OVERWEIGHT AND OBESITY AS A PREDISPOSITION FOR OSTEOPENIC CONDITION DEVELOPMENT IN A PATIENT WITH CORONARY ARTERY DISEASE
Relevance. Сalcification of arterial tissue is not just a passive process of calcium phosphate precipitation or adsorption in the terminal stage of arteriosclerosis, but also a highly organized process that is regulated by mechanisms analogous to bone mineralization.
Aim: to optimize the diagnosis of the structural and functional state of bone tissue in patients with coronary artery disease and obesity, and to determine the possible interrelationbetween these specifiedparameters and lipid metabolism indicators.
Materials and methods: A cohort prospective study conducted from 2016 to 2017 on the basis of the Ukrainian State Clinical Hospital "Kharkov City Clinical Hospital No. 11" in Kharkov. 98 patients with CAD who were divided into 4 groups depending on the body mass index were examined. The control group included 20 practically healthy people of the same sex and age. The state of bone tissue exchange was assessed by the content of bone alkaline phosphatase (BAP) and tartrate-resistant bone phosphatase (TRBP) of blood serum; the content of total hydroxyprolinewas assessed in daily urine. The enzyme activity was studied by the kinetic method; the level of hydroxyproline - during oxidation of chloramine B. The parameters of the lipid spectrum were evaluated spectrophotometrically using standard test systems. Statistical analysis was carried out using the software package "Statistica 10.0" and Excel 2010. The results were presented as a median (Me) with interquartile interval [Q25%; Q75%] taking into account the absence of a normal distribution. The quantitative and ordinal changes were compared using the Mann-Whitney test. The correlation relation was calculated with the help of rank correlations of Spearman. The significance level of p was taken equal to or less than 0.05 (p <0.05) in all statistical analysis procedures
Results of the study: the level of BAP, as a marker of bone remodeling, was statistically significantly increased in patients with CAD and obesity I-II, with these values exceeding the limits of reference values. The TRBP index was statistically significantly different in all patient groups. At the same time, in patients with IHD and overweight, the level of TRBP was lower compared to the control group and in 2 times lower than in patients with obesity I-II. The total hydroxyprolinein urine also statistically significantly increased in all patient groups. However, it was the smallest in individuals with CAD and overweight and statistically significantly different from groups of patients with obesity I-II.
Conclusions: Thus, the levels of bone resorption and bone synthesis markers were the highest in patients with obesity I-II and the lowest in patients with coronary artery disease and overweightYekaterina V. Ivanova 1, https://orcid.org/0000-0002-8843-5820
Lyudmila M. Pasiyeshvili 1, https://orcid.org/0000-0001-7527-782X
1 Department of General Practice – Family Medicine and Internal Diseases,
Kharkiv National Medical University,
Kharkiv, Ukraine.
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15. Mohamed A., Abdelhalim K., Siddiqi N.J., Alhomida A.S., Mohammed S. Al-Ayed The changes in various hydroxyproline fractions in aortic tissue of rabbits are closely related to the progression of atherosclerosis. Lipids in Health and Disease. 2010, 9:26
16. Reid I.R. Relationships among body mass, its components, and bone. Bone. 2002;31:547–555
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18. Siddiqi N.J., Alhomida A.S. Effect of mercuric chloride on various hydroxyproline fractions in rat serum. Molecular and Cellular Biochemistry, 2005. 271:159-165.
19. Silvia Migliaccio, Emanuela A Greco, RacheleFornari, Lorenzo M DoniniIs obesity in women protective against osteoporosis? Diabetes Metab Syndr Obes. 2011. 4: 273–282.
20. Taichirou Morisawa, Akihiro Nakagomi, Keiichi Kohashi, Yoshiki Kusama Serum Tartrate-resistant Acid Phospahatase-5b Levels are Associated with the Severity and Extent of Coronary Atherosclerosis in Patients with Coronary Artery Disease. Journal of Atherosclerosis and Thrombosis, 2017 Oct 1; 24(10): 1058-1068
21. Hsu H.T., Camacho N.P. Isolation of calcifiable vesicles from human atherosclerotic aorta. Atherosclerosis. 1999.143:353–362.
22. Vattikuti R., Towler D.A. Osteogenic regulation of vascular calcification: an early perspective. Am J Physiol Endocrinol Metab. 2004. May; 286(5) P:686-96.
23. Zhao L.J., Jiang H., Papasian C.J. Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis. J Bone Miner Res. 2008;23:17–29.
Bibliography link
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Иванова Е.В., Пасиешвили Л.М. Избыточная масса тела и ожирение как предиспозиция для развития остеопенических состояний у пациентов с ишемической болезнью сердца / / Ғылым және Денсаулық сақтау. 2018. 4 (Т.20). Б. 50-60.