The aim: To estimate the prevalence of anemia in patients with ankylosing spondylitis, major pathogenetic variants and their relationship with the activity of the inflammatory process and the severity of the disease. Materials and methods: 118 patients with ankylosing spondylitis participated in the study, which performed hematologic, biochemical, immunological studies with general haemopoiesis and ferrokinetics parameters, plasma levels of CRP and IL-6. Results: It was found that in Ukrainian population of patients with ankylosing spondylitis, 28.8% of patients has anemic syndrome. The anemia spectrum is represented by ACD (44.1%), ACD with iron deficiency (29.4%) and IDA (23.5%). It is shown that the severity of anemic syndrome increases with the increase of the stage of activity of the inflammatory process. The presence and severity of anemia are closely related to the severe course of the disease, evaluated by the BASDAI and ASDAS index, and laboratory markers of inflammation CRP and IL-6 of serum. Conclusions: The obtained data is promising for the search of effective means of correction of anemic syndrome in patients with ankylosing spondylitis.
The aim: To assess the level of hepcidin in patients with AS, to determine its connection to the disease and various forms of anemia. Materials and methods: 118 patients with ankylosing spondylitis were examined and hematological, biochemical, immunologic indicators of the general parameters of hematopoiesis and ferrokinetics, plasma levels of CRP, IL-6 and hepcidin were determined. Results: It was found that high levels of hepcidin are found in 25% of patients with AS, 50% are limiting and only 25% are optimal. The serum levels of hepcidin in patients with AS are independent of the age, sex, and duration of the disease, but are closely associated with the activity (ESR, CRP, IL-6, BASDAI, and ASDAS levels) of the disease. Close pathogenetic connection of hepcidin with the formation of anemic syndrome was established. Patients with ACD were characterized by the highest levels of hepcidin. Conclusions: Hepcidin plays an important role in the pathogenesis of ACD in patients with AS and can be used as a diagnostic marker for differential diagnosis.
The aim: Was to evaluate the effect of 6-month pathogenetic treatment in combination with atorvastatinum on the endothelium function, lipid and adipokine levels, paroxonase activity and activity of inflammatory process in RA patients. Materials and methods: The study included 55 patients with RA, dividing into two groups depending on the intended therapy. The first group included 33 patients with “traditional” treatment by methotrexate, glucocorticoids, and non-steroid anti-inflammatory drugs. The second group included 22 patients with “traditional” treatment and additionally prescribed of atorvastatinum 20 mg/day. The lipid profile, leptin, adipokine, paroxonase activity. C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α) levels, FMDBA and IMT of carotid artery were determined in all participants of the study. Control parameters were recorded before the start, after 1 and 6 months of treatment. Results: The FMDBA has increased by 32% in the second group, compared by only 10.9% in the first group. The dynamics of IMT in the first group was also twice lower than in group with the additional use of atorvastatinum. The leptin levels in the second group significantly decreased by 27% and adiponectin levels increased by 12.8%, than in the first group – by 12.8% and by 7% respectively. The appointment of statins over 6 months resulted in DAS28, TNF-α, ESR and CRP reduction by 15%, 31%, 25% and 21.5% respectively. In the first group the dynamics of indicate rates ranged from 7.8% to 22.5%, and was significantly lower than in the second group. Conclusions: As a result of the study, it was found that the appointment of atorvastatinum 20 mg/day during 6 months not only reduces dyslipidemia, but also significantly reduces the inflammatory process and adipokine dysregulation, normalizes serum paraoxonase activity and improves the endothelium function.
