ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2018, 3(2): 114–119
https://doi.org/10.26693/jmbs03.02.114
Clinical Medicine

Influence of Vitamin D Receptor Gene Polymorphism on Expressiveness of Osteopenic Syndrome in Patients with Chronic Pancreatitis Accompanied with Hypertensive Disease

Pasieshvili L. M., Viun T. I.
Abstract

Research results of the effect of vitamin D receptor gene polymorphism on the formation of osteopenic syndrome in the isolated course of chronic pancreatitis (CP) and its combination with hypertensive disease (HD) are presented in the present study. Materials and methods. 110 patients were enrolled in the study. 70 of these people were included in the main group with a combined course of CP and HD; the average age of the group was 33.2 ± 2.1. The comparison group consisted of 40 patients with isolated HP; their age was 32.9 ± 3.1. The duration of HP was from 2 to 15 years with an interquartile magnitude (IM) of 4-7 years, with a medial tendency of 5 years. The history of HD ranged from 3 to 17 years with the same IM (4-8 years) and the medial trend of 5 years. The benchmarks for biochemical and genetic studies were obtained in a study of 70 practically healthy individuals, representing the main group by age and sex. HD diagnosis was performed on the recommendations of the European Society for Arterial Hypertension (ESAH) (2009) and the recommendations of the Working Group on Arterial Hypertension of the Ukrainian Association of Cardiology for the prevention and treatment of hypertension (2012), taking into account the classification of the degree and stage of hypertension, the risk of hypertension (risk stratification for evaluation forecast AG). The diagnosis of HD was verified by evaluating patients' complaints, anamneses, results of clinical and laboratory and instrumental research methods, referring to the Ministry of Health of Ukraine order № 271 dated 13.06.2005, updated on 09.10.2014 order № 638. Results and discussion. The selected gene refers to candidate genes whose polymorphism is associated with the development of osteopenic states. It was found that the presence of the pathological genotype BB of the VDR gene is a predictor of the development of osseous lesion, which is confirmed by the presence of a significant number of fractures (32,8%) щт the background of osteopenic conditions in patients with CP and HD in comparison with patients with isolated CP (25 %) This circumstance can be a result of the total quantitative (by the pathological genotype of BB) and qualitative (combination of calcium-dependent diseases) "accumulation", which causes the correction of dietary recommendations and is followed by the appointment of prophylactic courses of therapy with calcium preparations. Conclusions. The course of chronic pancreatitis in young people in 10% of cases is accompanied by fractures of bones of different localization. Joining the CP and HD significantly increases the number of such individuals, which may be the result of changes in calcium metabolism rates occurring in calcium-dependent diseases like chronic pancreatitis and hypertension. The presence of osteoporosis changes in patients with comorbidity of CP and HD may be due to the polymorphism of the vitamin D receptor gene, with the predominance of B-alleles.

Keywords: chronic pancreatitis, hypertensive disease, vitamin D receptor gene, osteophyte

