Background:Interest in highly specialized tissue cytokines contributed to the discovery of new biologically active molecules. Nesfatin-1 (NF) - discovered in 2006 as an anorexigenic factor. NF-1 is believed to be involved in the regulation of energy homeostasis by regulating appetite and water intake. The role of NF-1 in the pathogenesis of inflammatory diseases is poorly understood. Recently, studies have found a relationship between an increased level of NF-1 and inflammatory markers in various pathologies.Objectives:Study of the level of nesfatin-1 in the blood serum of healthy people, determination of the correlation between the level of NF-1 with the severity of clinical symptoms and classic markers of inflammation in patients with RA.Methods:120 persons were examined: 90 patients with RA and 30 healthy people. All patients underwent a complete clinical and laboratory examination. Plasma NF-1 levels were determined using commercial test systems (RaiBiotech, cat # EIA-NESF) according to the manufacturer’s instructions. Patients with various forms of RA were comparable in age to the group of healthy individuals. Statistical processing of clinical examination data was carried out using the “STATISTICA 10.0 for Windows” software package. Quantitative data were processed statistically using the parametric Student’s t-test, qualitative data using the non-parametric chi-square test. The significance of differences between groups was determined using analysis of variance. The results were considered statistically significant at p <0.05.Results:The average level of NF-1 in blood serum in healthy individuals was 31.79 ± 3.21 ng / ml (M ± σ). The level of normal NF-1 values in healthy individuals, defined as M ± 2σ, ranged from 25.3 to 37.83 ng / ml. There was no significant difference in the levels of circulating NF-1 and BMI in healthy individuals and patients with RA (p> 0.05). The inverse relationship of a lower level of NF-1 with an increase in BMI was not significant.Group 1 (66 patients with RA) with increased serum NF-1 levels (> 37.83 ng / ml), and group 2 (44 patients) with normal values (<37.83 ng / ml). A high level of NF-1 was characteristic for patients with high activity according to DAS28, RF seropositive, ACCP-positive, with extra-articular manifestations, who had been ill for 10 years or more. A reliable relationship between the level of NF-1 in the blood serum and laboratory parameters of RA activity - ESR, CRP, was shown, and secondary synovitis was more common. Our data show a direct correlation between the NF-1 level of the pro-inflammatory markers of RA.Conclusion:The positive correlation between the level of NF-1 and classical markers of inflammation, such as CRP and ESR, confirms the involvement of NF-1 in the pathophysiology of inflammation in RA. This is also evidenced by the correlation of a high level of NF-1 in the blood serum with a more severe clinical picture of RA. It is known that NF-1 can promote the release of pro-inflammatory cytokines such as interleukin-8 (IL-8), interleukin-6 (IL-6), and macrophage inflammatory protein-1a (MIP-1a) in the chondrocytes of RA patients.It is necessary to further study the role of NF-1 in the pathogenesis of systemic inflammatory reactions and the possibility of targeting pro-inflammatory cytokines, the possibility of regulating the level of NF-1 by drugs.References:[1]Kvlividze T.Z., Zavodovsky B.V., Akhverdyan Yu.R. Kvlividze T.Z., Zavodovsky B.V., Akhverdyan Yu.R., Polyakova Yu.V., Sivordova L.E., Yakovlev A.T., Zborovskaya I.A. Serum nesfatin -1 as a marker of systemic inflammation in rheumatoid arthritis. Klinicheskaya Laboratornaya Diagnostika (Russian Clinical Laboratory Diagnostics). 2019; 64 (1): 53-56 (in Russ.).Disclosure of Interests:None declared

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...

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...