V.M. Kovalenko, A.S. KozlyukCharacteristics of the peripheral arteries functional state under chronic systemic inflammation in patients with osteoarthrosis and concomitant metabolic syndrome

The aim – to study the dependence between systemic inflammation and endothelial function in patients with osteoarthrosis (ОА) and concomitant metabolic syndrome (MS).
Material and methods. 71 patients with OA and concomitant MS and 25 healthy subjects were examined. C-reactive protein (CRP), intracellular malondialdehyde (MDA), monocytes activity (MC), oxidative stress intensity (MDA in serum), renin angiotensin system activity with measurement of angiotensin converting enzyme activity (ACE act.) were studied. In addition, we studied lipid metabolism parameters, such as cholesterol (Chol.), triglycerides (Tg.), classes of lipoproteins and their atherogenic potential (concentrations of Chol. in circulating immune complex (CIC) and Tg in CIC). Besides, we studied flow mediated vasodilation (FMD), parameters of brachial artery and carotid intima-media thickness (CIMT).
Results. In patients with OA and MS CRP level was 5.6 times elevated and ACE activity was 3.17 times higher (p<0,001). MDA MC level and MDA serum level were 3,1 and 3.8 times higher, respectively, compared to the control group (Р<0.001). Besides, in patients with OA and MS lipid metabolism violation was detected, shown by elevated levels of Tg. and Chol. Tg. and Chol. concentrations in CIC were 5.6 and 5.5 times higher compared to the control group (Р<0.001). High activity of inflammatory reactions and oxidative stress was accompanied with 40 % reduction FMD of brachial artery (Р<0.001). Besides, CIMT was 55 % elevated (Р<0.001). Conclusion. In patients with OA and concomitant MS persisting elevation of inflammatory markers and oxidative stress intensity, atherogenic dyslipidemia and blood lipids peroxidation were found. In association with chronic low-intensity inflammation in patients with OA and MS reduction of FMD was found. Chronic systemic inflammation and elevation of modified lipoproteins play important role in endothelial dysfunction of arterial vessels.

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