Analysis of influence of omega-3-polyunsaturated fatty acids on biochemical values of the blood and adipokines content in patients with arterial hypertension, osteoarthritis and its combination with optimal and increased body weight

Abstract

Combination of arterial hypertension and osteoarthritis especially on the background of overweight leads to the heavier clinical course of diseases.The aim of research was to study is it any therapeutic advantage in the use of omega-3-polyunsaturated fatty acids (PUFA) in patients with arterial hypertension (AH), osteoarthritis (OA) and its combination in the aspect of hypolipidemic influence and adipokines level.Materials: There were examined 100 patients, 35 – with AH, 35 – with OA and 30 – with AH in combination with OA. The men-women ratio was 2,5:1, the mean age – 49,6±8,9 years. The mean AH duration was 7,4±3,8 years, the clinical presentation of disease corresponded with II stage. The prescription of osteoarthritis was 8,4±4,6 years the clinical presentation corresponded with OA 2-3 stages without the signs of synovitis.The control examinations were carried out in the group of practically healthy persons (n=22) comparable with the patients of other groups on age and sex. The blood for biochemical studies was taken on the first day of being in hospital approximately at the same time 9-10 a.m. fasting. The adipokines level was detected using immune-enzyme analysis.Depending on nosology all patients received the basal therapy that included: at AH – ACE inhibitors (lisinopril, enalapril), at OA – non-steroid anti-inflammatory preparations (meloxicam, ibuprofen, diclofenak sodium), chondroprotectors (mukosat, alflutop). Patients with the signs of dyslipidemia received hypolipidemic medical preparations (rosuvastatin).All patients with signs of hyperglycemia were randomly divided in two groups that included equal number of persons with all variants of nosologies. The group of comparison (50 persons) received depending on nosology basal therapy that included: at AH – ACE inhibitors (lisinopril), at OA – non-steroid anti-inflammatory preparations (meloxicam, ibuprofen, diclofenak sodium), chondroitin sulfate preparations (mukosat, alflutop). Patients with the signs of dyslipidemia received hypolipidemic medical preparations (rosuvastin). Patients of the main group (50 persons) were additionally prescribed with preparation that contains omega-3-PUFA – Epadol Neo as a source of omega-3-PUFA, 1 capsule 2 times for day for two month.All data were assessed using methods of variation analysis.Results. The standard therapy of the group of comparison partially improved dyslipidemic changes. The content of general cholesterol was decreased from 5,8±0,41 to 4,7±0,32 mmol/l (p<0,05). The use of omega-3-PUFA resulted in further improvement (4.4±0,22 mmol/l) in the main group. The same positive dynamics was detected for other indices – the high-density lipoprotein (HDL) content increased after treatment from 1,5±0,11 to 1,6±0,21 mmol/l in the group of comparison and to 1,76±0,13 (p<0,05) in the main group; triglycerides content in the main group and in the group of comparison came back to the normal values: 2,3±0,14 mmol/l before treatment; 1,8±0,08 mmol/l (p<0,05) and 1,6±0,01 mmol/l (p<0,05) in the group of comparison and іn the main one respectively.The treatment with the use of standard preparations has no influence on both adipokines level. Additional use of omega-3-PUFA significantly and reliably decreased the leptin content in the blood of patients with AH and overweight: from 49,2±5,48 ng/ml to 16,5±3,48 ng/ml (p<0,05). The less dynamics was observed in patients with OA and combination of AH and OA: the decrease of leptin level in blood from 40,5±4,3 to 34,1±4,94 ng/ml (p<0,05) and from 55,4±6,62 ng/ml to 38,6±3,62 ng/ml (p<0,05).Adiponectin content was sensitive to treatment. Positive statistically reliable changes were observed in patients of the main group with all studied pathologies (isolated AH, OA and its combination) after 2 month of use of omega-3-PUFA.Conclusions: The use of omega-3-PUFA in the complex treatment is effective for patients with AH and AH with concomitant OA as to hyperlipidemia correction. It favors the renewal of natural balance of adipokines: diminishes the leptin level, increases the adiponectin content