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
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.
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