Features of bone metabolism in patients with osteoarthritis, type 2 diabetes mellitus and their combination
Background. Osteoarthritis (OA) is one of the most common joint diseases characterized by periodic exacerbations, pain syndrome of varying severity, progressive course, which leads to deformity of the joints, a decrease of their function and deterioration of patients’ life quality. The association of OA with a variety of metabolic disorders, such as type 2 diabetes mellitus (DM) and obesity, is very important. The purpose of the study was to investigate the parameters of bone metabolism in patients with OA, type 2 diabetes mellitus and their combination in patients with different phenotypes, as well as the correlation between parameters of bone metabolism and the level of proinflammatory cytokines. Materials and methods. A total of 104 patients with OA alone, type 2 DM alone and a combination of OA with type 2 DM were examined (31 men, mean age 54.02 ± 0.67 years). The survey plan included evaluation of C-reactive protein (СRP), osteocalcin, calcitonin, Ca, P, Mg, tumor necrosis factor a (TNF-a), interleukin-1b (IL-1b) in the blood. The X-ray examination of the knees was performed in all patients with OA. Results. The significantly higher levels of osteocalcin were determined in the control group and in the group of patients with OA alone as compared to the groups of patients with type 2 DM alone and OA combined with type 2 DM. That is, the following was valid for osteocalcin: control = OA > T2DM = = ОА + T2DM = ОА + + T2DM + obesity. The highest number of significant correlations was found in the group with comorbid pathology and obesity. We determined the relationships between osteocalcin and TNF-a (r = –0.78, p < 0.05), IL-1b (r = –0.75, p < 0.05), CRP (r = –0. 46, p < 0.05), between Ca and TNF-a (r = 0.67, p < 0.05), IL-1b (r = 0.59; p < 0.05), between calcitonin and TNF-a (r = 0.56, p < 0.05), IL-1b (r = 0.46, p < 0.05), CRP (r = 0.42, p < 0.05), between Mg and TNF-a (r = –0.47, p < 0.05). The results of the canonical analysis of cytokine activity and parameters of bone metabolism suggest that a significant correlation exists between cytokines and the characteristics of bone metabolism (canonical correlation = 0.52, p < 0.05), the largest contribution to this connection is made by IL-1b among cytokines, and by osteocalcin — among bone metabolism indices. Conclusions. The study demonstrates a definite role of systemic inflammation in the development of bone metabolism disorders that can influence the progression of OA.
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