Министерство науки и высшего образования Российской Федерации Федеральное государственное бюджетное научное учреждение «Научно-исследовательский институт клинической и экспериментальной ревматологии имени А.Б. Зборовского» Федеральное государственное бюджетное образовательное учреждение высшего образования «Волгоградский государственный медицинский университет» Министерства здравоохранения Российской Федерации

Background:Attention is drawn to the frequent combination of osteoarthritis (OA) with cardiovascular disease. Non-specific inflammation plays a significant role in the pathogenesis of OA and atherosclerosis. Limiting the physical activity of patients with OA is an additional important factor aggravating the course of cardiovascular disease (CVD). Chronic pain syndrome, causing a neuroendocrine response, is often the cause of the development of complications of atherosclerotic disease. Dyslipidemia is the main cause of atherosclerosis and vascular thrombosis.Objectives:To study variants of lipid metabolism disorders in female and male patients of different age groups with osteoarthritis.Methods:Case histories of 90 patients with OA were analyzed. The average age of patients was 63.27 ± 11.31 years. The average body mass index (BMI) is 39.8 ± 3.2. All patients underwent questionnaires, general clinical and biochemical blood tests with lipid profile determination, anthropometry, bioimpedansometry, and the main metabolic rate assessment using indirect calorimetry in dynamics (at the beginning of the study and after 3 months).Results:Burdened heredity for obesity, arterial hypertension (AH), diabetes mellitus (DM) was revealed. AH was diagnosed in 76 patients (84.4%), type II diabetes in 17 (18.9%), dyslipidemia and hypercholesterolemia in 56 (62.2%). Statins were taken by 43 patients (47.8%) - group I patients, which is associated with low adherence to therapy, group II included patients who did not initially take statins or stopped taking them at least 6 months before inclusion in the study.Against the background of diet therapy and physiotherapy exercises, BMI (R0.99; p <0.05), fat mass (R0.95; p <0.05) significantly decreased, lipid profile normalization was noted: total cholesterol (R0.66; p <0 .05), LDL (R0.69; p <0.05), HDL (R0.95; p <0.05), TG (R0.57; p <0.05), AST decreased (R0.64; p <0.05) and ALT (R0.76; p <0.05) in both groups of patients, regardless of lipid-lowering therapy. A decrease in fat mass correlated with TG levels (R0.51; p <0.05), an increase in skeletal muscle mass (R0.60; p <0.05), lean mass (R0.72; p <0.05), and active cell mass (R0.59; p <0.05). The lipid profile in the I group of patients was significantly better before and at the end of the study. Long-term effects have not been investigated due to the short duration of the study.Conclusion:In patients with OA, a high frequency of concomitant diseases of the cardiovascular system, lipid metabolism disorders was found. Non-drug therapy has a positive effect on the lipid profile and the level of transaminases. The decrease in body weight due to loss of fat mass reliably correlates with the level of TG. Timely use of statins contributes to the normalization of the lipid profile, reduces the risk of cardiovascular disease in patients with OA. It is necessary to study lipid profile disorders in patients with OA with recommendations for lifestyle modification (diet, physical activity), and if necessary, prescribe lipid-correcting therapy.References:[1]E. Simakova, B. Zavodovsky, L. Sivordova [et al]. Prognostic significance of lipid disorders markers determination in pathogenesis of osteoarthritis. Vestnik Rossijskoj voenno-medicinskoj akademii. 2013. No. 2 (42). P.29-32.[2]Zavodovsky B.V., Sivordova L.E. Prognostic significance value of definition of leptin level determination in osteoarthritis. Siberian Medical Journal (Irkutsk). 2012; 115(8):069-072.Disclosure of Interests:None declared

