Background:Bone mineral density and proteins/peptides determination in blood and urine as markers of bone resorption and formation are currently used to diagnose osteoporosis (OP) and metabolic bone diseases. Recent evidence suggests that in RA changes in the secretion of hormones of white adipose tissue can be revealed [1,2,3,4].Objectives:To study the clinical and diagnostic value of serum fetuin A, nesfatin, hemerin, leptin, adiponektin, resistin, visfatin determination in RA patients complicated by OP.Methods:We examined 88 women with documented diagnosis of RA and mean disease duration of 6.56±0.88 years. We used EULAR/ARA 2010 criteria to diagnose the patients. Female patients with II degree of disease activity (DAS28), Steinbrocker stage II (erosive), rheumatoid factor- and anti-cyclic-citrullinated peptide antibody-positive were prevalent. We excluded patients who had surgery or developed an infection within the last 8 weeks, pregnant and breast-feeding women, those with severe heart, liver or kidney disease, immune deficiency, leukopenia or chronic infection.A control group of 45 healthy females aged of 25 and 59 years were included in the study. There were no reported findings of joint pain and RA symptoms in the group. The groups were adjusted for age (p>0.05) and showed no statistically significant differences.We measured serum fetuin A, nesfatin, hemerin, leptin, adiponektin, resistin, visfatin levels (µg/ml) using ELISA commercial test systems. We used spectrophotometer with wavelength of 450 nm to detect the test results («Multiskan» immunoenzyme analyzer, Finland). We plotted a curve using computer software. We diagnosed OP using dual-energy X-ray absorptiometry with LUNAR DPX PRO (GE, USA).Results:At the first stage, the level of pro-inflammatory cytokines was studied in a group of healthy individuals. Then, the reference values of these indicators were measured as М ± 2δ. Patients with OP and RA had significantly higher levels of serum pro-inflammatory cytokines (р<0.001). For example, mean serum Adiponectin levels in RA patients who had normal bone density and had no OP were 35.21±0.6 µg/ml. Mean serum Adiponectin levels in RA/OP patients with low bone mineral density were 52.42±0.69 µg/ml. Adiponectin levels of 44 µg/ml and higher were associated with osteoporosis. Adiponectin levels of 43.9 µg/ml and lower were associated with normal bone density. Other pro-inflammatory cytokines have demonstrated similar dynamics of level serum.Conclusion:Thus, we revealed that fetuin A, nesfatin, hemerin, leptin, adiponektin, resistin, visfatin levels depend on osteoporosis presence in RA patients. The test may be used to reduce the risk of low-energy fractures and to improve the quality of life in RA.References:[1]Akhverdyan Y. et al. Laboratory markers of inflammation and serum nicotinamide phosphoribosyltransferase level in rheumatoid arthritis patients // Ann. Rheum. Dis., 2017, vol.76, suppl.2, p.1149.[2]Kvlividze Z. et al. Elevated nesfatin-1 levels in patients with rheumatoid arthritis // Ann Rheum Dis, 2018, vol.77, p.A1762.[3]Papichev E. et al. Fetuin-A: clinical and laboratory associations in women with rheumatoid arthritis // Ann Rheum Dis, 2018, vol.77, p.A1228.[4]Polyakova J. S. et al. Serum visfatin determination in rheumatoid arthritis // Ann. Rheum. Dis. 2014; 73 (Suppl2).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

BackgroundObesity 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 (hemerin, lipokain, serum amyloid protein 3) [1,2,3,4,5]. Nowadays one of the most actively studied adipokines is nicotinamide phosphoribosyltransferase (visfatin, Nampt).ObjectivesWe investigated the relationship the effect of weight loss over 5 kg on the clinical manifestations of OA and Nampt serum levels in patients with OA.MethodsWe observed 160 patients with different forms of OA ranged in age from 36 to 78 years, of whom there were 104 (65%) women (mean age 52.08 ± 1,58 years), and 56 (35%) of men (mean age - 54.07 ± 2,0 years) and the control group (60 healthy persons) with no complaints of pain in the joints over a lifetime, and without clinical signs of OA. Nampt level in serum was determined by ELISA using a commercial test systems.ResultsAs 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 36 patients (23%). All patients were divided into two groups to study the effect of weight loss on the clinical manifestations of OA. These data proves that obesity may be an important risk factor for OA progression. As a result, weight loss results in decreasing metabolic disorder severity. In the second group of patients we have seen a decrease in all the parameters, but a significant difference has been observed only in the level of CRP, level of pain at rest and during walking according to VAS scale and total index on the WOMAC. However, patients with weight loss over 5 kg had significantly greater positive dynamics of clinical parameters than in the second group without weight loss. This fact is probably explained by the decreased activity of inflammatory process after OA therapy and weight reduction.ConclusionThus, as a result of our study patients with OA 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 visfatin in the pathogenesis of osteoarthritis. All patients with OA 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. Adipokines as new laboratory markers in osteoarthritis//Ann Rheum Dis 2013. – Vol.72 (Suppls. 3):702.[2] Degtiarev, V.K.; Aleksandrov, A.V. et al. The influence of general magnetic therapy on the psychological status of the patients presenting with osteoarthrosis//Voprosy kurortologii, fizioterapii, i lechebno fizicheskoy kultury 2013, №3, P.27-30.[3] Zavodovsky, B. V. et al. The efficacy and safety of etoricoxib versus meloxicam in the...

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