Level of different micro­ and macroelements and activity of matrix metalloproteinase 9 in patients with gastroesophageal reflux disease that developed against the background of undifferentiated connective tissue dysplasia

Abstract

Objective — to study the levels of micro- and macroelements in the erythrocyte mass and changes in the activity of matrix metalloproteinase 9 (MMP 9) in patients with undifferentiated connective tissue dysplasia (UCTD) and gastroesophageal reflux disease (GERD) comorbidity.Materials and methods. The study involved 357 in-hospital patients with GERD, for whom the UCTD signs were evaluated according to the criteria recommended by M. Moska et al., A. Doria et al., and T.I. Kadurina’s criteria and L.M. Abakumova in the modification of T. Milkovskaya-Dimitrova, and the degree of their expression on the scale of T.Y. Smolnova. Based on these criteria, 122 patients were selected and divided into two groups: Group I included 76 patients with GERD combined with UCTD, Group II consisted of 46 patients with isolated GERD. The control group consisted of 20 practically healthy persons without signs of pathology. The investigation of micro- and macroelements’ levels in the erythrocyte mass was performed with atomic absorption spectrophotometry, serum MMP 9 levels were defined with immunoassay method.Results and discussion. In GERD patients, the levels of micro- and macroelements in the erythrocyte mass was slightly different from that in healthy ones. They showed only a tendency to increase of Cu content in 1.6 times, Zn in 3.2 times, and the absence of deviations of the level of Fe, Mg, Ca and Mn. Patients form Group I demonstrated a significant increase of Cu concentration in 2.7 times as compared with control group and in 1.8 times compared with data of Group II patients. Zn level in patients of Group I was higher in 6.3 times compared with healthy, and in 2.03 times compared with patients of Group II (p < 0.05). The level of Fe was increased in 1.2 and 1.005 times and the Mg content was lowered in 1.55 and 1.18 times, respectively (p < 0.05). The concentration of MMP 9 in patients of the Group І (Me — 3399.283; Mo — 3091.61; interquartile range (LQ—HQ) — 3081.201—4039.798 pg/ml) was higher in 2.5 times than in healthy ones and in 1.9 times compared with patients of the Group ІІ (Me — 1859.467; Mo — 1200,718; LQ—HQ = 1014.925—2757.495 pg/ml) (p < 0.05).Conclusions. The study provided confirmations, that at GERD against the UCTD background, the disturbance of micro- and macronutrient levels and MMP 9 activity are deeper, that requires to include the drugs, aimed on the correction of the identified changes, into the complex therapy.