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Arthritis und Rheuma 2019; 39(02): 117-125
DOI: 10.1055/a-0860-9477
Kinderrheumatologie
© Georg Thieme Verlag KG Stuttgart · New York

Kardiovaskuläres Risiko und chronische Entzündung

Kardiovaskuläre Risikofaktoren im Kindes- und JugendalterCardiovascular risk and chronic inflammationCardiovascular risk factors in childhood and adolescence
Florian Milatz
1   Programmbereich Epidemiologie, Deutsches Rheuma- Forschungszentrum Berlin
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Publication History

Publication Date:
03 May 2019 (online)

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Zusammenfassung

Aus postmortalen Untersuchungen ist bekannt, dass die Bildung atherosklerotischer Gefäßwandläsionen ihren Ursprung bereits im Kindesalter findet und in enger Beziehung zu bekannten kardiovaskulären Risikofaktoren Erwachsener steht. Um mit Hilfe der Regenerationspotenziale im Kindes- und Jugendalter eine beschleunigte Entwicklung atherosklerotischer Gefäßveränderungen zu verhindern, bedarf es einerfrühzeitigen Diagnose und konsequenten Behandlung kardiovaskulärer Risikofaktoren. Heranwachsende mit einer Autoimmunerkrankung, wie z. B. einer juvenilen idiopathischen Arthritis (JIA), besitzen aufgrund chronischer Entzündungszustände, medikamentöser Therapien und metabolischer Veränderungen ein erhöhtes kardiovaskuläres Risiko. Zur Exposition nicht traditioneller Risiken gesellen sich traditionelle, verhaltensbasierte Risikofaktoren, deren Vermeidung im Rahmen chronischer Erkrankungen besondere Bedeutung beigemessen wird. Der aktuelle wissenschaftliche Datenbestand bei JIA unterstreicht aus kardiovaskulärer Sicht die Notwendigkeit von Lebensstilmodifikationen, einschließlich insbesondere der Vermeidung eines bewegungsarmen, durch niedrigen energetischen Aufwand gekennzeichneten Alltags.

Summary

Post-mortem studies have shown that the development of atherosclerotic vascular wall lesions originates in childhood and is closely related to known cardiovascular risk factors in adults. In order to prevent an accelerated development of atherosclerotic vascular changes with the help of regeneration potentials in childhood and adolescence, an early diagnosis and consistent treatment of cardiovascular risk factors are required. Adolescents with autoimmune disease, such as juvenile idiopathic arthritis (JIA), have an increased cardiovascular risk due to chronic inflammatory conditions, drug therapy and metabolic changes. The exposure to non-traditional risks is accompanied by traditional, behavioural risk factors, the avoidance of which is becoming increasingly important, especially in the context of chronic diseases. The current scientific database in JIA highlights the need for lifestyle modifications, including the avoidance of an everyday life characterized by low levels of physical activity and energy expenditure.

Schlüsselwörter

Kinder und Jugendliche - kardiovaskuläre Risikofaktoren - juvenile idiopathische Arthritis

Keywords

Children and adolescents - cardiovascular risk factors - juvenile idiopathic arthritis
 

