OSTEOARTHROSE IN COMBINATION WITH METABOLIC SYNDROME IN THERAPEUTIC PRACTICE

Zhdan V. M., Shylkina L. M., Babanina M. Yu., Oliinichenko Ya. O., Martyniuk D. I.

LITERATURE REVIEWS

Scentific article

Nowadays, osteoarthrosis is one of the most widespread disabling conditions. It represents a chronic progressive disease of synovial joints of non-inflammatory nature with diversiform etiology that is characterized by degeneration of the articular cartilage, the appearance of structural changes in the subchondral bone and synovitis of varying degrees of severity. This pathology has tendency to increase prevalence rate with the patient age and the most commonly occurs after 40 years. According to statistics, osteoarthrosis is diagnosed in 20% of the globe population. The risk factors of osteoarthrosis origin can be divided into several groups, namely genetic, non-genetic and exanthropic. Genetic factors include: gender (mainly female), hereditary pathology of gene collagen of II type, mutation of gene collagen of II type, other hereditary diseases of bones and joints, ethnic origin. Non-genetic factors include: elderly age, overweight, level decrease of female sex hormones (e.g., during menopause), malformations of bones and joints, surgical intervention on joints in past medical history (e.g., menisectomy). Exanthropic risk factors of osteoarthrosis origin include professional occupation that is related to continuous joint load, joint injuries, and sport activity. Sometimes the conduction of differential diagnostics is a quite complicated task in the practice of a general practitioner. It is associated with the presence of a large number of pathological conditions which leads to bone and joint damage, as well as diseases that sometimes can have inapparent clinical picture, especially in patients who take pharmaceutical products (e.g., steroid hormones, antibiotics). Under certain circumstances, making of a final diagnosis is complicated by the absence of clear clinical manifestations, long-lasting of disease progression, monosymptomatic or polysyndromic lesions of the supporting-motor apparatus, which may cause masking under other pathological conditions. Therefore, differential diagnosis of joint damage can take up an extended period of time sometimes for months or even years. Collected medical history of a patient in great depth and an objective physical examination conducted by a general practitioner, that contains 60-75% of the information required to make a final diagnosis are the most important stages of early diagnosis and verification of osteoarthritis. The use of lab tests, X-ray and ultrasound diagnostics promotes the clarification of joint damage nature in some cases. Osteoarthritis is often accompanied by the appearance of degenerative-dystrophic processes in combination with the metabolic syndrome (abdominal obesity with arterial hypertension, dislipidemy and hyperglycemia). The genesis of joint damage in combination with endocrine disorders may be related to such factors as change of the overall responsiveness of the body and metabolic disorders. These factors should be taken into consideration when choosing the optimal treatment tactics. The combination of several diseases is quite often observed in patients, especially in the elderly age and senile age, so current scientific studies are aimed at studying the complex relationships between these pathologies for the purpose of choosing the most optimal treatment tactics that will improve the quality of the patient life. The combination of several diseases in one patient complicates the course of each of them and provides for the use of medicines of different directions, the simultaneous use of which can lead to a wider detection of their side effects. Arterial hypertension, ischemic heart disease, obesity, osteoarthritis are the most common diseases. At present, arterial hypertension is the most common pathology of the cardiovascular system, the obesity is one of the most common chronic diseases and osteoarthritis is one of the pathologies that occurs with the highest frequency in the rheumatological diseases structure. The adverse effects that can occur in patients with associate pathologies may be quite different and the frequency of occurrence and their causes of these disorders are increased with age. The lifestyle, regularity of preventive examinations, attitude of patients to treatment, age-related physiological changes have an influence on this. These changes occur long before than manifested clinically, but they can be the cause of disability and death in some cases.

osteoarthrosis, endocrine disorders, metabolic syndrome, general medical practice.

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«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 34-39 pages, index UDK 616.72-002-008.9

10.29254/2077-4214-2020-1-155-34-39