CHANGES IN THE INDICATORS OF LIPID PEROXIDATION, GLUTATHIONE LEVEL OF ANTIOXIDANT DEFENSE, IL–18, IL–10, AND MATRILIN 3 IN PATIENTS WITH OSTEOARTHRITIS IN COMBINATION WITH TYPE 2 DIABETES, OBESITY, ARTERIAL HYPERTENSION

Abstract

A number of studies indicate that oxidative stress (OS) is involved in pathogenesis and progression of osteoarthritis (OA). It is known that the OS is a disturbance of the balance between prooxidant and antioxidant systems in cells and tissues. Intensification of lipid peroxidation (LP) leads to the release of proinflammatory cytokines, disturbance of microcirculation, collagen structure and contributes to the progression of the degenerative process in the articular tissues.

The aim of the study – to determine changes in lipid peroxidation and glutathione levels of antioxidant defense,IL-18, IL-10 and matrilin 3 in patients with osteoarthritis in combination with type 2 diabetes, obesity, and arterial hypertension.

Material and Methods. 116 patients with type 2 diabetes, obesity and arterial hypertension aged 16 to 65 years (mean age 40.5 years) were examined. In the distribution of patients in groups by age, qualitative age periods were adopted, recommended by the committee of experts from the World Health Organization (WHO) [37]: young age (16–29 years) – 0.79 %,mature age (30–44 years) – 10.24 %, middle age (45–59 years) – 53.54 %, old age (60–65 years) – 35.43 %. Most of the patients were middle-aged (economically active). Four clinical groups of dynamic observation (with isolated osteoarthritis and concomitant diseases) were identified.

The lipid peroxidation was studied according to the method of Vladimirov Yu. A. (1999), state of indicators of glutathione level of antioxidant defense according to the titration method of O. V. Travina in the modification of I. F. Meshchishen, I. V. Petrova (1983). The analysis of cytokines in blood serum: interleukin 10 and 18, was performed using the appropriate sets of BenderMedSystemsGmbH (Austria) solid-phase enzyme-immunoassay method PlatinumELISA, according to the manufacturer's instructions.

Results and Discussion. In all groups of patients, indicators of malonic aldehyde increased, but in a greater degree in patients where osteoarthritis ran with type 2 diabetes, obesity and hypertension. Reduction of antioxidant defense according to data of glutathione recovered was also the most expressed in patients of this group. Indicators of IL-18 were the highest in osteoarthrosis with obesity and arterial hypertension, and IL-10 – in the presence of diabetes. Indicators of matriline 3 vary ambiguously.

Conclusions. In patients with type 2 diabetes, obesity and arterial hypertension, the balance between lipid peroxidation processes and the glutathione level of antioxidant defense is significantly disturbed, which is associated with activation of IL-18 and significant IL-10 deficiency. Matrilin 3 indicators reduce in isolated osteoarthritis and its combination with arterial hypertension, rising in the III and IV groups compared to the practically healthy individuals (PHI).