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Sangeeta Sule,1 Kevin Fontaine2 1Department of Pediatric, Pediatric Rheumatology, Johns Hopkins University, Baltimore, MD, USA; 2Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA Objective: The objective of this study was to determine the risk of obesity and metabolic syndrome in adults with a history of juvenile arthritis (JA). Methods: Using the National Health and Nutrition Examination Survey (NHANES), we compared the characteristics of respondents with arthritis (JA vs rheumatoid arthritis [RA]) to those of the control group without arthritis. We used logistic regression analyses, controlling for age, race, and gender, to determine the ORs for metabolic syndrome. Results: Obesity was increased in the JA group with 67% respondents having body mass index ≥30 kg/m2 vs 55% respondents in the no arthritis cohort (p=0.004). In unadjusted analyses, there was increased odds of metabolic syndrome in JA (OR 6.2, p=0.001) and RA groups compared to those without arthritis (OR 7.7, p=0.001). After adjusting for age, gender, and race, the odds of metabolic syndrome remained increased in JA (OR 5.2, p=0.001) and RA (OR 3.2, p=0.001) groups. Conclusion: Adults with a history of JA have a significantly increased risk of metabolic syndrome compared to those without arthritis. These findings are important because metabolic syndrome has been associated with an increased risk of cardiovascular disease and death in other populations. Keywords: juvenile arthritis, outcomes research, cardiovascular disease

Carrie R Howell,1 Caroline N Harada,2 Kevin R Fontaine,3 Michael J Mugavero,4 Andrea L Cherrington1 1Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 2Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA; 3Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Al, USA; 4Department of Medicine, Division of General Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, USACorrespondence: Carrie R Howell, Department of Medicine, Division of Preventive Medicine, Medical Towers Suite 638, 1717 11th Avenue South, Birmingham, AL, 35294, USA, Email chowell@uabmc.eduAbstract: The evidence of suboptimal social determinants of health (SDoH) on poor health outcomes has resulted in widespread calls for research to identify ways to measure and address social needs to improve health outcomes and reduce disparities. While assessing SDoH has become increasingly important in diabetes care and prevention research, little guidance has been offered on how to address suboptimal determinants in diabetes-related clinical care, prevention efforts, medical education and research. Not surprisingly, many patients experience multiple social needs – some that are more urgent (housing) than others (transportation/resources), therefore the order in which these needs are addressed needs to be considered in the context of diabetes care/outcomes. Here we discuss how conceptualizing diabetes related health through the lens of Maslow’s hierarchy of needs has potential to help prioritize individual social needs that should be addressed to improve outcomes in the context of population-level determinants in the communities where people live.Keywords: social determinants of health, diabetes, clinical care, clinical education

Sangeeta D Sule,1 Kevin R Fontaine21Division of Rheumatology, Children’s National Health System, Washington, DC 20010, USA; 2Department of Public Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AB, USABackground: Juvenile idiopathic arthritis (JIA) is an inflammatory autoimmune disease that can cause severe impairment and disability. Exercise is recommended to preserve joint mobility and function. Our objectives were to assess the safety, feasibility, and effects of slow speed resistance exercise in children with polyarticular JIA.Methods: Patients were recruited from a pediatric rheumatology clinic at an urban hospital and randomized to exercise or control groups. In the intervention group, slow speed resistance exercise with individualized instruction by a certified trainer was performed 1–2 times per week for 12 weeks. The control group performed home-based aerobic exercise 3 days per week for 12 weeks. Pre and post-body composition measurements by dual-energy X-ray absorptiometry; aerobic fitness by peak oxygen uptake during cycle ergometry; isometric muscle strength; and quality of life measures were obtained.Results: In the exercise group, 9/17 (53%) completed any exercise training. Of these nine subjects, five (55%) completed all 12 weeks of the protocol. In the control group, 8/16 (50%) reported compliance with the recommended aerobic exercise training at least one time per week. Only 2 subjects (12%) reported exercising more than once per week. There was no significant difference between pre- and post-measurements in any category in the exercise group. There was also significantly elevated body fat in both groups with only 17% in the control group and 23% in the exercise group meeting recommended