Abstract
The aim. The aim of the study was to conduct a comparative analysis of fibroblast growth factor-2, the total content and fractions of sulfated glycosoaminoglycans as well as free and peptide-bounding oxyproline as the markers of connective tissue metabolism in young patients with mitral valve prolapse, type 1 diabetes mellitus and the combination of both indications.
 Materials and methods. 93 patients between 19 and 33 years old with either mitral valve prolapse, or type 1 diabetes or the combination of both indications were examined. Group 1 was represented by 36 patients with the monomorbid type 1 diabetes mellitus. Group 2 consisted of 33 patients with type 1 diabetes mellitus and mitral valve prolapse. The comparison group included 24 people with diagnosed mitral valve prolapse. The concentration of fibroblast growth factor-2 in blood plasma was determined by the enzyme immunoassay using a Quantikine reagent kit (Human FGF basic Immunoassay), manufactured by R&D Systems, Inc. (USA) and expressed in pg/ml. The total content and fractions of glycosaminoglycans in blood serum were determined by the method of N. G. Stern et al. and expressed in units of optical density. The level of free and peptide-bounding oxyproline in blood serum were determined by the method of P. N. Sharaev and expressed in µmol/L.
 Results. Fibroblast growth factor-2 was higher in group 2, where it was 23.7±0.25 pg/ml compared to the control group – 14.20±0.22 pg/ml (p <0.01). There was also a significant difference in the levels of fibroblast growth factor-2 between groups 1 where it equaled 15.33±0.24 pg/ml and 2 – 23.71±0.25 pg/ml (p<0.01). The total content of glycosaminoglycans in comparison with the control group, where it was equal to 9.7±0.62 odu, was higher in all groups of patients: in group 1 it was 12.07±1.04 odu, in the comparison group it was 11.75±0.83 odu, in the group with the combined pathology it was 13.32±1.59 odu (p<0.05). The values of glycosaminoglycans II fraction, were higher in group 2 – 4.96±0.59 odu. The level of peptide-bound oxyproline, just as the level of free oxyproline, significantly increased in patients with comorbid pathology in group 2, compared to the control group: 16.06±1.54 µmol/l versus 8.7±0.81 µmol/l (p<0.01) respectively.
 Conclusions. The values of fibroblast growth factor-2, glycosaminoglycans II fraction, free and peptide-bound oxyproline were significantly higher in patients with diabetes mellitus and mitral valve prolapse in comparison with the control group. Fibroblast growth factor-2 was higher in patients with comorbid pathology compared to the monomorbid diabetes patients.
Highlights
Connective tissue is one of the most prevalent and functionally loaded tissue structures in the body
The content of free oxyproline, which is the marker of collagen synthesis and degradation, significantly increased in patients of group 2 with a combination of type 1 diabetes mellitus and mitral valve prolapse, compared to the control group, (p < 0.05) (Table 1)
An increase in the content of free oxyproline in patients with concomitant pathology may indicate an increase in the intensity of destructive processes in the collagen metabolism, which corresponds to the presence of a subclinical chronic inflammatory process of low intensity and is a pathological part of the development of diabetes vascular complications (Table 1)
Summary
Connective tissue is one of the most prevalent and functionally loaded tissue structures in the body. It actively participates in the regulation of metabolic processes, providing the synthesis and secretion of cytokines, growth factors, tissue hormones, enzymes, etc. It has a regulatory effect on reproduction, differentiation of cells, the intercellular substance metabolism and, as a consequence, the formation of organ structures at the embryonic and postnatal development stages. Connective tissue is represented by a cellular component, fibrillar structures (collagen, elastin), as well as glycoproteins and proteoglycans. Oxyproline is one of the main aminoacids of collagen, which makes free oxyproline and peptide-binding oxyproline one of the most significant biomarkers of collagen metabolism [4]
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