Dyslipidaemia in juvenile dermatomyositis: the role of disease activity.

OBJECTIVES: To evaluate the presence of dyslipidaemia in JDM and its possible risk factors.

METHODS: Twenty-five JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycaemia, insulin, antibodies and muscle enzymes. JDM scores were assessed: CMAS, MMT, DAS, MYOACT and MYTAX.

RESULTS: Abnormal lipid profile was found in nine patients and four controls (36% vs. 16%, p=0.196). JDM patients demonstrated significant higher levels of triglycerides (TG) [80(31-340) vs. 61(19-182) mg/dL, p=0.011] and higher frequency of abnormal levels of high density lipoproteins (HDL) (28% vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidaemia demonstrated significant lower median of HDL levels [29(0-49) vs. 50(39-72) mg/dL, p=0.0005], higher frequency of low HDL levels (77% vs. 0%, p=0.0001), higher TG levels [128(31-340) vs. 69(46-138) mg/dL, p=0.011], and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) when compared to those without this condition. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid profile. JDM with dyslipidaemia had higher ESR (26 vs. 1 4.5mm/1sthour, p=0.006), CRP (2.1 vs. 0.4mg/dL, p=0.01), DAS (6 vs. 2, p=0.008), MYOACT(0.13 vs. 0.01, p=0.012), MYTAX(0.06vs.0,p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidaemia. Positive correlations were detected between TG levels and CRP (r=0.697, p=0.001), DAS (r=0.610, p=0.001), MYOACT (r=0.661, p=0.001), MYTAX (r=0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body composition, lipodystrophy, anti-LPL antibodies, and treatment except by higher frequency of cyclosporine current use in patients with dyslipidaemia (33% vs. 0%, p=0.03).

CONCLUSIONS: Dyslipidaemia in JDM patients was characterised by increased levels of TG and low levels of HDL. Disease activity and cyclosporine use were the mainly factors associated to these abnormalities.