ANALYSIS OF INDICATORS OF BONE-CARTILAGE TISSUE METABOLISM AND DATA OF INSTRUMENTAL EXAMINATIONS IN PATIENTS WITH OSTEOARTHROSIS IN COMBINATION WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Introduction. Osteoarthritis (OA) remains a fairly common pathology, affecting about 20% of the world’s population. It is often combined with various diseases, including sometimes with chronic obstructive pulmonary disease (COPD).The Aim of the Study is to investigate the features of bone and cartilage tissue metabolism and instrumental examination data in patients with OA combined with COPD.Research Methods. 48 patients with OA (group I) and 25 patients with OA combined with COPD (group II) were examined. The control group consisted of 20 healthy people. The diagnosis of OA was established according to the criteria developed by the American College of Rheumatology and approved by the Ukrainian Rheumatology Association. The diagnosis of COPD was verified based on data according to the Order of the Ministry of Health of Ukraine dated June 27, 2013 No. 555.Bone metabolism was assessed by the concentration of oxyproline, rumalon antibodies and alkaline phosphatase activity. Immunological studies included the determination of C-reactive protein and TNF-α in serum.In addition, radiography and ultrasound of the affected joints were performed.Results and Discussion. In patients with OA combined with COPD, the level of oxyproline and rumalon antibodies increased statistically significantly compared to patients with OA without concomitant pathology (p<0.05), alkaline phosphatase activity did not change (p>0.05). These indicators increased with increasing radiological stage of the pathological process. According to ultrasound, signs of intra-articular inflammation were more pronounced in patients with OA with COPD with radiological stage II than in patients with stage I. In patients with synovitis, the concentration of C-reactive protein significantly exceeded this indicator in patients without joint effusion (p<0.001). The level of TNF-α did not differ in these groups (p>0.05).Conclusions. In patients with OA with concomitant pathology, the formation of oxyproline is enhanced and antigen-specific blood activation increases in the presence of rumalone, which indicates a high intensity of cartilage tissue degradation processes.In the II radiological stage of OA, the level of cartilage metabolism markers is higher than in I. According to ultrasound, more pronounced signs of intra-articular inflammation were found in patients with OA with COPD with the II radiological stage than in patients with the I stage.