Background:Overweight in patients with rheumatic diseases is a condition that prolongs chronic inflammation and promotes synthesis and secretion of pro-inflammatory factors by adipose tissue, such as classical cytokines, tumor necrosis factor-α (TNF-α), adipokines (leptin, adiponektin, resistin) and other newly identified proinflammatory factors (fetuin A, nesfatin, hemerin, lipokain, serum amyloid protein 3) [1,2,3,4].Objectives:We investigated the relationship the effect of weight loss over 5 kg on the clinical manifestations of arthritis and hormones of adipose tissue serum levels in patients with rheumatoid arthritis (RA).Methods:We observed 80 female patients with RA (EULAR/ARA 2010 criteria) ranged in age from 39 to 69 years (mean age 51,72 ± 5,83 years) and the control group (60 healthy persons) with no complaints of pain in the joints over a lifetime, and without clinical signs of RA. Fetuin A, nesfatin, hemerin, leptin, adiponektin, resistin, visfatin level in serum was determined by ELISA-test using a commercial test systems.Results:As overweight patients were recruited in the study, hypocaloric diet low in animal fats and physiotherapy has been recommended to all participants. The positive dynamics in body weight loss over 5kg within 3 months has been achieved by 34 patients (27,2%). In RA patients with weight loss, a significant decrease in the serum level of pro-inflammatory cytokines (fetuin A, nesfatin, hemerin, leptin, adiponektin, resistin, visfatin (p<0.01)) and an increase in the quality of life according to the EQ-5D-5L (p<0.001) index were observed. This fact is probably explained by the decreased activity of inflammatory process after RA therapy and weight reduction.Conclusion:Thus, as a result of our study patients with RA with weight loss of more than 5 kg had more obvious pain relief than patients with the original weight. These findings suggest that there is a possible role of tissue pro-inflammatory cytokines in the pathogenesis of rheumatoid arthritis. All patients with RA with a BMI over 25 kg / m 2 are recommended to lower their weight to decrease the mechanical stress on the joints, and also to reduce the severity of inflammation and metabolic disorders.References:[1]Akhverdyan, Y. et al. The nicotinamide-phosphoribosiltransferase as a marker of systemic inflammation under osteoarthrosis // Klin Lab Diagn. 2017; 62(10):606-610.[2]Kravtcov, V. et al. High level of adipokines and overweight as factors contributing to osteoarthritis progression // Osteoporosis International, 2019. V.30 (2). S. 408.[3]Papichev, E. V. et al. Parameters of mineral-bone metabolism and fetuin-А level in patients with rheumatoid arthritis // Osteoporosis International, 2019. V.30 (2), S.381.[4]Polyakova J. et al. Tissue cytokines and their role in the pathogenesis of rheumatic diseases // Annal.Rheum.Diseases, 2019. Т. 30 (2), № S.387.Disclosure of Interests:None declared

BackgroundCareful attention to postmenopausal osteoporosis (OP) leads to an underestimation of this problem in men.ObjectivesTo assess the frequency of bone mineral density reduction (BMD) in men referred for examination, analysis of bone mineralization disorders in men at different age periods, the main reasons for referral for examination.MethodsDuring the year, a two-energy X-ray absorption osteodensitometry (LUNAR XP, USA) was examined by 2,731 patients according to a standard program.ResultsAmong the 2731 patients referred for examination, the proportion of men is 5%, men over 60 years old are 2%, male children and teenagers are 0.29%. Normal BMD was detected in 31.88%, low bone mass (LBM) - in 39.86%, OP - in 28.26%.60.14% (83 people) - men of young and middle age, NCM was detected in 33 men, OP - in 14. In 8 - severe form. Reduced BMD patients revealed the presence of serious underlying disease (ankylosing spondylitis, rheumatoid arthritis (RA), systemic lupus erythematosus, diabetes mellitus I type, diffuse toxic goiter disease operated stomach, ulcerative colitis, chronic autoimmune hepatitis and alimentary toxic hepatitis with outcome in cirrhosis of the liver, bronchial asthma (BA), alveolitis.Elderly and senile men among the surveyed were 55 people (39.86%), LBM - in 22 of them, OP - in 25. Low traumatic fractures in the anamnesis in this group of patients were detected in 13 of 55. In 6 - multiple vertebral fractures, in 2 - multiple repeated fractures of tubular bones. Secondary causes of a decrease in BMD were detected only in 5 out of 55 (9.09%) men aged 60 years and older (RA, BA, idiopathic alveolitis, liver cirrhosis; all currently or with a history of glucocorticoid therapy).Normal BMD was detected in 44 men. Up to 59, their number was 36 people (81.8%), 60 years and older - only 8 (18.2%). The majority of men with normal BMD indices were sent for examination by dentists, endocrinologists, orthopedic traumatologists. 5 adolescents with BMD in accordance with normal age criteria BMD had repeated traumatic bone fractures in history (fractures during sports (wrestling, football)).ConclusionUnlike women, men do not pay enough attention to the prevention of OP, often use dairy products in limited quantities, do not take calcium preparations for prophylactic purposes. A high percentage of the population is characterized by low physical activity. Men more often than women abuse alcohol and smoking.OP occurs without obvious clinical manifestations until the moment of fracture of the skeleton bones, primary care physicians and hospitals have low alertness for the detection of OP in men. FRAX (fracture risk assessment tool) makes it easy to calculate the probability of a 10-year risk of fractures and identify men at high risk for further examination. The urgency of the problem is due to the increase in the average life expectancy of a modern person.References[1] Problemy diagnostiki nizkotravmatichnyh perelomov pozvonkov u lic starshego vozrasta. Pisareva V., Mihajlov M., Poljakov V.[et al]. Russian Jour...

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