Peculiarities of bone tissue metabolism in patients with acute otitis media with impared carbonhydrate metabolism

Introductions: Relevance of the study is due to the unrecognized effect of carbohydrate metabolism disorders on bone tissue metabolism in patients with acute otitis media (AOM). Aim: to determine the peculiarities of bone tissue metabolism in patients with AOM caused by disorders of carbohydrate metabolism. Materials and methods: Our study included 73 patients aged 18 to 79 (29 males and 44 females) who were randomized into 4 groups according to the aim of the research: Group 1 – 17 patients with AOM, Group 2 – 15 patients with AOM combined with paranasal sinus pathology, Group 3 – 20 patients with AOM on the background of type 2 diabetes mellitus, Group 4 – 21 patients with AOM combined with transitory disorders of glucose metabolism. On the basis of clinical examination all patients were tested for glycosylated hemoglobin (HbAlc), blood calcium level and parathormone as a marker of bone resorption and osteocalcin as a marker of bone remodeling. Results of the study and discussion: The statistical evaluation of the indicators identified a reliable difference between groups 1-2 and groups 3-4, while between groups 1 and 2, 3 and 4 reliable difference in metabolic parameters of bone tissue has not been established. The level of glucosylated hemoglobin was significantly elevated even for transitory signs of carbohydrate metabolism disorders (5,17±0,17%, 4,95±0,17%, 9,8±0,46% and 7,78±0,19% in groups 1,2, 3 and 4 respectively).The value of parathormone was within the reference values, but it proved to be significantly (p˂0,001) higher in glucose metabolism disorders (56.8±3.02pg/ml and 52.56±2.7pg/ml in groups 3 and 4, respectively).The amount of osteocalcin and calcium tended to decrease in type 2 diabetes mellitus (group 3) and in transitory disorders (group 4), but without a significant difference (p˃0.05). Correlation analysis revealed a strong correlation between glucose and glucosylated hemoglobin levels in patients in group 3 and the average strength in patients in group 4 (r=0.832 and r=0.44, respectively). The increase of parathormone level on the basis of carbohydrate metabolism disorders was due to the presence of correlation with the level of glucosylated haemoglobin in groups 3 and 4 (r=0.705 and r=0.81 respectively). Calcium correlations of r=-0.77 and r=-0.56 with parathormone level and r=-0.79 and r=-0.44 with glucosylated haemoglobin level were found in patients of groups 3 and 4 accordingly. In the absence of glucose metabolism disorders in groups 1 and 2, no significant correlations were found, except for physiologically determined correlations of parathormone and calcium levels in group 1 (r=-0.489). Conclusions: Disorders of carbohydrate metabolism negatively affect metabolism of bone tissue due to activation of bone resorption processes. This is manifested by correlated with the level of glycosylated hemoglobin by an increase in the amount of parathormone with pathogenetic significance of both type 2 diabetes mellitus and transitory disorders of carbohydrate metabolism.In this category of patients, the level of parathormone and its dynamics, as well as the determination of glucosylated hemoglobin are informative even in transitory disorders of carbohydrate metabolism.