Preclinical Carotid Atherosclerosis in Patients With Juvenile-Onset Mixed Connective Tissue Disease

Background: This study investigated preclinical atherosclerosis in patients with juvenile mixed connective tissue disease (JMCTD), which is a chronic inflammatory disease with a varied phenotype. Mixed connective tissue disease (MCTD) has well known associations with other autoimmune diseases known to have increased risk of cardiovascular disease. However, the cardiovascular risk for patients with the juvenile form remains unclear. Materials and methods: Forty-nine patients with JMCTD and 45 age-and sex-matched controls took part in this study. They underwent blood tests, clinical examination, and ultrasound measurement of the carotid arteries. Results: We found that patients had significantly higher average carotid intima-media thickness (IMT) as compared to controls (mean 0.57 +/- 0.09 versus 0.53 +/- 0.06, P = .03). IMT also increased with both increasing disease duration (years from diagnosis), and severity as assessed by the physicians global assessment score, after adjustment for age. Conclusions: This is the first study to demonstrate increased preclinical atherosclerosis in juvenile MCTD. Our findings suggest that the atherosclerotic burden in this patient group, which was independent of traditional cardiovascular risk factors, might be secondary to the underlying connective tissue disease.