Dynamics of acute phase indices in patients with rheumatoid arthritis combined with abdominal obesity, type 2 diabetes mellitus and arterial hypertension depending on Т-786С eNOS gene polymorphism following treatment
Keywords:rheumatoid arthritis, abdominal obesity, type 2 diabetes mellitus, arterial hypertension, acute phase indices, T-786C еNOS gene, treatment
Background. The development of modern approaches to the pharmacotherapy of rheumatoid arthritis (RA) associated with abdominal obesity (AO), type 2 diabetes mellitus (DM 2) and arterial hypertension (AH) remains relevant today. The purpose of the study was to investigate the dynamics of acute-phase indices following treatment in patients with RA combined with AO, DM 2 and AH, depending on the T-786C gene polymorphism of endothelial nitric oxide synthase (eNOS). Materials and methods. Sixty patients with RA and 20 apparently healthy persons passed the stage of screening. The polymorphism of the eNOS gene (rs2070744) was determined by polymerase chain reaction, and when evaluating the efficacy of treatment, the presence of comorbid pathology was taken into account. Results. Following treatment, the content of acute phase inflammation indices decreased: C-reactive protein in carriers of unfavorable СС-genotype — by 30.74 % (p = 0.002), TT-genotype — by 44.16 %, and TС-genotype — by 32.21 % (p < 0.001). The level of the rheumatoid factor decreased in the carriers of the TT-genotype by 49.66 % (p < 0.001), TС-genotype — by 26.46 % (p < 0.001) and СС-genotype — by 29.75 % (p < 0.001). The content of cyclic citrullinated peptide antibodies reduced only among carriers of the TT-genotype — by 10.79 % (p < 0.05). The level of antistreptolysin O has probably decreased by 14.07 and 21.44 %, with no statistically significant advantage in СС-genotype carriers (p > 0.05). The content of seromucoid and serum test parameters reduced in СС-genotype carriers by 19.52 (p < 0.05) and 24.56 % (p < 0.05), in carriers of the TT-genotype — by 13.84 (p < 0.05) and 18.71 % (p < 0.05) and TС-genotype — by 18.49 (p < 0.05) and 22.89 % (p < 0.001), respectively. Conclusions. After the treatment, the reduction in the content of the acute phase inflammation indices in the carriers of the TT-genotype was the most significant.
Ministry of Нealth of Ukraine. Unified clinical protocol of primary, secondary (specialized), tertiary (highly specialized) medical aid and medical rehabilitation: Rheumatoid arthritis. Kyiv; 2014. 45 p. (in Ukrainian).
Kovalenko VM. Optimisation of swelling and inflammatory joint syndromes’ treatment in patients with rheumatic joint diseases: the evidence-based data and experience in Ukraine. Ukrai'ns'kyj revmatologichnyj zhurnal. 2011;44(2):43-47. (in Ukrainian).
Gavrilenko TІ, Il’iash MG, Mіtchenko OІ, et al. The role of vascular endothelial growth factor in development of inflammation and immunological react in patients with early rheumatoid arthritis. Ukrai'ns'kyj revmatologichnyj zhurnal. 2012;49(3):58-63. (in Ukrainian).
Iaremenko OB, Mykytenko GM. The influence of comorbidity and extra-articular manifestations of rheumatoid arthritis on the efficacy and tolerability of syntetic disease modifying antirheuvmatic drugs. Ukrai'ns'kyj revmatologichnyj zhurnal. 2015;1(59):28-35. (in Russian).
Kovalenko VN, Golovach IYu, Bortkevych OP. Current objectives for target treatment of rheumatoid arthritis: from monoclonal antibodies to blockers of signaling pathways molecules. Ukrai'ns'kyj revmatologichnyj zhurnal. 2012;49(3):5-15. (in Russian).
Ministry of Нealth of Ukraine. Order № 384 dated May 24, 2012. On approval and implementation of medical-technological documents for the standardization of medical assistance in arterial hypertension. Available from: http://old.moz.gov.ua/ua/portal/dn_20120524_384.html. Accessed: May 24, 2012. (in Ukrainian).
Ministry of Health of Ukraine. Order № 263 dated April 11, 2014. On approval and implementation of medical-technological documents for the standardization of medical assistance in rheumatoid arthritis. Available from: http://old.moz.gov.ua/ua/portal/dn_20140411_0263.html. Accessed: April 11, 2014. (in Ukrainian).
Andersson ML, Svensson B, Bergman S. Chronic widespread pain in patients with rheumatoid arthritis and the relation between pain and disease activity measures over the first 5 years. J Rheumatol. 2013 Dec;40(12):1977-85. doi: 10.3899/jrheum.130493.
Dougados M, Soubrier M, Antunez A, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis. 2014 Jan;73(1):62-8. doi: 10.1136/annrheumdis-2013-204223.
Strand V, Burmester GR, Ogale S, Devenport J, John A, Emery P. Improvements in health-related quality of life after treatment with tocilizumab in patients with rheumatoid arthritis to tumor necrosis factor inhibitors: results from the 24-week randomized controlled RADIATE study. Rheumatology (Oxford). 2012 Oct;51(10):1860-1869. doi: 10.1093/rheumatology/kes131.
Huffman MD, Lioyd-Jones DM, Ning H, et al. Quantifying options for reducing coronary heart disease mortality by 2020. Circulation. 2013 Jun 25;127(25):2477-2484. doi: 10.1161/CIRCULATIONAHA.112.000769.
Pekhenko VS. Features nitrogen metabolism in patients with rheumatoid arthritis, combined with hypertension and its changes in different types of medication. Scientific Issue Ternopil Volodymyr Hnatiuk National Pedagogical University Series: Biology. 2016;66(2):85-90. (in Ukrainian).
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