Effects of different therapies on the lipid profile in children with juvenile idiopathic arthritis

2025-11-17T13:32:06+02:00

The aim of the study was to carry out a comparative effect assessment of methotrexate (MTX), adalimumab (ADA), and tocilizumab (TOC) on the blood lipid profile in children with JIA to figure out possible metabolic consequences and risks.

Materials and methods: 120 patients with JIA were enrolled in the study and later divided into 3 different therapy-based groups: ADA group (n=60), TOC group (n=30), and MTX group (n=30). All patients underwent the same clinical, laboratory and instrumental evaluation, which included the disease activity assessment by JADAS27 scale and lipid profile analysis (total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), triglycerides (TG), atherogenic coefficient (AC), both at disease onset and 3 months after reaching the pharmacological remission.

Results: There were no statistically significant differences in TC, VLDL-C, and AC levels between the therapy groups at enrollment. However, the TOC group had higher TG and VLDL-C levels. All groups showed decreases in LDL-C and HDL-C levels, therefore suggesting a “lipid paradox”. Statistically significant differences were detected during remission: patients in the ADA group had a stable lipid profile with increasing HDL-C levels, whereas in the TOC and MTX groups a significant increase in atherogenic lipid parameters was seen (TC, LDL-C, TG, AC) together with a reduction in HDL-C levels. The relative incidence of dyslipidemia in remission was 33% in the ADA group, 97% in the TOC group, and 73% in the MTX group. Only in ADA group, 8.3% of patients showed regression of dyslipidemia. Spearman correlation analysis showed direct relations of JIA activity by JADAS27 with atherogenic lipids, confirming the inflammation influence on lipid metabolism even in remission.

Conclusions: The results suggest that the use of different JIA therapy can significantly affect the blood lipid profile. TNF-α inhibitors helped to stabilize or even improve lipid profiles, while the therapy with tocilizumab and methotrexate was associated with the development of atherogenic dyslipidemia. This confirms the need for lipid profile monitoring in children with JIA

Features of clinical manifestations of generalized periodontal diseases in patients with diabetes mellitus type 2

2025-11-27T19:04:33+02:00

Aim: to establish the features of the configuration of generalized periodontal diseases and their clinical manifestations in the format of basic characteristics of type 2 diabetes mellitus.

Materials and methods: Clinical, radiological and statistical methods were used. The subjects were 75 patients with type 2 diabetes mellitus, aged 19-44 years (mean age 26±3.8), who made up the main group (M), and 60 patients without signs of diabetes mellitus of a similar age - the comparison group (C). For a detailed analysis of the features of the clinical manifestation of GPD in patients with diabetes mellitus, all patients of the main (M) and comparison (C) groups were divided into several subgroups. M1 subgroup - patients with various forms of gingivitis. M2 subgroup was represented by patients with generalized periodontitis (GP) with type 2 diabetes mellitus as the underlying pathology. The comparative (C) group included two subgroups (C1), (C2) with different forms of gingivitis and periodontal disease, respectively.

Results of our own studies. A high frequency of periodontal disease was diagnosed, reaching 100%, including both independent diseases of the periodontal soft tissues and all components of the periodontal complex, which was characteristic of all age groups and depended on the age of the patients, the duration and stages of type 2 diabetes. Periodontitis was mainly of stages I-II, chronic course prevailed over other stages of periodontal disease (80±4.6%). Radiologically, all patients, regardless of the severity of periodontal disease, had a characteristic vertical and horizontal type of resorption, pronounced osteoporosis of the bone component of the periodontal complex and expansion of the periodontal gap. The advantages and priorities of different segments of periodontal complex damage were traced in no case. For all patients with GP, a high degree of tissue sensitization to bone antigen was finalized, characterizing significant changes in the bone component of the periodontal complex in type 2 diabetes. A hypothesis of a plausible paradigm of the interdependence of GPD and type 2 diabetes as affiliated diseases was proposed as the first stage of further development of this direction.

Conclusions: a direct relationship and interdependence of generalized periodontal diseases in the format of basic characteristics of type 2 diabetes have been established

ScienceRise: Medical Science

Effects of different therapies on the lipid profile in children with juvenile idiopathic arthritis

Features of clinical manifestations of generalized periodontal diseases in patients with diabetes mellitus type 2