Aim. To identify clinical and laboratory peculiarities of a combined clinical course of metabolic and articular syndromes. Materials and Methods. In the research 126 individuals participated. They were arranged into 3 groups: the 1st group included 46 patients with comorbid pathology, the 2nd group – 44 patients with metabolic syndrome, and the 3d group – 36 patients with articular syndrome. The following parameters were evaluated: anthropometric data (height, body mass, body mass index, waist circumference), lipid spectrum, glycohemoglobin, nonspecific markers of inflammation, daily profile of arterial pressure. Results. In the group with comorbid pathology higher average values of body mass were recorded – 115.8 [60;140] kg in comparison with the 2nd and 3d groups – 93.5 [72;130] and 71.5 [58;98] kg, respectively; erythrocyte sedimentation rate – 18.3 [5;34] mm/h was reliably higher than in the 2nd group (11.5 [2;24] mm/h), and median cholesterol (6.18 [5,39;6,85] mmol/L) was higher than in the 3d group (4.82 [3,48;5,61] mmol/L). In the 1st and 2nd groups higher average values of systolic arterial pressure were recorded in comparison with the 3d group – 158,5 [120;190]; 154,6 [115;190] and 126,4 [96;168] mm Hg, respectively. Conclusions. In patients with combined metabolic and articular syndromes higher values of body mass and systolic arterial pressure were identified. Based on the laboratory findings, parameters of cholesterol and erythrocyte sedimentation rate were higher in patients with comorbid condition than in those with the isolated pathologies.

I . P . P A V L O V R U S S I A N M E D I C A L BIOLOGICAL HERALD. 2018; 26(2):229-37 I . P . P A V L O V R U S S I A N M E D I C A L BIOLOGICAL HERALD. 2018; 26(2):229-37© Д.Ю. Горбунова 1 , З.А. Моргунова 2 , О.М. Урясьев 1 ФГБОУ ВО Рязанский государственный медицинский университет им. акад. И.П. Павлова Минздрава России, Рязань, Россия (1) ГБУ РО Городская клиническая больница №11, Рязань, Россия (2) Цель. Выявить клинические и лабораторные особенности совместного течения метаболического и суставного синдромов. Материалы и методы. В исследовании участвовало 126 человек. Из них было сформировано 3 группы: в 1-ую вошло 46 пациентов c коморбидной патологией, во 2-ую -44 пациента с метаболическим синдромом, в 3-ью -36 человек с суставным синдромом. Оценивались следующие параметры: антропометрические данные (рост, масса тела, индекс массы тела, окружность талии), липидный спектр, гликированный гемоглобин, неспецифические маркеры воспаления, суточный профиль артериального давления. Результаты. В группе коморбидной патологии получены более высокие средние значения массы тела -115,8 [60;140] кг, чем во 2-ой и 3-ей группах -93,5 [72;130] и 71,5 [58;98] кг, соответственно; показатель скорости оседания эритроцитов -18,3 [5;34] мм/ч -был достоверно выше, чем во 2-ой группе (11,5 [2;24] мм/ч), а медиана холестерина (6,18 [5,39;6,85] ммоль/л) выше, чем в 3-ей группе (4,82 [3,48;5,61] ммоль/л). В 1ой и 2-ой группах зарегистрированы более высокие средние показатели систолического артериального давления по сравнению с 3-ей группой -158,5 [120;190]; 154,6 [115;190] и 126,4 [96;168] мм рт ст, соответственно. Выводы. У пациентов с сочетанным течением метаболического и суставного синдромов выявлены более высокие значения массы тела и систолического артериального давления. По данным лабораторного обследования у больных с коморбидным состоянием наблюдаются более высокие показатели холестерина и скорости оседания эритроцитов, чем при изолированных патологиях.Ключевые слова: метаболический синдром, суставной синдром, коморбидность, ревматические заболевания. Municipal Clinical Hospital №11, Ryazan, Russia (2) Aim. To identify clinical and laboratory peculiarities of a combined clinical course of metabolic and articular syndromes. Materials and Methods. In the research 126 individuals participated. They were arranged into 3 groups: the 1 st group included 46 patients with comorbid pathology, the 2 nd group -44 patients with metabolic syndrome, and the 3 d group - КЛИНИЧЕСКИЕ И ЛАБОРАТОРНЫЕ ОСОБЕННОСТИ СОЧЕТАННОГО ТЕЧЕНИЯ МЕТАБОЛИЧЕСКОГО И СУСТАВНОГО СИНДРОМОВ ОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕ O R I GI N AL ST U DY

Literature review is devoted to the most important medical-social problems of the XXI century - metabolic syndrome and diabetes mellitus type 2. Dirung the last decades prevalence of this pathology is steadily growing worldwide. Metabolic syndrome is associated with high risk of developing diabetes type 2, which is associated with early disability and high mortality from vascular complications. The wide spread of undiagnosed diabetes among persons of working age results in the need for early active detection of the disease in this group. Prophylaxis plays a huge role in the prevention of negative effects of diabetes. Since the major modifiable risk factors of its development are visceral obesity and a complex of its associated states (metabolic syndrome components), normalization of body weight preserves its significance as a measure of primary, secondary and tertiary prevention. In patients with diabetes not only carbohydrate metabolism requires correction, but also body mass, lipid profile, blood pressure, and hemostasis system, that should be considered when choosing a glucose-lowering drug. The article presents the results of nationwide epidemiological studies devoted to the evaluation of prevalence of metabolic syndrome and diabetes type 2 among the adult population. Current understanding of pathogenesis of metabolic syndrome and diabetes is discussed. Attention is paid to 2017 guidelines of the American diabetes Association for obesity management in terms of diabetes prevention, as well as medications that can be used for weight loss in metabolic syndrome. The new criteria for screening for diabetes type 2 are described, the main results of recent studies on cardiovascular safety of glucose-lowering drugs are presented.

Background. Osteoarthrosis is characterized by wide prevalence, especially among patients of older age groups, a high risk of restrictions on the musculoskeletal system function, which results in the patients impaired ability to work and reduced quality of life. Aim: investigate the possibilities of thermographic assessment of efficiency of magnetotherapy of the articular syndrome in osteoarthrosis of the knee joints. Methods. The study included 57 patients (46 women and 11 men) with osteoarthrosis of the knee joints (mean age 61.27.4 years). The patients were divided into two groups. In the group 1 (n=29), magnetotherapy with the ALMAG-01 apparatus was used, while in the group 2 (n=28), the placebo apparatus was applied. Results. The inclusion of magnetotherapy in the complex therapy of osteoarthrosis of the knee joints, according to thermographic data, increases significantly the efficiency of treatment and differs significantly from the placebo magnetotherapy procedures. In patients with osteoarthrosis of the knee joints of the X-ray stages I and II, a combination of course treatment using a traveling pulsed magnetic field and standard drug therapy revealed a positive dynamics in normalization of the temperature balance of the joints. In patients with osteoarthrosis of the X-ray stage I, the minimum efficiency of magnetotherapy was revealed according to thermography, which indicates low severity of the inflammatory joint syndrome. Conclusion. The method of infrared thermography can be used as a diagnostic technique, as it reflects the degree of activity of the inflammatory process in the joints with osteoarthrosis.