Changes of lipid metabolism in patients with rheumatoid arthritis and concomitant arterial hypertension, abdominal obesity and diabetes mellitus type 2 depending on the gene polymorphism T-786C of endothelial nitric oxide synthase
We have investigated the violations of blood lipid parameters in patients with rheumatoid arthritis (RA) combined with arterial hypertension (AH), abdominal obesity (AO) and diabetes mellitus type 2 (DM 2) depending on the gene polymorphism T-786C of endothelial nitric oxide synthase (eNOS). Materials and methods. The stage of screening was completed by 60 patients with rheumatoid arthritis, AH, AO and DM 2 and 20 apparently healthy people. The eNOS gene polymorphism (rs2070744) was determined by polymerase chain reaction, and during the evaluation of the lipid profile we took into account the presence of comorbid conditions. Results. The study showed that RA course was associated with dyslipidemia: a cholesterol level above population norm was detected in 61.67 % of patients, low-density lipoprotein cholesterol — almost in every second person (45.0 %), triglycerides (TG) — in 80.0 % of individuals, high-density lipoprotein (HDL) cholesterol, on the contrary, was below normal in 2/3 of patients (65.0 %). Typing of dyslipidemia indicates the presence in almost half of patients (45.0 %) of mixed ІІb type by D. Fredrickson, in every third (35.0 %) — endogenous hyperlipidemia type IV (hypertriglyceridemia). Conclusions. Changes in lipid metabolism taking into account polymorphic variants of eNOS gene (rs2070744) are associated with higher levels of TG in carriers of the mutant С-allele — by 81.71 % (рТТ = 0.04) and 36.58 % (рТТ = 0.015), as well as with a greater number of individuals with cholesterol levels above the population norm, among carriers of СС-genotype — by 75.0 % (p = 0.005). But among carriers of wild T-allele, there are more persons with a low content of antiatherogenic HDL cholesterol — by 31.04 % (p = 0.018) and 30.44 % (p = 0.039), and patients with high levels of TG — by 51.72 % (p < 0.001) and 56.52 % (p < 0.001), respectively.
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