy and various autoimmune diseases, such as JDM, scleroderma and systemic lupus erythematosus. Cardiovascular disease may also be present in patients with JDM and is included in the comprehensive concept of metabolic syndrome, whose manifestations include central obesity, hyperglycemia, dyslipidemia, and hypertension. Objectives: To evaluate the presence of lipodystrophy and cardiovascular risk (CVR) in children and adolescents with JDM; to verify the association between CVR (biochemical methods and measurement of mean carotid thickness) and lipodystrophy, body composition, activity and duration of the disease, presence of hepatic steatosis. . Patients and methods: patients with JDM (n = 45), age range from 5 to 21 years, minimum disease duration of 6 months, regardless of disease activity or treatment will be evaluated. Patients with other autoimmune and chronic diseases (except JDM and overweight / obesity), malignancy, infectious processes and pregnant women will be excluded. Demographic, clinical, and laboratory data regarding the disease and medications in use will be collected. Presence of disease activity will be identified through clinical parameters, complementary tests (periungual capillaroscopy and serum levels of muscle enzymes) and validated questionnaires. Clinical assessment of lipodystrophy will be classified according to etiology and extension. Other parameters will be evaluated: nutritional status (weight, height, body mass index), body composition (dual X-ray absorptiometry), food consumption (24 hour recall), carotid intima-media thickness (ultrasonography) and abdominal ultrasonography, as well as biochemical markers analysis related to lipid metabolism and inflammation. (AU)