  • Literatur

  • 1 Statistisches Bundesamt. Zahl der Todesfälle im Jahr 2015 um 6,5 % gestiegen. Zugriff am 12. Dezember 2018 unter https://www.destatis.de/DE/PresseService/Presse/Pressemitteilungen/2017/01/PD17_022_232pdf.pdf?__blob=publicationFile
  • 2 Berenson GS, Srinivasan SR, Bao W. et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults.. N Engl J Med 1998; 338: 1650-1656
    CrossrefPubMedGoogle Scholar
  • 3 Zieske AW, Malcolm GT, Strong JP. Natural history and risk factors of atherosclerosis in children and youth: the PDAY study.. Pediatr Pathol Mol Med 2002; 21: 213-237
    CrossrefPubMedGoogle Scholar
  • 4 Juonala M, Magnussen CG, Berenson GS. et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors.. N Engl J Med 2011; 365: 1876-1885
    CrossrefPubMedGoogle Scholar
  • 5 Laitinen TT, Pahkala K, Magnussen CG. et al. Ideal cardiovascular health in childhood and cardiometabolic outcomes in adulthood. The cardiovascular risk in young Finns study.. Circulation 2012; 125: 1971-1978
    CrossrefPubMedGoogle Scholar
  • 6 Stabouli S, Kotsis V, Karagianni C. et al. Blood pressure and carotid artery intima-media thickness in children and adolescents: the role of obesity.. Hellenic J Cardiol 2012; 53: 41-47.
    PubMedGoogle Scholar
  • 7 Ezzati M, Lopez AD, Rodgers A. et al. Selected major risk factors and global and regional burden of disease.. Lancet 2002; 360: 1347-1360
    CrossrefPubMedGoogle Scholar
  • 8 Neuhauser HK, Thamm M, Ellert U. et al. Blood pressure percentiles by age and height from nonoverweight children and adolescents in Germany.. Pediatrics 2011; 127: e978-e988
    CrossrefPubMedGoogle Scholar
  • 9 Grundy SM. Primary prevention of coronary heart disease: integrating risk assessment with intervention.. Circulation 1999; 100: 988-998
    CrossrefPubMedGoogle Scholar
  • 10 Lee IM. Physical activity and cardiac protection.. Curr Sports Med Rep 2010; 9: 214-219
    CrossrefPubMedGoogle Scholar
  • 11 Brage S, Wedderkopp N, Ekelund U. et al. Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS).. Diabetes Care 2004; 27: 2141-2148
    CrossrefPubMedGoogle Scholar
  • 12 Finger JD, Varnaccia G, Borrmann A. et al. Körperliche Aktivität von Kindern und Jugendlichen in Deutschland – Querschnittergebnisse aus KiGGS Welle 2 und Trends.. Journal of Health Monitoring 2018; 3: 24-31
    Google Scholar
  • 13 Andersen LB, Harro M, Sardinha LB. et al. Physical activity and clustered cardiovascular risk in children: a crosssectional study (The European youth heart study).. The Lancet 2006; 368: 299-304
    CrossrefPubMedGoogle Scholar
  • 14 Lampert T, Sygusch R, Schlack R. Nutzung elektronischer Medien im Jugendalter. Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS).. Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007; 50: 643-652
    Google Scholar
  • 15 Mons U, Kahnert S. Neuberechnung der tabakattributablen Mortalität – Nationale und regionale Daten für Deutschland.. Gesundheitswesen 2019; 81: 24-33
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Zeiher J, Lange C, Starker A. et al. Tabak- und Alkoholkonsum bei 11-bis 17-Jährigen in Deutschland – Querschnittergebnisse aus KiGGS Welle 2 und Trends.. Journal of Health Monitoring 2018; 3: 23-44
    PubMedGoogle Scholar
  • 17 West HW, Juonala M, Gall SL. et al. Exposure to parental smoking in childhood is associated with increased risk of carotid atherosclerotic plaque in adulthood. The cardiovascular risk in young Finns study.. Circulation 2015; 131: 1239-1246
    CrossrefPubMedGoogle Scholar
