Pathomorphosis of the metabolic phenotype osteoarthritis: the role of obesity, diabetes and hypothyroidism (age and gender features)
Background. Osteoarthritis (OA) is one of the most common diseases of the musculoskeletal system, which is characterized by a high level of comorbidity. The growing prevalence of obesity, diabetes mellitus (DM) and hypothyroidism as components of the OA metabolic phenotype are noteworthy comorbid phenomena. The purpose of the study was to investigate inter-relation and variants of inter-aggravation of OA phenotype as well as the age and gender features of pathomorphism of OA metabolic phenotype for concomitant obesity, type DM and hypothyroidism. Materials and methods. The survey covered 312 patients aged 37–76 years with primary OA. The research methods were following: clinical, X-ray, ultrasonographic, biochemical, radioimmunological, statistical. Results. Among the selected patients, the OA metabolic phenotype was dominant (62.9 %), the main component of which was obesity but in 19 % of cases this phenotype subsequently collapsed type 2 DM and 18 % patients had hypothyroidism (subclinical form was detected in 13.78 % cases), mainly in women, a significant difference was observed in age-related obesity, DM, hypothyroidism. Verified endocrine diseases significantly worsened dyslipidemia manifestation, course, degree, and the results of ОА treatment and the treatment of comorbid cardiovascular and digestive diseases. By clinical prognostic, therapeutic and preventive features OA metabolic phenotype is divided into the subtype A — obesity and DM, and subtype B — obesity and hypothyroidism. Conclusions. The OA metabolic phenotype is dominant in its structure, and the determination of subtype A (OA, obesity and DM) and subtype B (OA, obesity and hypothyroidism) will contribute to substantiated improvement of the therapeutic and prophylactic strategy as regards the individualized treatment.
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