慢性胰腺炎合并高血压病患者骨质减少的实施机制

T. Viun
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The emergence of secondary osteoporosis (SO) is not only phenotypically but also genetically conditioned, which is the basis for studying the gene aberrations of “osteopenically directed genes” and determining the content of SO biochemical markers. \nAim of study: to establish the features of the comorbid course of CP and hypertension, to optimize the diagnosis of osteoporotic conditions by studying the content of biochemical markers of OP (total acid phosphatase (TAP) and tartrate-resistant acid phosphatise (TRAP)) and polymorphism of the vitamin D receptor genes (VDR). \nMaterials and methods of research. To solve this problem, 110 patients with CP were examined and further divided into 2 groups: treatment group — 70 persons with CP and hypertensive disease (HD), and the comparison group — 40 patients with isolated CP. These groups were representative by age and sex. The condition of bone tissue was studied in assessing the content of indicators of total acid phosphatase (TAP) and non-prostatic acid phosphatase (TRAP) in blood serum. At the same time, VDR was determined. \nResults. It was found that the vast majority of patients in the treatment group (84.3%) had an unfavourable B-allele; against the comparison group — 77.5% of events. Changes in the VDR gene polymorphism affected the incidence of the osteoarticular system (CCP, χ2 = 20.81, p <0.01) and had a statistically significant relationship in the distribution of alleles between groups (CCP, χ2 = 30.08, p <0.01). The parameters of TAP and TRAP in patients with combined course of HP and CP were 8.7 ± 2.3 U/L and 5.1 ± 2.3 U/L, respectively, and in the comparison group — 6.9 ± 3.0 U/L and 3.5 ± 2.1 U/L. Thus, the content of TAP and TRAP exceeded the control in the treatment group by 2.5 (TAP) and 1.9 (TRAP) times (p<0.01) and in the comparison group by 2.0 (TAP) and 1.3 TRAP) times (p<0.01), which allowed us to state the development of osteopenic conditions. The distribution of alleles of the VDR gene was characterized by the predominance of the B-allele and was “supported” by changes in the biochemical markers of osteoporosis, which led to the development of osteopenicconditions in such individuals. Thus, the combination of HP and CP is an unfavourable factor in the development of osteoporosis and the basis for early detection of osteoporetic changes. \nConclusions. In the combined course of CP and arterial hypertension, there is an increase in the number of persons with the B-allele of the VDR gene (84.3% of cases), the carriers of which have a high risk of osteopenia. With the comorbidity of CP and HD, there are fluctuations in the content of TAP and TRAP, correlating with VDR. 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引用次数: 0