  • 18 Schwab KO, Doerfer J, Hallermann K. et al. Marked smoking-associated increase of cardiovascular risk in childhood type 1 diabetes.. Int J Adolesc Med Health 2008; 20: 285-292
    PubMedGoogle Scholar
  • 19 Celermajer DS, Adams MR, Clarkson P. et al. Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults.. N Eng J Med 1996; 334: 150-154
    CrossrefPubMedGoogle Scholar
  • 20 Kromeyer-Hauschild K, Moss A, Wabitsch M. Referenzwerte für den Body-Mass-Index für Kinder, Jugendliche und Erwachsene in Deutsch-land: Anpassung der AGA-BMI_Referenz im Altersbereich von 15 bis 18 Jahren.. Adipositas 2015; 9: 123-127
    Google Scholar
  • 21 Kromeyer-Hauschild K, Wabitsch M, Kunze D. et al. Perzentile für den Body-Mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben.. Monatsschrift Kinderheilkunde 2001; 149: 807-818
    CrossrefGoogle Scholar
  • 22 Schienkiewitz A, Brettschneider AK, Damerow S. et al. Übergewicht und Adipositas im Kindes- und Jugendalter in Deutschland – Querschnittergebnisse aus KiGGS Welle 2 und Trends.. Journal of Health Monitoring 2018; 3: 16-23
    Google Scholar
  • 23 World Health Organization (WHO). Obesity and overweight. Zugriff am 20. Dezember 2018 unter http://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
  • 24 Larsson C, Hernell O, Lind T. Moderately elevated body mass index is associated with metabolic variables and cardiovascular risk factors in Swedish children.. Acta Paediatr 2011; 100: 102-108
    CrossrefPubMedGoogle Scholar
  • 25 Wunsch R, Sousa G de, Toschke AM. et al. Intima-media thickness in obese children before and after weight loss.. Pediatrics 2006; 118: 2334-2340
    CrossrefPubMedGoogle Scholar
  • 26 Mokha JS, Srinivasan SR, Dasmahapatra P. et al. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: the Bogalusa Heart Study.. BMC Pediatrics 2010; 10: 73
    CrossrefPubMedGoogle Scholar
  • 27 World Health Organization Global health risks: mortality and burden of disease attributable to selected major risks [Elektronische Version].. Geneva: World Health Organization; 2009
    Google Scholar
  • 28 Scheidt-Nave Y, Du H, Knopf A. et al. Verbreitung von Fettstoffwechselstörungen bei Erwachsenen in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).. Bundesgesundheitsblatt 2013; 56: 661-667
    Google Scholar
  • 29 Raitakari OT, Juonala M, Kähönen M. et al. Cardiovascular Risk Factors in Childhood and Carotid Artery Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study.. JAMA 2003; 290: 2277-2283
    CrossrefPubMedGoogle Scholar
  • 30 Lind M, Svensson AM, Kosiborod M. et al. Glycemic control and excess mortality in type 1 diabetes.. N Engl J Med 2014; 371: 1972-1982
    CrossrefPubMedGoogle Scholar
  • 31 Bertilsson L, Andersson-Gare B, Fasth A. et al. Disease course, outcome, and predictors of outcome in apopulation-based juvenile chronic arthritis cohort followed for 17 years.. J Rheumatol 2013; 40: 715-724
    CrossrefPubMedGoogle Scholar
  • 32 Selvaag AM, Aulie HA, Lilleby V. et al. Disease progression into adulthood and predictors of long-term active disease in juvenile idiopathic arthritis.. Ann Rheum Dis 2016; 75: 190-195
    CrossrefPubMedGoogle Scholar
  • 33 Raab A, Sengler C, Niewerth M. et al. Comorbidity profiles among adult patients with juvenile idiopathic arthritis: results of a biologic register.. Clin Exp Rheumatol 2013; 31: 796-802
    PubMedGoogle Scholar
  • 34 Aulie HA, Selvaag AM, Gunther A. et al. Arterial haemodynamics and coronary artery calcification in adult patients with juvenile idiopathic arthritis.. Ann Rheum Dis 2015; 74: 1515-1521
    CrossrefPubMedGoogle Scholar
