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SAT0491 METABOLIC DISORDERS IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

Background: The urgency of identifying metabolic disorders causing the formation and complication of rheumatic diseases is associated with the difficulties of early and differential diagnosis, and often unfavorable outcomes with a high incidence of patient disability. Objectives: The purpose of the study is to study the lipid, lipoprotein spectrum of blood serum, lipid peroxidation and antioxidant protection in children with juvenile idiopathic arthritis (JIA). Methods: On the state of lipid metabolism was evaluated by the study content of total lipids, total cholesterol, triglycerides, lipoprotein spectrum of blood serum apolipoprotein atherosclerotic and antiatherogenic lipoproteins (apoB, apoA, apoE), activity of lipoprotein lipase, primary and secondary products of lipid peroxidation (LPO) and the content of antioxidant ability of water - and fat-soluble antioxidants. Results: 147 children with juvenile idiopathic arthritis (JIA) aged from 2 to 17 years were examined. The control group consisted of 50 healthy children. In children with JIA, a significant increase in the content of triglycerides, total cholesterol (p<0.001) and a decrease in cholesterol-HDL levels (p<0.05) in comparison with the same indicators in the control group was established. The mean concentrations of cholesterol-HDL significantly decreased with an increase in the degree of disease activity: 1.15 [0.98; 1.3] mmol/l with minimal activity, 1.02 [0.87; 1.17] mmol/l with moderate activity and 0.94 [0.78; 1.01] mmol/l with a high activity of the disease. Lipoprotein lipase is a key enzyme in lipid metabolism, ensuring the hydrolysis of plasma triglycerides found in chylomicrons and very low density lipoproteins. An increase in the catalytic activity of lipoprotein lipase leads to a decrease in the level of TG and an increase in the level of HDL in the blood. According to the results of the survey in children with JIA, the concentration of lipoprotein lipase was 13.9 [7.1; 25.3] μg/l, with obesity 27.5 [9.9; 47.8] μg/l. A direct relationship was established between its content in blood serum and the concentration of LDL (rs=0.37; p<0.05) and the inverse with the level of LDL (rs = –0.4; p<0.05). There was a significant difference (p<0.05) by gender: the level of lipoprotein lipase in the blood serum in girls was 25.8 [16.7 - 54.4] μg/l, in boys - 15.6 [7.8 - 29,0] μg/l. A correlation was also established between the level of lipoprotein lipase and body mass index (rs = 0.35; p<0.05). According to the results of the study, a significant (p<0.05) increase in the level of primary (DK233) and secondary (DK278 and MDA) LPO products in the blood serum of children with JIA was found in comparison with the control group. During the correlation analysis, a positive correlation was established between the levels of DK233, DK278 in serum and ESR (rs = 0.587, p<0.01). The results obtained indicate the intensification of lipid peroxidation processes. A significant (p<0.05–0.01) decrease in the content of water-soluble (ACW) and fat-soluble (ACL) antioxidant capacity of substances in the blood serum of children with JIA was found when compared with similar indicators in the control group. During the correlation analysis, a negative correlation was established between the level of CRP and the content of ACL in serum (rs = -0.346, p<0.05), between the content of ACW and CRP in serum (rs = -0.54, p<0, 01). Conclusion: It can be concluded that the activation of lipid peroxidation and the failure of the antioxidant system play a significant role in the development and progression of JIA in the examined children, as well as in the formation of atherogenic disorders by the lipid peroxidation mechanism. In addition, children with JIA have abnormalities in the lipid spectrum, acquiring an atherogenic orientation, which, together with hemostasiological changes, can be regarded as a risk factor for atherothrombosis. Disclosure of Interests: None declared