Top

Pediatric Rheumatology

Published in:

Open Access 01-12-2016 | Short Report

Abnormal body composition, cardiovascular endurance, and muscle strength in pediatric SLE

Authors: Sangeeta Sule, Kevin Fontaine

Published in: Pediatric Rheumatology | Issue 1/2016

Abstract

Background

Children with SLE are known to have higher fat mass compared to their peers but there are no published data regarding exercise capacity as measured by cardiovascular endurance and muscle strength. In our pilot study of ten children with SLE, we sought to examine body composition, cardiovascular endurance, and isometric muscle strength.

Findings

Ten pediatric SLE patients were studied with a mean age of 15.5 years and 90 % female. Percent body fat above 30 %, the recommended normal level in adolescent females, were found in 89 % of female subjects and 40 % of all participants had lower than the recommended norms of muscle mass for their age/gender. Subjects with renal disease were more likely to have low muscle mass compared to those without renal disease (p = 0.03). Cardiovascular endurance was reported as estimated maximal oxygen consumption (VO₂max) during cycle ergometry. All participants scored in less than fifth percentile for VO₂max measurements compared to data from age and gender matched published norms. Isokinetic muscle strength testing was performed on upper and lower extremities. Only one participant (male subject) reached goal percentiles for age and gender.

Conclusions

We found significant deficit in body composition, muscle strength and cardiovascular endurance in the pediatric SLE population compared to reported published norms. Clinicians should consider these data and focus on exercise programs that can increase aerobic capacity and muscle strength in this high-risk population.

Ward MM. Premature morbidity from cardiovascular and cerebrovascular diseases in women with systemic lupus erythematosus. Arthritis Rheum. 1999;42(2):338–46.CrossRefPubMed

Brunner HI, Silverman ED, To T, Bombardier C, Feldman BM. Risk factors for damage in childhood-onset systemic lupus erythematosus: cumulative disease activity and medication use predict disease damage. Arthritis Rheum. 2002;46(2):436–44.CrossRefPubMed

Ilowite NT, Samuel P, Ginzler E, Jacobson MS. Dyslipoproteinemia in pediatric systemic lupus erythematosus. Arthritis Rheum. 1988;31(7):859–63.CrossRefPubMed

Asanuma Y, Oeser A, Shintani AK, Turner E, Olsen N, Fazio S, Linton MF, Raggi P, Stein CM. Premature coronary-artery atherosclerosis in systemic lupus erythematosus. N Engl J Med. 2003;349(25):2407–15.CrossRefPubMed

Ardoin SP, Schanberg LE, Sandborg C, Yow E, Barnhart HX, Mieszkalski K, Ilowite NT, von Scheven E, Eberhard A, Levy DM, Kimura Y, Silverman E, Bowyer SL, Punaro L, Singer NG, Sherry DD, McCurdy D, Klein-Gitelman M, Wallace C, Silver R, Wagner-Weiner L, Higgins GC, Brunner HI, Jung LK, Imundo L, Soep JB, Reed AM, APPLE investigators. Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort. Lupus. 2010;19(11):1315–25.CrossRefPubMedPubMedCentral

Schanberg LE, Sandborg C, Barnhart HX, Ardoin SP, Yow E, Evans GW, Mieszkalski KL, Ilowite NT, Eberhard A, Levy DM, Kimura Y, von Scheven E, Silverman E, Bowyer SL, Punaro L, Singer NG, Sherry DD, McCurdy D, Klein-Gitelman M, Wallace C, Silver R, Wagner-Weiner L, Higgins GC, Brunner HI, Jung L, Soep JB, Reed A. Atherosclerosis Prevention in Pediatric Lupus Erythematosus Investigators. Premature atherosclerosis in pediatric systemic lupus erythematosus: risk factors for increased carotid intima-media thickness in the atherosclerosis prevention in pediatric lupus erythematosus cohort. Arthritis Rheum. 2009;60(5):1496–507.CrossRefPubMedPubMedCentral

Houghton KM, Tucker LB, Potts JE, McKenzie DC. Fitness, fatigue, disease activity, and quality of life in pediatric lupus. Arthritis Rheum. 2009;59(4):537–5.CrossRef

Eriksson K, Svenungsson E, Karreskog H, Gunnarsson I, Gustafsson J, Moller S, Pettersson S, Bostrom C. Physical activity in patients with systemic lupus erythematosus and matched controls. Scand J Rheumatol. 2012;41(4):290–7.CrossRefPubMed

Bostrom C, Dupre B, Tengvar P, Jansson E, Opava CH, Lundberg IE. Aerobic capacity correlates to self-assessed physical function but not to overall disease activity or organ damage in women with systemic lupus erythematosus with low-to-moderate disease activity and organ damage. Lupus. 2008;17(2):100–4.CrossRefPubMed

10.

