Pathogenetic significance of comorbidity of juvenile rheumatoid arthritis and components of metabolic syndrome (LITERATURE REVIEW)

Juvenile rheumatoid arthritis (JRA) is one of the most common rheumatic diseases of childhood. The pathogenetic significance of comorbidity of JRA and metabolic syndrome (MS) consists in the increased risk of cardiovascular complications and early atherosclerosis. There is evidence of mutual aggravation of inflammatory manifestations and metabolic disorders in patients with rheumatoid arthritis. An important link in the pathogenesis of JRA in children is a disorder of lipid metabolism, as well as changes in the lipid composition of cell membranes with activation of lipid peroxidation system and reduction of serum antioxidant substances, contributing to systemic lesions. The activity of psoriatic arthritis, asymptomatic hyperuricemia and gouty arthritis was found to be closely related to MS. Monitoring of metabolic cardiovascular risk factors in JRA is critical, because if two or more cardiovascular risk factors are identified, patients become high risk. To minimize the negative impact of metabolic factors in JRA, a complex of measures is aimed at including non medication and medication interventions.