Progredientality of osteopenic syndrome course in patients with comorbidity osteoarthritis and obesity

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Objective — to determine the influence of hormonal activity of adipose tissue and polymorphism of Bsml c.IVS7 G > A, rs1544410 gene of vitamin D receptors (VDR) on the formation of osteopenic conditions in young people with osteoarthritis (OA) and obesity.Materials and methods. The examinations involved 96 young patients (up to 45 years) with cumulative course of OA and obesity and 34 patients without obesity. The anthropometric criteria of obesity was assessed based on the Quetelet index or the body mass index (BMI). Evaluation of the functional state of the musculoskeletal system and analysis of the algofunctional activity parameters were performed using a test questionnaire WOMAC. Measurements of mineral density of the bone was performed using dual-energy x-ray absorptiometry, which was performed on the HOLOGIC Explorer QDR W Series Bone Densitometer (USA). The adipocytokine levels of apelin-13 in the blood serum was determined (by an immunoenzyme method) using a set of reagents Human (Germany). The determination of polymorphism in the human genome was carried out by polymerase chain reaction in real time using a set of VDR (Bsml c.IVS7 G > A, rs1544410) Mutation of the vitamin D receptor. The statistical analysis of data was carried out using a computer package of Stata 12.1 application programs. Statistical processing was carried out using the Shapiro—Wilkie W-test, Pearson, and the homogeneity of variances with the Leven criterion. Results and discussion. An increase in the adipokine apelin-13 levels in the blood serum was established in these patients, and its levels depended on the X-ray stage of the disease and on the indices of algofunctional activity according to the WOMAC index independently on the BMI. It has been shown that the vast majority of young patients with OA and excessive body mass or obesity had the unfoolable variant ВВ-genotype of VDR. Its presence resulted in the more severe diagnosed X-ray stages of the disease, development of osteopenic states and increase of apelin levels.Conclusions. Among patients with OA and obesity, an unfavorable variant BB-genotype of the G63980A mutation of the VDR is found quite often (45.8 %) relative to the control group (11.5 %), which is confirmed in such patients with radiological progression of joint damage and the formation of osteopenic conditions (75.9 %). The OA course in young adults with overweight or obesity occurs against the background of an increase in the levels of adipocytokine apelin-13, VDR does not depend on the degree of obesity, but has a dependence on the X-ray stage of the disease.