Lilleby V, Haugen M, Morkrid L, Frey Froslie K, Holven KB, Forre O. Body composition, lipid and lipoprotein levels in childhood-onset systemic lupus erythematosus. Scand J Rheumatol. 2007;36(1):40–7.CrossRefPubMed

11.

Regio P, Bonfa E, Takayama L, Pereira R. The influence of lean mass in trabecular and cortical bone in juvenile onset systemic lupus erythematosus. Lupus. 2008;17(9):787–92.CrossRefPubMed

12.

Caetano M, Terreri MT, Ortiz T, Pinheiro M, Souza F, Sarni R. Bone mineral density reduction in adolescents with systemic erythematosus lupus: association with lack of vitamin D supplementation. Clin Rheumatol. 2015;34(12):2065–70.CrossRefPubMed

13.

Sinicato NA, Postal M, Peres FA, Pelicari Kde O, Marini R, dos Santos AO, Ramos CD, Appenzeller S. Obesity and cytokines in childhood-onset systemic lupus erythematosus. J Immunol Res. 2014;2014:162047.CrossRefPubMedPubMedCentral

14.

Mina R, Klein-Gitelman MS, Nelson S, Eberhard BA, Higgins G, Singer NG, Onel K, Tucker L, O’Neil KM, Punaro M, Levy DM, Haines K, Ying J, Brunner HI. Effects of obesity on health-related quality of life in juvenile-onset systemic lupus erythematosus. Lupus. 2015;24(2):191–7.CrossRefPubMed

15.

Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25(11):1271–7.CrossRefPubMed

16.

Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus [letter]. Arthritis Rheum. 1997;40(9):1725.CrossRefPubMed

17.

Schned ES, Glickstein SL, Doyle MA. Derivation of the SLEDAI [letter]. Arthritis Rheum. 1993;36(6):877–8.CrossRefPubMed

18.

Eisenmann JC, Laurson KR, Welk GJ. Aerobic fitness percentiles for U.S. adolescents. Am J Prev Med. 2011;41(4 Suppl 2):S106–10.CrossRefPubMed

19.

Laurson KR, Eisenmann JC, Welk GJ. Development of youth percent body fat standards using receiver operating characteristic curves. Am J Prev Med. 2011;41(4 Suppl 2):S93–9.CrossRefPubMed

20.

Laurson KR, Eisenmann JC, Welk GJ. Body fat percentile curves for U.S. children and adolescents. Am J Prev Med. 2011;41(4 Suppl 2):S87–92.CrossRefPubMed

21.

Welk GJ, Laurson KR, Eisenmann JC, Cureton KJ. Development of youth aerobic-capacity standards using receiver operating characteristic curves. Am J Prev Med. 2011;41(4 Suppl 2):S111–6.CrossRefPubMed

22.

Ogden CL, Li Y, Freedman DS, Borrud LG, Flegal KM. Smoothed percentage body fat percentiles for U.S. children and adolescents, 1999–2004. Natl Health Stat Report. 2011;43(43):1–7.PubMed

23.

Katz P, Julian L, Tonner MC, Yazdany J, Trupin L, Yelin E, Criswell LA. Physical activity, obesity, and cognitive impairment among women with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2012;64(4):502–10.CrossRef

24.

Andrews JS, Trupin L, Schmajuk G, Barton J, Margaretten M, Yazdany J, Yelin EH, Katz PP. Muscle strength, muscle mass, and physical disability in women with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2015;67(1):120–7.CrossRef

25.

Andrews JS, Trupin L, Schmajuk G, Barton J, Margaretten M, Yazdany J, Yelin EH, Katz PP. Muscle strength and changes in physical function in women with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2015;67(8):1070–7.CrossRef

Title: Abnormal body composition, cardiovascular endurance, and muscle strength in pediatric SLE
Authors: Sangeeta Sule
Kevin Fontaine
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Pediatric Rheumatology / Issue 1/2016
Electronic ISSN: 1546-0096
DOI: https://doi.org/10.1186/s12969-016-0110-8

ACC 2024 Congress

Springer Medicine

Abnormal body composition, cardiovascular endurance, and muscle strength in pediatric SLE

Abstract

Background

Findings

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Findings

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Macrophage activation syndrome triggered by coeliac disease: a unique case report

Safety and efficacy of pregabalin in adolescents with fibromyalgia: a randomized, double-blind, placebo-controlled trial and a 6-month open-label extension study

Decreasing patient cost and travel time through pediatric rheumatology telemedicine visits

Familial autoimmunity in the childhood arthritis and rheumatology research alliance registry

Juvenile idiopathic arthritis-associated uveitis

Treatment with high-dose recombinant human hyaluronidase-facilitated subcutaneous immune globulins in patients with juvenile dermatomyositis who are intolerant to intravenous immune globulins: a report of 5 cases