  • 35 Butbul AY, Stremler R, Benseler SM. et al. Sleep and fatigue and the relationship to pain, disease activity and quality of life in juvenile idiopathic arthritis and juvenile dermatomyositis.. Rheumatology 2011; 50: 2051-2060
    CrossrefPubMedGoogle Scholar
  • 36 Takken T, Hemel A, van der Net J. et al. Aerobic fitness in children with juvenile idiopathic arthritis: a systematic review.. J Rheumatol 2002; 29: 2643-2647
    Google Scholar
  • 37 Norgaard M, Twilt M, Andersen LB. et al. Accelerometry-based monitoring of daily physical activity in children with juvenile idiopathic arthritis.. Scand J Rheumatol 2016; 45: 179-187
    CrossrefPubMedGoogle Scholar
  • 38 Klepper SE, Darbee J, Effgen SK. et al. Physical fitness levels in children with polyarticular juvenile rheumatoid arthritis.. Arthritis care and research: the official J Arthritis Health Professions Association. 1992; 5 (02) 93-100
    Google Scholar
  • 39 Lelieveld OT, Armbrust W, van Leeuwen MA. et al. Physical activity in adolescents with juvenile idiopathic arthritis.. Arthritis Rheum 2008; 59: 1379-1384
    CrossrefPubMedGoogle Scholar
  • 40 Bos GJ, Lelieveld OT, Armbrust W. et al. Physical activity in children with Juvenile Idiopathic Arthritis compared to controls.. Pediatr Rheumatol Online J 2016; 14: 42
    CrossrefPubMedGoogle Scholar
  • 41 Gueddari S, Amine B, Rostom S. et al. Physical activity, functional ability, and disease activity in children and adolescents with juvenile idiopathic arthritis.. Clin Rheumatol 2014; 33: 1289-1294
    CrossrefPubMedGoogle Scholar
  • 42 Long AR, Rouster-Stevens KA. The role of exercise therapy in the management of juvenile idiopathic arthritis.. Curr Opin Rheumatol 2010; 22: 213-217
    CrossrefPubMedGoogle Scholar
  • 43 Klepper SE. Exercise in pediatric rheumatic diseases.. Curr Opin Rheumatol 2008; 20: 619-624
    CrossrefPubMedGoogle Scholar
  • 44 Bohr A, Nielsen S, Müller K. et al. Reduced physical activity in children and adolescents with juvenile idiopathic arthritis despite satisfactory control of inflammation.. Pediatr Rheumatol 2015; 13: 57
    CrossrefPubMedGoogle Scholar
  • 45 Van Pelt PA, Takken T, van Brussel M. et al. Aerobic capacity and disease activity in children, adolescents and young adults with juvenile idiopathic arthritis (JIA).. Pediatr Rheumatol 2012; 10: 27
    CrossrefPubMedGoogle Scholar
  • 46 Grönlund MM, Kaartoaho M, Putto-Laurila A. et al. Juvenile idiopathic arthritis patients with low inflammatory activity have increased adiposity.. Scand J Rheumatol 2014; 43: 488-492
    CrossrefPubMedGoogle Scholar
  • 47 Caetano MC, Sarni RO, Terreri MT. et al. Excess of adiposity in female children and adolescents with juvenile idiopathic arthritis.. Clin Rheumatol 2012; 31: 967-971
    CrossrefPubMedGoogle Scholar
  • 48 Surís J, Michaud P, Akre C. et al. Health risk behaviors in adolescents with chronic conditions.. Pediatrics 2008; 122: e1113-e1118
    CrossrefPubMedGoogle Scholar
  • 49 Nash AA, Britto MT, Lovell DJ. et al. Substance use among adolescents with juvenile rheumatoid arthritis.. Arthritis Care Res 1998; 11: 3916
    Google Scholar
  • 50 Listing M, Liedmann I, Niewerth M. Health behavior in adolescents with juvenile idiopathic arthritis- results of the inception cohort of newly diagnosed patients (ICON).. Ann Rheum Dis 2017; 76 (Suppl. 02) 76 1-76
    CrossrefPubMedGoogle Scholar
  • 51 Tam CS, Clement K, Baur LA. et al. Obesity and low-grade inflammation: a paediatric perspective.. Obes reviews : an official J Int Assoc Stud Obes 2010; 11 (02) 118-126
    Google Scholar
