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)
Journal Title: Гастроентерологія - Year 2018, Vol 52, Issue 3
Abstract
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.
Authors and Affiliations
J. I. Serdulets
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