ROLE OF CALCIUM-PHOSPHORUS METABOLISM IN THE PATHOGENESIS OF STABLE CORONARY ARTERY DISEASE IN PATIENTS WITH OBESITY

Pasiyeshvili L. M., Ivanova K. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

According to the World Health Organization (WHO), stable coronary artery disease (SCAD) takes the first place among the causes of disability and mortality worldwide. The second equally important problem of modern society is obesity, which is called the non-infectious epidemic of the 21-st century. An analysis of the structure of diseases that run over the background of excess weight, proves its negative impact on the development of hypertension, ischemic stroke, osteoarthritis, breast cancer and endometriosis. But one of the positive aspects of obesity is its protective effect on the development of osteoporosis (OP). There is an assumption that a certain similarity between the mechanisms of OP development and atherosclerosis is due to processes that occur with the participation of mononuclear cells. In this case it can be assumed that the protective effect of adipose tissue in osteopenic conditions is a predictor of accelerating the formation of atherosclerotic plaques. This assumption was a scientific hypothesis for which this study was conducted. The purpose of the study was to determine the indices of mineral and lipid metabolism and to establish the connection between the severity of the osteopenic syndrome in patients with stable coronary artery disease (SCAD) and obesity. We examined 98 people with SCAD, included 79 with concomitant obesity (main group), 19 with normal weight (group of comparison). The average age of patients in the main group was 52.4 ± 1.44 years, the comparison group – 51.8 ± 1.94 years. The duration of the history of SCAD was 2.9 ± 1.2 and 2.4 ± 1.6 years, respectively. Gender ratios were as follows: in both groups, women predominated – 54.8% and 52.9% respectively. The mean BMI was 31.87 ± 0.26% in the main group and 23.8 ± 0.24% in the comparison group. The control group included 20 practically healthy people representative by gender and age. The presence of acute coronary syndrome, chronic heart failure of the functional class IV (NYHA) and other diseases associated with osteogenic states (bowel disease, diabetes mellitus, thyroid disease, etc.) were the criteria for exclusion from the study. The parameters of the mineral metabolism of blood serum were not higher than the reference norms, however they were significantly higher in patients with SCAD and obesity in comparison with other groups. The rates of mineral metabolism in daily urine were significantly higher in patients with SCAD and obesity. Data from the densitometric study showed that osteopenic conditions were more often diagnosed in patients with normal body weight. Consequently, the comorbidity of SCAD and obesity is a high risk of developing osteodeficiency states, which is confirmed by early changes in the parameters of calcium-phosphorus metabolism.

stable coronary artery disease, obesity, osteoporosis, mineral metabolism

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«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 175-179 pages, index UDK 616.12-005.5-056.257-092-078:577.121.083.3:546.18:546.41

10.29254/2077-4214-2018-1-2-143-175-179