  • 52 Pelajo CF, Lopez-Benitez JM, Miller LC. Obesity and disease activity in juvenile idiopathic arthritis.. Pediatr Rheumatol online J 2012; 10 (01) 3
    CrossrefPubMedGoogle Scholar
  • 53 Schenck S, Niewerth M, Sengler C. et al. Prevalence of overweight in children and adolescents with juvenile idiopathic arthritis.. Scand J Rheumatol 2015; 44: 288-295
    CrossrefPubMedGoogle Scholar
  • 54 Amine B, Ibn YY, Rostom S. et al. Prevalence of overweight among Moroccan children and adolescents with juvenile idiopathic arthritis.. Joint Bone Spine 2011; 78 (06) 584-586.
    CrossrefPubMedGoogle Scholar
  • 55 Glowinska-Olszewska B, Bossowski A, Dobrenko E. et al. Subclinical Cardiovascular System Changes in Obese Patients with Juvenile Idiopathic Arthritis.. Mediaters of Inflammation 2013; 2013: 436702
    Google Scholar
  • 56 Caetano MC, Sarni ROS, Terreri MTL. et al. Excess of adiposity in female children and adolescents with juvenile idiopathic arthritis.. Clin Rheumatol 2012; 31: 967-971
    CrossrefPubMedGoogle Scholar
  • 57 Samad A, Stoll ML, Lavi I. et al. Adiposity in Juvenile Psoriatic Arthritis.. J Rheumatol 2018; 45: 411-418
    Google Scholar
  • 58 Ilowite NT, Samuel P, Beseler L. et al. Dyslipoproteinemia in juvenile rheumatoid arthritis.. J Pediatr 1989; 114: 823-826
    CrossrefPubMedGoogle Scholar
  • 59 Tselepis AD, Elisaf M, Besis S. et al. Association of the inflammatory state in active juvenile rheumatoid arthritis with hypo-high-density lipoproteinemia and reduced lipoprotein-associated platelet-activating factor acetylhydrolase activity.. Arthritis Rheum 1999; 42: 373-383
    CrossrefPubMedGoogle Scholar
  • 60 Goncalves M, D’Almeida V, Guerra-Shinohara EM. et al. Homocysteine and lipid profile in children with Juvenile Idiopathic Arthritis.. Pediatr Rheumatol Online J 2007; 5: 2
    CrossrefPubMedGoogle Scholar
  • 61 Bakkaloglu A, Kirel B, Ozen S. et al. Plasma lipids and lipoproteins in juvenile chronic arthritis.. Clin Rheumatol 1996; 15: 341-345
    CrossrefPubMedGoogle Scholar
  • 62 Marangoni RG, Hayata AL, Borba EF. et al. Decreased high-density lipo-protein cholesterol levels in polyarticular juvenile idiopathic arthritis.. Clinics (Sao Paulo) 2011; 66: 1549-1552
    CrossrefPubMedGoogle Scholar
  • 63 Breda L, Di Marzio D, Giannini C. et al. Relationship between inflammatory markers, oxidant-antioxidant status and intima-media thickness in prepubertal children with juvenile idiopathic arthritis.. Clin Res Cardiol 2013; 102: 63-71
    CrossrefPubMedGoogle Scholar
  • 64 Schenck S, Rosenbauer J, Niewerth M. et al. Comorbidity of Type 1 Diabetes Mellitus in Patients with Juvenile Idiopathic Arthritis.. J Pediatr 2018; 192: 196-203
    CrossrefPubMedGoogle Scholar
  • 65 Prahalad S, O’Brien E, Fraser AM. et al. Familial aggregation of juvenile idiopathic arthritis.. Arthritis Rheum 2004; 50: 4022-4027
    CrossrefPubMedGoogle Scholar
  • 66 Pohjankoski H, Kautiainen H, Kotaniemi K. et al. Autoimmune diseases in children with juvenile idiopathic arthritis.. Scand J Rheumatol 2010; 39: 435-436
    CrossrefPubMedGoogle Scholar
  • 67 Bharti BB, Kumar S, Kapoor A. et al. Assessment of left ventricular systolic and diastolic function in juvenile rheumatoid arthritis.. J Postgrad Med 2004; 50: 262-267
    PubMedGoogle Scholar
  • 68 Oguz D, Ocal B, Ertan U. et al. Left ventricular diastolic functions in juvenile rheumatoid arthritis.. Pediatr Cardiol 2000; 21: 374-377
    CrossrefPubMedGoogle Scholar
  • 69 Alkady EA, Helmy HA, Mohamed-Hussein AA. Assessment of cardiac and pulmonary function in children with juvenile idiopathic arthritis.. Rheumatol Int 2012; 32: 39-46
    CrossrefPubMedGoogle Scholar