Pathomorphosis of the metabolic phenotype osteoarthritis: the role of obesity, diabetes and hypothyroidism (age and gender features)

Authors

  • L.O. Voloshyna SHEI “Bukovinian State Medical University”, Chernivtsi, Ukraine
  • S.I. Smiyan SHEI “I. Horbachevskyy Ternopil State Medical University”, Ternopil, Ukraine

DOI:

https://doi.org/10.22141/2224-0721.13.5.2017.110018

Keywords:

osteoarthritis, metabolic phenotype, obesity, diabetes mellitus, hypothyroidism, diagnosis

Abstract

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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References

Castañeda S, Roman-Blas JA, Largo R, Herrero-Beaumont G. Subchondral bone as a key target for osteoarthritis treatment. Biochemical Pharmacology. 2012;83(3):315-23. doi: 10.1016/j.bcp.2011.09.018.

Voloshina LO. The early diagnosis of hypothyroidism as a factor in the progression of osteoarthritis and comorbid processes, the features of phytocorrection. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2016;7(79):86-92. doi:10.22141/2224-0721.7.79.2016.86424ю (in Ukrainian)

Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011 Jun 18;377(9783):2115-26. doi: 10.1016/S0140-6736(11)60243-2.

Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality and comorbidity of the rheumatic diseases. Arthritis Res Ther. 2009;11(3):229. doi: 10.1186/ar2669.

Walance E, Salisburi C, Guthrie B, Lewis C, Fahey T, Smith SM. Managing patients with multimorbidity in primary care. BMJ. 2015 Jan 20;350:h176. doi: 10.1136/bmj.h176.

Marengoni A, Angleman S, Fratiglioni A. Prevalence of disability according to multimorbidity and disease clustering: a population-based study. Journal of Comorbidity. 2011;1:11-18.

Zhuo Q, Yang W, Chen J, Wang Y. Metabolic syndrome meets osteoarthritis. Nat Rev Rheumatol. 2012 Dec;8(12):729-37. doi: 10.1038/nrrheum.2012.135.

Yoshimura N, Muraki S, Oka H, et al. Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: а 3-year follov-up of the ROAD study. Osteoarthritis Cartilage. 2012 Nov;20(11):1217-26. doi: 10.1016/j.joca.2012.06.006.

Goldriny MB, Otero M. Inflammation in osteoarthritis. Curr Opin Rheumatol. 2011 Sep;23(5):471-8. doi: 10.1097/BOR.0b013e328349c2b1.

Boe C, Vangsness CT. Fish Oil and Osteoarthritis: Current Evidence. Am J Orthop (Belle Mead NJ). 2015 Jul;44(7):302-5. PMID: 26161757.

Heidari B, Javadian Y, Babaei M, Yousef-Ghahari B. Restorative Effect of Vitamin D Insufficiency on Knee Pain and Quadriceps Muscle Strength in Knee Osteoarthritis. Acta Med Iran. 2015 Aug;53(8):466-70. PMID: 26545990.

Knoop J, van der Leeden M, Thorstensson CA, et al. Identification of Phenotypes with Different Clinical Outcomes in Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken). 2011 Nov;63(11):1535-42. doi: 10.1002/acr.20571.

Garber JR, Cobin RH, Gharib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012 Nov-Dec;18(6):988-1028. doi: 10.4158/EP12280.GL.

Duntas LH, Mantzou E, Koutras DA. Effects of a six month treatment with selenomethionine in patients with autoimmune thyroiditis. Eur J Endocrinol. 2003 Apr;148(4):389-93. PMID: 12656658.

Berenbaum F. Diabetes-induced osteoarthritis: from a new paradigm to a new phenotype. Ann Rheum Dis. 2011 Aug;70(8):1354-6. doi: 10.1136/ard.2010.146399.

Eaton CB, Sayeed SM, Robertset M, et al. Metabolic syndrome, advanced glycation end products and knee osteoarthritis progression: a report from OAI. Osteoarthritis Cartilage. 2013 Apr;21(Suppl):S165-6. doi: 10.1016/j.joca.2013.02.354.

Wang X, Hunter D, Xu J, Ding C. Metabolic triggered inflammation in osteoarthritis. Osteoarthritis Cartilage. 2015 Jan;23(1):22-30. doi: 10.1016/j.joca.2014.10.002.

Sokolove J, Lepus CM. Role of inflammation in the pathogenesis of osteoarthritis: latest findings and interpretations. Ther Adv Musculoskelet Dis. 2013 Apr;5(2):77-94. doi: 10.1177/1759720X12467868.

Crapo LM. Subclinical hypothyroidism and cardiovascular disease. Arch Intern Med. 2005 Nov 28;165(21):2451-2. doi: 10.1001/archinte.165.21.2451.

Published

2021-09-02

How to Cite

Voloshyna, L., & Smiyan, S. (2021). Pathomorphosis of the metabolic phenotype osteoarthritis: the role of obesity, diabetes and hypothyroidism (age and gender features). INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 13(5), 303–310. https://doi.org/10.22141/2224-0721.13.5.2017.110018

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Section

Original Researches