Microangiopathy in Naifold Videocapillaroscopy and Its Relations to sE- Selectin, Endothelin-1, and hsCRP as Putative Endothelium Dysfunction Markers among Adolescents with Raynaud's Phenomenon.

The aim of this study was to analyze the relationship between the qualitative abnormalities on nailfold videocapillaroscopy (NVC), and the concentrations of selected biomarkers (sE-selectin, endothelin-1, high-sensitivity c-reactive protein (hsCRP)) and lipid metabolism parameters in children and adolescents with Raynaud's phenomenon (RP). Raynaud's phenomenon, to assess whether nailfold capillary changes may reflect the degree of systemic blood vessel abnormalities. The study group included 66 patients (34 undifferentiated-uRP and 32 secondary-sRP) aged 6-19 years and the control group. In both groups, NVC was performed and the selected biomarkers were measured (sE-selectin, endothelin-1, hsCRP) and lipid profile. Endothelin-1, sE-selectin and hsCRP concentrations in patients from both RP groups were significantly higher; concentration of HDL fraction was significantly lower compared with the control group. The analysis of multiple linear regression demonstrated that megacapillaries most strongly determine the sE-selectin value (p = 0.04) and hsCRP (p = 0.03). Both the total cholesterol and low-density lipoprotein (LDL) fraction concentrations were determined by the presence of avascular areas (p = 0.02). In conclusion, specific pathologic NVC changes were associated with higher endothelial damage biomarkers concentration and adverse changes in the lipid profile.

[Relationship between bone mineral content and growth disorders in children with juvenile idiopathic arthritis]. / Zaleznosc miedzy masa mineralna kosci a zaburzeniami wzrastania u dzieci chorych na mlodziencze idiopatyczne zapalenie stawów.

UNLABELLED: In chronic inflammatory processes in children efforts are made to evaluate bone mineral content (BMC) with the use of densitometric parameters, which at the same time determine equivalent of lean body mass (LBM). This functional analysis of the musculoskeletal system by using DXA method seems to be particularly useful for the examination of bone mass in children suffering from juvenile idiopathic arthritis (JIA). THE AIM OF THE STUDY was to assess body mass content having regard of the BMC/LBM ratio in JIA children, depending on the degree of growth inhibition, disease advancement phase and the therapy applied. MATERIAL AND METHODS: The study comprised 97 children aged 5-18 (mean age 12.7+/-3.8 years), 45 girls and 52 boys with diagnosed JIA according to ILAR criteria of 1997. The average duration of disease was 4.1+/-3.1 years. Antropometric and densitometric measurement was made in every child. Body height was defined by Standard Deviation Height Velocity Score - SDHVS (SDS). Patients were divided into 2 groups: I - 28-group with SDS ratio < -2.0; 11 - 69 children with normal height. For the evaluation of disease development and advancement of anatomic changes in joints criteria of Steinbrocker were applied: I grade - without joint damage, II - insignificant or moderate joints damage, III-IV - established deformation. The densitometric research was conducted with the use of double-energy X-ray absorptiometry (DXA) method. Bone mineral density (BMD) was assessed in the whole skeleton (TB BMD), in the vertebras L2-L4 (SB MD), Z-score index for SBMD and BMC, LBM, TB BMC/LBM defined by the Z-score index and compared to norms for age and growth. RESULTS: Bone mineral density defined as Z-score index for SBMD <-2.0 was reported in 21 children (21.6%). Muscle-skeletal Z-score index for TB BMC/LBM in relation to norms of gender and growth lower than -1.0 was proved in 23 children (23.6%). Considerably lower Z-score index for TB BMC/LBM (p < 0.01) characterized children with growth inhibition and children with significant joints damage (p < 0.02). There was no significant correlation between densitometric parameters and applied treatment with glucocorticoids and without glucocorticoids. CONCLUSIONS: Decrease of bone mineral mass defined as muscle-skeletal Z-score index for TB BMC/LBM was found in almost quarter of patients within the group of JIA children. In the group of children with growth deficiency and with larger joints damage bone mass was significantly lower.

Bone mineral metabolism in children with juvenile idiopathic arthritis--preliminary report.

INTRODUCTION: There are very few reports assessing bone mineral mass and its metabolism in the course of juvenile idiopathic arthritis (JIA). STUDY OBJECTIVE: To assess the levels of selected serum markers of bone formation (OCN) and resorption (CTx) in JIA children. MATERIAL AND METHODS: The study involved 52 children with JIA diagnosed according to the EULAR criteria of 1997, aged 6-18 years. All patients underwent densitometric measurements using dual-energy X-ray absorptiometry (DXA) to assess TBBMD (g/cm2), Spine BMD (g/cm2), Z-score for SBMD, TBBMC (g), and LBM (g). The following parameters were determined in blood serum: the level of osteocalcin (OCN) and C-terminal type I alpha-collagen chain telopeptide (CTx) using the Elecsys 2010 system (N-MID Osteocalcin, Beta-CrossLaps). A gender- and age-matched control group consisted of 16 healthy children. RESULTS: The mean concentrations of both osteocalcin (p<0.001) and CTx (p<0.005) were significantly higher in JIA patients as compared to the healthy controls (OCN 113.2+/-54.9 ng/ml vs. 70.2+/-48.3 ng/ml; CTx 1.4+/-0.5 mug/l vs. 1.2 +/-0.45 microg/l). The concentrations of the bone turnover markers were significantly reduced in children with higher degrees of joint destruction compared to those with anatomically normal joints (p<0.05). The mean concentration of CTx showed a significant negative correlation with the TB BMC/LBM Z-score (p<0.05). Reduced bone mass (Z-score for SBMD< -2.0) was found in 23.6% of the affected children. CONCLUSIONS: The JIA patients had elevated levels of OCN and CTx compared to the healthy controls. Reduced bone turnover was observed in children with higher degrees of joint destruction.

[Growth disorders in the course of chronic juvenile arthritis]. / Zaburzenia wzrastania w przebiegu mlodzienczego idiopatycznego zapalenia stawów.

INTRODUCTION: Juvenile idiopathic arthritis (JIA) is the most common chronic arthropathy, in witch an inflammatory process may lead not only to fixed deformities but also to developmental disturbances, including growth inhibition. The study objective of the current study was to assess the relationship of the degree of physical development disturbances in children with JIA with disease duration, clinical type, the Steinbrocker class of the disease and the therapy applied. MATERIAL AND METHODS: Anthropometric parameters were analysed in 97 children aged 2-18 years (45 girls and 52 boys) with JIA. Bone densitometry (DXA) was performed in 51 children to assess the mineral mass of the whole skeleton (Total BMD) and L2-L4 vertebrae. Results Growth deficiency below -2.0 SDHS--Standard Deviation Height Score (group I) was found in 25 children (25.8%), with the predominance of older children (p<0.05) suffering from a polyarticular type. Children with considerable joint destruction (class III and IV according to Steinbrocker) exhibited lower height (p<0.002) as compared to the group of children without growth disorders (group II) and with early or moderate anatomical joint damage. Significant differences in BMI were noted between group I and II (16.05 and 18.12, respectively; p<0.02). A significant reduction in total bone mineral mass were found in group I as compared to group II (total BMD 0.736 g/cm2 and 0.922 g/cm2; p<0.05). CONCLUSIONS: Growth deficiencies which strongly correlated with the degree of joint destruction and thus with inflammatory activity were found in 25% of the study children and adolescents with JIA. Growth retardation was accompanied by a significant bone mass reduction.