BackgroundCobalamin (vitamin B12) insufficienty is associated with the development of many diseases. It is known that the growth of clinical and subclinical manifestations of atherosclerotic vascular lesions are often associated with low cobalamin level. Cobalamin status is unknown in patients with antiphospholipid syndrome (APS). There are no data about the role of folic acid in the development of atherosclerotic vascular lesions in patients with APSObjectivesTo evaluate vitamin B12 status in patients with APS and to explore its relationship with atherosclerotic vascular lesion.MethodsWe observed 82 patients with APS and 37 healthy individuals. Content of cobalamin (vitamin B12) in serum were determined by immunochemical detection (ECLIA). Cobalamin level above 200 pg/ml was considered as normal within 200–300 pg/mL - both extremely low, below 200 pg/ml - insufficienty. All patients were underwent detection of endothelial dysfunction - dilatation of brachial artery endothelium, investigation of “intima-media” thickness of common carotid artery (IMT) and the presence of atherosclerotic plaques (AP).ResultsIn patients with APS we recorded a significant reduction of cobalamin in the serum (351±14,3 pg/mL (95% CI: 148–562 pg/mL) compared to control group (445±18,1 pg/mL (95% CI: 272–622 pg/mL). Indicators of cobalamin status in patients with secondary APS were significantly worse than patients with primary APS. Thus, in patients with secondary APS cobalamin content was on 26.7% lower (95% CI: 140–559 pg/ml) than in the control group. In patients with primary APS cobalamin content was on 13.0% lower (95% CI: 202–565 pg/ml) than in controls, but 18.7% higher than in patients with secondary APS. Cobalamin (vitamin B12) insufficienty is accompanied by significant thickening of the walls of the common carotid artery. Thus, in patients with cobalamin deficiency IMT was on 17% higher than that in patients with optimal levels of the vitamin. Cobalamin deficiency is also associated with endothelial dysfunction. Thus, in patients with vitamin deficiency dilatation of brachial artery was significantly, by 48.6% less than in people with normal vitamin B12 status. The share of people with the presence of atherosclerotic plaques, transient ischemic attack (TIA), stroke, myocardial infarction (MI) and angina in patients with cobalamin deficiency was also higher.ConclusionsThus, in patients with APS low cobalamin status is associated with subclinical manifestations of atherosclerotic vascular lesions.Disclosure of InterestNone declared
BackgroundIt is known that endothelin-1 is one of the leading factors in the development of coronary artery disease, acute myocardial infarction, atherosclerosis of cerebral and peripheral vessels, pulmonary hypertension, ischemic lesion of the brain vessels etc. Patients with rheumatic diseases also have an elevetaion of endothelin-1 in serum. But it remains unclear whether the endothelin-1 level may reflect endothelium dysfunction in patients with antiphospholipid syndrome (APS) and serve as an early marker of atherosclerosis.ObjectivesThe aim of the study was to evaluate the endothelin-1 concentration, its association with antiphospholipid antibodies and atherosclerotic vascular lesions in patients with APS.MethodsAccording to our observation, there were 82 patients, among which 34 (41.6%) with primary antiphospholipid syndrome (PAPS) and 48 (58.4%) with secondary antiphospholipid syndrome (SAPS). The control group consisted of 37 practically healthy persons. The groups of patients were comparable by age, sex, and duration of the disease. The APS diagnosis was established according to the international classification criteria (2006). The content of the anticardiolipin antibodies IgG, anti-beta2-glycoprotein-1 antibodies IgG, IgA, IgM and endothelin-1 were determined by the immune enzyme method using commercial sets of Trinity Biotech Captia USA - Ireland, ORGenTec GmbH Germany and «Endothelin-1» (Cormay, England). All patients were assessed for the level of endothelium-dependent vasodilation (EDVD), the thickness of the intima-media complex of the common carotid artery (IMT), the presence of atherosclerotic plaque (AP) and clinical manifestations of vascular involvement.ResultsThe analysis of endothelin-1 levels has showed that its content was in 2.3 times higher in patients with APS than in the control group. The proportion of people with optimal endothelin-1 content was twice lower, and the proportion of people with extremely high and high rates was 1.6 and 5.3 times higher, respectively, among patients with APS, than in the control group. Also differences in the endothelin-1 level have been established depending on the type of APS. The content of endothelin-1 was significantly higher (1.3 times) in patients with SAPS, than in PAPS. Among the patients with SAPS, the proportion of patients with an optimal level of endothelin-1 was 1.7 times lower, and the proportion of patients with high levels was 1.6 times higher than in patients with PAPS. The significantly lower endothelin-1 level was recorded in patients with highly positive antibodies to cardiolipin and beta-2 glycoprotein-1. Correlation analysis has showen direct correlation between anticardiolipin antibodies of the IgG class and anti-beta2-glycoprotein-1 antibodies and endothelin-1 concentration (r=0.35 and 0.34). High endothelin-1 level was an adverse factor of structural and functional atherosclerotic changes of the heart and blood vessels in patients with APS. IMT increasing and EDVD decreasing were from 1.7 to 6.6 times more frequent among patients...
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