Features of bone metabolism in patients with osteoarthritis, type 2 diabetes mellitus and their combination

Background. Osteoarthritis (OA) is one of the most common joint diseases characterized by periodic exa­cerbations, pain syndrome of varying severity, progressive course, which leads to deformity of the joints, a decrease of their function and deterioration of patients’ life quality. The association of OA with a variety of metabolic disorders, such as type 2 diabetes mellitus (DM) and obesity, is very important. The purpose of the study was to investigate the parameters of bone metabolism in patients with OA, type 2 diabetes mellitus and their combination in patients with different phenotypes, as well as the correlation between parameters of bone metabolism and the level of proinflammatory cytokines. Materials and me­thods. A total of 104 patients with OA alone, type 2 DM alone and a combination of OA with type 2 DM were examined (31 men, mean age 54.02 ± 0.67 years). The survey plan included evaluation of C-reactive protein (СRP), osteocalcin, calcitonin, Ca, P, Mg, tumor necrosis factor a (TNF-a), interleukin-1b (­IL-1b) in the blood. The X-ray exa­mination of the knees was performed in all patients with OA. Results. The significantly higher levels of osteocalcin were determined in the control group and in the group of patients with OA alone as compared to the groups of patients with type 2 DM alone and OA combined with type 2 DM. That is, the following was va­lid for osteocalcin: control = OA > T2DM = = ОА + T2DM = ОА + + T2DM + obesity. The highest number of significant correlations was found in the group with comorbid pathology and obesity. We determined the relationships between osteocalcin and TNF-a (r = –0.78, p < 0.05), IL-1b (r = –0.75, p < 0.05), CRP (r = –0. 46, p < 0.05), between Ca and TNF-a (r = 0.67, p < 0.05), IL-1b (r = 0.59; p < 0.05), between calcitonin and TNF-a (r = 0.56, p < 0.05), IL-1b (r = 0.46, p < 0.05), CRP (r = 0.42, p < 0.05), between Mg and TNF-a (r = –0.47, p < 0.05). The results of the canonical analysis of cytokine activity and parameters of bone metabolism suggest that a significant correlation exists between cytokines and the characteristics of bone metabolism (canonical correlation = 0.52, p < 0.05), the largest contribution to this connection is made by IL-1b among cytokines, and by osteocalcin — among bone metabolism indices. Conclusions. The study demonstrates a definite role of systemic inflammation in the development of bone metabolism disorders that can influence the progression of OA

Effect of Combination Therapy with Alpha-Lipoic Acid on the Fractalkine Level in Patients with Coronary Artery Disease and Type 2 Diabetes Mellitus

Background. The aim of research — to assess the fractalkine levels in patients with coronary artery disease (CAD), depending on the presence of type 2 diabetes mellitus (DM) and the nature of coronary artery lesions before treatment and during the standard and combination therapy with the addition of alpha-lipoic acid. Materials and methods. We have examined 131 patients with CAD (89 men and 42 women), mean age of them was 59.60 ± 9.11 years. The control group consisted of 20 apparently healthy volunteers of the same age and sex. Depending on the presence of type 2 DM, patients with CAD were divided into 2 groups: the first group (n = 70) — patients with concomitant type 2 DM, the second group (n = 61) — patients with CAD and without concomitant type 2 DM. All patients were performed coronary angiography to verify the diagnosis of CAD. All patients, depending on the nature of coronary artery lesions and therapy, were divided into 2 subgroups — subgroup IA (standard therapy) and the subgroup IB (combination therapy). All patients were evaluated fractalkine levels before therapy and after 3 months of treatment. Results. The study found that patients with CAD, both with concomitant type 2 DM or without it, had significantly increased levels of fractalkine compared with the control group (p < 0.05). When comparing treatment regimens, it was found that in the subgroup of standard therapy, fractalkine ave­rage level before treatment was 485.07 ± 106.55 pg/ml, and after 3 months of therapy — 444.08 ± 99.86 pg/ml, while there was no significant difference between baseline value and the value reached after 3 months (p = 0.08), although there was a trend to reduce the level of this indicator. Patients from IB subgroup (n = 105), who received combination therapy, had a significant trend to reduce the fractalkine level in 3 months as compared to the initial value before therapy (510.49 ± 103.95 pg/ml vs 575.56 ± 123.86 pg/ml; p = 0.00001). The relative reduction in fractalkine level in the subgroup IA was 8.45 %, in the subgroup IB — 11.3 %. Conclusions. The study results demonstrate the impact of endothelial dysfunction on the development and progression of atherosclerosis, especially in patients with concomitant type 2 DM. Applying alpha-lipoic acid in combination therapy schemes contributes to a significant reduction in fractalkine levels, and, thus, leads to a decrease in endothelial dysfunction and, as a result, to the possible improvement of prognosis in this group of patients

Застосування еластографії у хворих із хронічними захворюваннями печінки

The article considers the advantages and disadvantages of the non-invasive method for diagnosing liver fibrosis — elastography. The types of this research method, applications were described. The most effective types of elastography for various chronic liver diseases were indicated (chronic hepatitis B and C, non-alcoholic fatty liver disease, autoimmune diseases of the hepatobiliary system and alcoholic liver disease). The latest research results were analyzed.В статье рассмотрены преимущества и недостатки неинвазивного метода диагностики фиброза печени — эластографии. Описаны виды данного метода исследования, области применения. Указаны наиболее эффективные виды эластографии для различных хронических заболеваний печени (хронические гепатиты В и С, неалкогольная жировая болезнь печени, аутоиммунные заболевания гепатобилиарной системы и алкогольная болезнь печени). Проанализированы данные новых рандомизированных контролируемых исследований.У статті розглянуті переваги й недоліки неінвазивного методу діагностики фіброзу печінки — еластографії. Описано види даного методу дослідження, області застосування. Вказані найбільш ефективні види еластографії для різних хронічних захворювань печінки (хронічні гепатити В і С, неалкогольна жирова хвороба печінки, аутоімунні захворювання гепатобіліарної системи та алкогольна хвороба печінки). Проаналізовані дані нових рандомізованих контрольованих досліджень

The Role of Disturbances of Bioelement Metabolism in Nonalcoholic Fatty Liver Disease in Patients with Diabetes Mellitus Type 2

Patients with diabetes mellitus type 2 and fatty liver disease were examined. Except the common methods, for differential diagnosis we have used determination of bioelement content of the blood (potassium, sodium, magnesium, copper, zinc, iron, calcium). Changes of micro- and macroelement metabolism in patients with diabetes mellitus type 2 and nonalcoholic fatty liver disease depending on the activity of pathological process in the liver and stage of the disease. When examining patients, it is appropriate to measure the levels of potassium, sodium, magnesium, copper, zinc, iron and calcium as additional criteria to evaluate the severity of the disease and functional state of the liver