摘要

慢性胰腺炎(CP)和高血压病(HD)的合并症通常是相互合并的,可以被认为是并发症形成的预测状态。这是由于个别致病环节的交叉,它们的结合加强了这种交叉。作为这样一种并发症,可以考虑骨质疏松症,导致骨组织代谢紊乱,伴定量和定性变化。继发性骨质疏松症(secondary osteoporosis, SO)的出现不仅是表型的,而且是遗传条件的,这是研究“骨质疏松导向基因”基因畸变和测定SO生化标志物含量的基础。研究目的:通过研究总酸性磷酸酶(TAP)和抗酒石酸酸性磷酸酶(TRAP)生化标志物含量及维生素D受体基因(VDR)多态性,建立CP与高血压的共病病程特征,优化骨质疏松症的诊断。研究材料和方法。为了解决这一问题,我们对110例CP患者进行了检查,并将其进一步分为两组:治疗组70例CP合并高血压疾病(HD)患者,对照组40例孤立性CP患者。这些组按年龄和性别具有代表性。测定血清总酸性磷酸酶(TAP)和非前列腺酸性磷酸酶(TRAP)指标的含量,研究骨组织状况。同时,确定了VDR。结果。结果发现,治疗组绝大多数患者(84.3%)存在不利的b等位基因;与对照组相比- 77.5%的事件。VDR基因多态性变化影响骨关节系统发病率(χ2 = 20.81, p <0.01),组间等位基因分布差异有统计学意义(χ2 = 30.08, p <0.01)。HP和CP合并病程患者的TAP和TRAP参数分别为8.7±2.3 U/L和5.1±2.3 U/L,对照组为6.9±3.0 U/L和3.5±2.1 U/L。因此,治疗组的TAP和TRAP含量比对照组多2.5倍(TAP)和1.9倍(TRAP) (p<0.01),对照组多2.0倍(TAP)和1.3倍(TRAP) (p<0.01),说明骨减少的发生。VDR基因的等位基因分布以b等位基因的优势为特征,并受到骨质疏松症生化标志物变化的“支持”,导致这些个体出现骨质增生。因此,HP和CP的合并是骨质疏松症发展的不利因素,也是早期发现骨质疏松改变的基础。结论。在CP合并高血压的过程中,携带VDR基因b等位基因的人数增加(占病例的84.3%),其携带者有骨质减少的高风险。CP和HD合并症时,TAP和TRAP的含量有波动,与VDR相关。在CP和HD患者中,TAP和TRAP含量的增加通常发生在不利的VDR基因b等位基因的背景下。CP与HD的联合病程是骨质疏松症并发症早期诊断的基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mechanisms of implementation of osteopenic conditions in patients with combined course of chronic pancreatitis and hypertensive disease
The comorbidity of chronic pancreatitis (CP) and hypertensive disease (HD), which are often combined with each other, can be considered as predictor states of the complication formation. This is due to the intersection of individual pathogenic links, which are enhanced by their combination. As such a complication, it is possible to consider osteoporotic conditions, leading to metabolic disturbances of bone tissue with quantitative and qualitative changes. The emergence of secondary osteoporosis (SO) is not only phenotypically but also genetically conditioned, which is the basis for studying the gene aberrations of “osteopenically directed genes” and determining the content of SO biochemical markers. Aim of study: to establish the features of the comorbid course of CP and hypertension, to optimize the diagnosis of osteoporotic conditions by studying the content of biochemical markers of OP (total acid phosphatase (TAP) and tartrate-resistant acid phosphatise (TRAP)) and polymorphism of the vitamin D receptor genes (VDR). Materials and methods of research. To solve this problem, 110 patients with CP were examined and further divided into 2 groups: treatment group — 70 persons with CP and hypertensive disease (HD), and the comparison group — 40 patients with isolated CP. These groups were representative by age and sex. The condition of bone tissue was studied in assessing the content of indicators of total acid phosphatase (TAP) and non-prostatic acid phosphatase (TRAP) in blood serum. At the same time, VDR was determined. Results. It was found that the vast majority of patients in the treatment group (84.3%) had an unfavourable B-allele; against the comparison group — 77.5% of events. Changes in the VDR gene polymorphism affected the incidence of the osteoarticular system (CCP, χ2 = 20.81, p <0.01) and had a statistically significant relationship in the distribution of alleles between groups (CCP, χ2 = 30.08, p <0.01). The parameters of TAP and TRAP in patients with combined course of HP and CP were 8.7 ± 2.3 U/L and 5.1 ± 2.3 U/L, respectively, and in the comparison group — 6.9 ± 3.0 U/L and 3.5 ± 2.1 U/L. Thus, the content of TAP and TRAP exceeded the control in the treatment group by 2.5 (TAP) and 1.9 (TRAP) times (p<0.01) and in the comparison group by 2.0 (TAP) and 1.3 TRAP) times (p<0.01), which allowed us to state the development of osteopenic conditions. The distribution of alleles of the VDR gene was characterized by the predominance of the B-allele and was “supported” by changes in the biochemical markers of osteoporosis, which led to the development of osteopenicconditions in such individuals. Thus, the combination of HP and CP is an unfavourable factor in the development of osteoporosis and the basis for early detection of osteoporetic changes. Conclusions. In the combined course of CP and arterial hypertension, there is an increase in the number of persons with the B-allele of the VDR gene (84.3% of cases), the carriers of which have a high risk of osteopenia. With the comorbidity of CP and HD, there are fluctuations in the content of TAP and TRAP, correlating with VDR. Increase in the content of TAP and TRAP in patients with CP and HD often occurs against the background of an unfavourable B-allele of the VDR gene. Combined course of CP and HD is the basis for early diagnosis of osteoporotic complications.
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