Features of metabolic changes treatment at type 2 diabetes mellitus, obesity and arterial hypertension in patients with osteoarthritis taking into account indicators of genotypes of gene of anti-inflammatory interleukin-10 (IL-10, C592A)
Background. A number of studies demonstrate the involvement of chronic systemic inflammation to the pathogenesis and progression of metabolic syndrome (type 2 diabetes mellitus with obesity and arterial hypertension) in patients with osteoarthritis. Its exacerbation associated with polymorbidity leads to a violation of the microcirculation, structure of collagen and promotes the degenerative process in the articular tissues, where the protein of the extracellular matrix matrilin-3 plays a role. It is proved to be associated with the level of the corresponding genotypes of pro-inflammatory and anti-inflammatory genes. The purpose of the study was to study changes in the genotypes of genes of anti-inflammatory interleukin-10 (IL-10, C592A) provoked by the treatment in patients with osteoarthritis combined with type 2 diabetes mellitus, obesity, arterial hypertension. Materials and methods. One hundred and sixteen patients with type 2 diabetes mellitus, obesity and arterial hypertension aged 16 to 65 years (mean age 40.5 years) were examined. To analyze the effectiveness of treatment depending on the genotype of the anti-inflammatory interleukin-10 (IL-10, C592A) the surveyed patients were divided into groups depending on those genotypes. Results. Due to the treatment, lipid peroxidation activity significantly decreased (more effective in carriers of the C-allele of the IL-10 gene (C592A)) against the background of not significant increase in antioxidant protection, which did not correlate with polymorphous variants of the IL-10 gene (rs1800872). The concentration of pro-inflammatory cytokine IL-18 reduced by 25.6 % in the CC-genotype carriers, in CA-genotype carriers — by 18.58 %, in AA-genotype patients — by 15.37 % (p > 0.05). And the level of anti-inflammatory IL-10, on the contrary, increased by 11.69, 18.0 and 23.08 %, respectively (p > 0.05). A slight increase in the extracellular matrix protein matrilin-3 was established in the CC-genotype carriers by 4.4 %, in the CA-genotype patients — by 13.5 %, and in the carriers of AA-genotype of the gene of IL-10 (C592A) — by 13.8 % (p > 0.05). Conclusions. The results of the treatment demonstrated a decrease in the activity of the lipid peroxidation (more effective in carriers of the C-allele of the IL-10 gene (C592A)) against the background of not significant increase in antioxidant protection, which did not correlate with polymorphous variants of the IL-10 gene (rs1800872). The therapy resulted in great reduction of the concentration of pro-inflammatory cytokine IL-18 in CC-genotype and CA-genotype patients, and increase in the level of anti-inflammatory IL-10 in carriers of the AA-genotype of the gene IL-10 (C592A). These patients experienced the improvement in matrilin-3 indices. The following study will be related to the effect of this treatment algorithm on proteolytic and collagenolytic activity in patients with metabolic syndrome and osteoarthrosis.
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