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    Variation in the Clinical Manifestation of Rheumatoid Arthritis Based on the Residence Areas

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    The study included rheumatoid arthritis patients from three regions of Uzbekistan, viz., Tashkent city - zone I (n=144), Khorezm region – zone II (n=112) and the Namangan region – zone III (n=104). Comparative clinical and laboratory analyses showed the clear evidence of aggressive joint syndrome dominance in zone II (71.4%), which was higher than those of the patients in zone III (P<0.05), as well as the development of severe destructive lesions of the joints, even up to the joints ankylosing. Also, zone II was dominated by the visceral forms of the disease, up to 52.7%, whereas in zone I this value was 31.3%, while zone III was characterized by the low rates of extra-articular manifestations, at 11.5% (P<0.05). Moreover, the zone II patients in comparison with zone I patients more frequently required hospitalization and ambulant therapy (P<0.05). A retrospective study of the genetic aspects of rheumatoid arthritis patients had established the fact that in zone I, 52.14% of the patients’ family history was burdened with rheumatoid arthritis (28.6% in zone II and 24.1% in zone III); while in zone II - there was an upward trend in the incidence of the disease among the descendants of the rheumatoid arthritis patients, at 55.4% (27.8% in zone I and 23.1% in zone III). Thus, a comparative analysis demonstrated that the clinical and epidemiological parameters of rheumatoid arthritis were different in all the three areas of Uzbekistan, which did not exclude the probability of the influence of climatic and geographical factors on the course of the rheumatoid arthritis
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