JUVENILE idiopathic arthritis (JIA), the most common chronic rheumatic disease in children, may carry underrecognized risks for endocrine dysfunction, according to a new study that highlights significant growth and hormonal disturbances in this vulnerable population. Conducted at a pediatric rheumatology department in India, the prospective observational study evaluated 107 children with JIA and revealed that nearly one-third exhibited growth impairments or pubertal delays, driven in part by disruptions in the growth hormone-insulin-like growth factor-1 (GH-IGF1) axis.
The study followed children aged 13 (±4) years with a mean disease duration of 33 (±24) months. Enthesitis-related arthritis (ERA) emerged as the most common subtype, affecting over half (51.4%) of the participants. Growth assessments revealed that 20.6% of children were stunted, 22.4% were underweight, and 25.2% had low body mass index (BMI)—factors strongly associated with disease severity and duration.
Further analysis indicated that stunted growth was more likely in children with early disease onset (p = 0.015) and elevated growth hormone levels (p = 0.013), suggesting a compensatory mechanism within the GH-IGF1 axis. Underweight children faced longer disease durations (p = 0.047) and greater joint damage (p = 0.006), while low BMI was linked to high disease activity, increased damage, poorer quality of life, and worse functional outcomes (p < 0.01). Although delayed puberty was relatively uncommon, identified in just 2.8% of participants, girls with low estradiol levels experienced longer corticosteroid exposure, hinting at potential medication-related endocrine effects. Additionally, 22.4% of children exhibited slower growth velocity without any clear causative factors, underscoring the complex interplay between disease activity, treatment, and hormonal regulation. These findings underscore the importance of regular growth and endocrine monitoring in children with JIA, particularly given the association between hormonal imbalances and disease burden. Early recognition and intervention may mitigate long-term developmental impacts in this high-risk pediatric group. Reference: Kumar D et al. Endocrine dysfunction in patients with juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2025;23(1):41.
