Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever
Abstract Background There’s an increasing role of nailfold capillaroscopy in the evaluation of peripheral vascular disease in chronic inflammatory disorders. Familial Mediterranean fever (FMF) is one such disorder, which raises concerns about increased cardiovascular risk, with scarce data available...
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BMC
2025-02-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-025-01861-8 |
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| author | Ahmed S. Abo Hola Rania S. El Zayat Wafaa Ahmed Shehata Mai I. Elashmawy Noha E. Khalaf Heba M. S. El Zefzaf |
| author_facet | Ahmed S. Abo Hola Rania S. El Zayat Wafaa Ahmed Shehata Mai I. Elashmawy Noha E. Khalaf Heba M. S. El Zefzaf |
| author_sort | Ahmed S. Abo Hola |
| collection | DOAJ |
| description | Abstract Background There’s an increasing role of nailfold capillaroscopy in the evaluation of peripheral vascular disease in chronic inflammatory disorders. Familial Mediterranean fever (FMF) is one such disorder, which raises concerns about increased cardiovascular risk, with scarce data available in children. Therefore, we aimed to evaluate insulin resistance, lipid profile, atherogenic indices, and nailfold capillary (NC) changes in children with FMF. Methods Fifty-four children diagnosed with FMF were evaluated by measuring complete blood count, ESR, CRP, serum amyloid A (SAA), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), lipid profile, and atherogenic indices, along with a nailfold capillaroscopic examination, both during acute attacks and attack-free periods. Results During attack-free periods, patients exhibited higher total leucocytic counts, ESR, CRP, SAA, HOMA-IR, total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), Castelli’s risk index I (CRI I), and atherogenic coefficient (AC), and a lower hemoglobin level than controls. Additionally, the NC examination identified avascular areas in 14.8% of patients, tortuosities in 18.5%, enlargements in 14.8%, and microhemorrhages in 7.4%. These parameters showed significant increases during acute attacks. HOMA-IR showed positive correlations with TC, non-HDL-C, CRI I, and AC; however, NC changes were strongly connected with disease duration and SAA. Conclusions Insulin resistance, alterations in serum lipids and atherogenic indices, and NC changes significantly endure in children with FMF during attack-free periods compared to controls, with more prominence during acute attacks. These parameters are linked to subclinical vascular injury and elevated cardiovascular risk, so their monitoring is crucial in these patients for early detection and intervention. |
| format | Article |
| id | doaj-art-b2843f4968404c678b969966a53d2115 |
| institution | Kabale University |
| issn | 1824-7288 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj-art-b2843f4968404c678b969966a53d21152025-02-09T12:47:58ZengBMCItalian Journal of Pediatrics1824-72882025-02-0151111210.1186/s13052-025-01861-8Metabolic consequences and nailfold capillary changes in children with familial Mediterranean feverAhmed S. Abo Hola0Rania S. El Zayat1Wafaa Ahmed Shehata2Mai I. Elashmawy3Noha E. Khalaf4Heba M. S. El Zefzaf5Department of Pediatrics, Faculty of Medicine, Menoufia UniversityDepartment of Pediatrics, Faculty of Medicine, Menoufia UniversityDepartment of Dermatology, Andrology & STDs, Faculty of Medicine, Menoufia UniversityClinical Pathology Department, National Liver Institute, Menoufia UniversityEgyptian Ministry of HealthDepartment of Pediatrics, Faculty of Medicine, Menoufia UniversityAbstract Background There’s an increasing role of nailfold capillaroscopy in the evaluation of peripheral vascular disease in chronic inflammatory disorders. Familial Mediterranean fever (FMF) is one such disorder, which raises concerns about increased cardiovascular risk, with scarce data available in children. Therefore, we aimed to evaluate insulin resistance, lipid profile, atherogenic indices, and nailfold capillary (NC) changes in children with FMF. Methods Fifty-four children diagnosed with FMF were evaluated by measuring complete blood count, ESR, CRP, serum amyloid A (SAA), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), lipid profile, and atherogenic indices, along with a nailfold capillaroscopic examination, both during acute attacks and attack-free periods. Results During attack-free periods, patients exhibited higher total leucocytic counts, ESR, CRP, SAA, HOMA-IR, total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), Castelli’s risk index I (CRI I), and atherogenic coefficient (AC), and a lower hemoglobin level than controls. Additionally, the NC examination identified avascular areas in 14.8% of patients, tortuosities in 18.5%, enlargements in 14.8%, and microhemorrhages in 7.4%. These parameters showed significant increases during acute attacks. HOMA-IR showed positive correlations with TC, non-HDL-C, CRI I, and AC; however, NC changes were strongly connected with disease duration and SAA. Conclusions Insulin resistance, alterations in serum lipids and atherogenic indices, and NC changes significantly endure in children with FMF during attack-free periods compared to controls, with more prominence during acute attacks. These parameters are linked to subclinical vascular injury and elevated cardiovascular risk, so their monitoring is crucial in these patients for early detection and intervention.https://doi.org/10.1186/s13052-025-01861-8Atherogenic indicesFamilial Mediterranean feverInsulin resistanceNailfold capillary changesSerum lipid profile |
| spellingShingle | Ahmed S. Abo Hola Rania S. El Zayat Wafaa Ahmed Shehata Mai I. Elashmawy Noha E. Khalaf Heba M. S. El Zefzaf Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever Italian Journal of Pediatrics Atherogenic indices Familial Mediterranean fever Insulin resistance Nailfold capillary changes Serum lipid profile |
| title | Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever |
| title_full | Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever |
| title_fullStr | Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever |
| title_full_unstemmed | Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever |
| title_short | Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever |
| title_sort | metabolic consequences and nailfold capillary changes in children with familial mediterranean fever |
| topic | Atherogenic indices Familial Mediterranean fever Insulin resistance Nailfold capillary changes Serum lipid profile |
| url | https://doi.org/10.1186/s13052-025-01861-8 |
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