Full text: PDF (Ukr) 381K

References
  1. Babinets LS, Kvasnitska OS, Mihenko LM, Pinkevich OYa. Osteodefitsit i vpliv suputnoi patolohiyi na yoho hlibinu pri khronichnomu pankreatiti. Bukovinskiy medichniy visnik. 2011; 15 (2/58): 183-5. [Ukrainian]
  2. Huberhrits NB. Trudnye voprosy hastroenterolohii. Suchasna hastroenterolohiya. 2011; 131-2. [Russian]
  3. Defitsit ta nedostatnist vitaminu D: epidemiolohiya, dia¬gnostika, profilaktika ta likuvannya. Za red VV Povoroznyuka, P Pludovski. Donetsk: Zaslavskiy OYu, 2014. 262 s. [Ukrainian]
  4. Drozdov VN, Chernyshova IV, Vinokurova LV, Embutnieks YuV, Tkachenko EV, Varvanina HH, Petrakov AV, Vyazhevich YuV. Rol ekzokrinnoy nedostatochnosti podzheludochnoy zhelezy v snizhenii mineralnoy plotnosti kostnoy tkani u bolnykh khronicheskim pankreatitom. Eksperim i klinich hastroenterolohiya. 2010; 8; 17-22. [Russian]
  5. Drozdov VN, Embutnieks YuV. Defitsit vitamina D v hastroenterolohii. Farmateka. 2008; 12: 53-7. [Russian]
  6. Paliy IH, Kolisnik SP. Zovnishnosekretorna nedostatnist pidshlunkovoi zalozi yak prediktor rozvitku osteodefitsitnikh staniv: novi mozhlivosti u likuvanni. Novosti meditsiny i farmatsii. Hastroenterolohiya (tematicheskiy nomer). 2010; 323: 12-3. [Ukrainian]
  7. Pasieshvili LM, Bobro LN. Rol zabolevaniy pishchevaritelnoho kanala v formirovanii i prohressirovanii vtorichnoho osteoporoza. Suchas hastroenterolohiya. 2008; 4: 12-8. [Russian]
  8. Sirenko YuN. Hipertonicheskaya bolezn i arterialnye hipertenzii. K: Zaslavskiy OYu, 2011. 287 s. [Russian]
  9. Sirenko YuM. Arterialna hipertenziya ta suputnya patolohiya. Donetsk: Vidavets Zaslavskiy OYu, 2010. 384 s. [Ukrainian]
  10. Stepanov YuM. Khvorobi orhaniv travlennya ta hastroenterolohichna dopomoha naselennyu Ukraini: zdobutki, problemi ta shlyakhi yikh virishennya. Zdorov’ya Ukraini. 2014; 3: 10-1. [Ukrainian]
  11. Khvorobi sistemi krovoobihu yak mediko-sotsialna i suspilno-politichna problema. Analitichno-metodichniy posibnik, rekomendovaniy dlya kardiolohiv, revmatolohiv, terapevtiv, orhanizatoriv okhoroni zdorov’ya ta likariv zahalnoi praktiki. Pid red VM Kovalenka. K: DU Nats nauk tsentr «Institut kardiolohiyi im akad MD Strazheska», 2014. 280 s. [Ukrainian]
  12. Embutnieks YuV, Drozdov VN, Chernyshova IV, i dr. Narushenie mineralnoy plotnosti kostnoy tkani u bolnykh s zabolevaniyami orhanov pishchevareniya. Eksperim i klin hastroenterolohiya. 2011; 9: 95-8. [Russian]
  13. Adachi JD. Osteoporosis and osteoarthritis: similarities and differences. Osteoporosis Int. 2013; 24 (1): S73.
  14. Bang D, Xu J, Keenan R, Pike V, Lehmann R, Tenner C, Crittenden D, Pillinger M, Krasnokutsky S. Cardiovascular Disease Prevalence in Patients with Osteoarthritis, Gout, or Both. Bulletinofthe Hospital Joint Disease. 2016; 74: 113-8. https://www.ncbi.nlm.nih.gov/pubmed/27281314
  15. 14.Cortet B. Assessment of pain in osteoarthritis and osteoporosis: similarities and differences. Osteoporosis Int. 2013: 24 (1): S71.
  16. Chandra R, Liddle RA. Recent advances in pancreatic endocrine and exocrine secretion. Curr Opin Gastroenterol. 2011; 27 (5): 439-43. https://www.ncbi.nlm.nih.gov/pubmed/21778879. https://www.ncbi.nlm.nih.gov/pmc/articles/3736574. https://doi.org/10.1097/MOG.0b013e328349e2e1
  17. Duggan SN, O’Sullivan M, Hamilton S, Feehan SM, Ridgway PF, Conlon KC. Patients with chronic pancreatitis are at increased risk for osteoporosis. Pancreas. 2012; 41 (7): 1119-24. https://www.ncbi.nlm.nih.gov/pubmed/22836855. https://doi.org/10.1097/MPA.0b013e31824abb4d
  18. Dujsikova H, Dite P, Tomandl J, Sevcikova A, Precechtelova M. Occurrence of metabolic osteopathy in patients with chronic pancreatitis. Pancreatology. 2008; 8 (6): 583-6. https://www.ncbi.nlm.nih.gov/pubmed/18824882. https://doi.org/10.1159/000159845
  19. Uitterlinden AG, Fang Yue, van Meurs JB, Pols HA, van Leeuwen JP. Genetics and biology of vitamin D receptor polymorphisms. Review. Gene. 2004; 338: 143-56. https://www.ncbi.nlm.nih.gov/pubmed/15315818. https://doi.org/10.1016/j.gene.2004.05.014
  20. Haussler MR, Whitfield GK, Kaneko I, Haussler CA, Hsieh D, Hsieh JC, Jurutka PW. Molecular mechanisms of vitamin D action. Calcif Tissue Int. 2013; 92 (2): 77-98. https://www.ncbi.nlm.nih.gov/pubmed/22782502. https://doi.org/10.1007/s00223-012-9619-0
  21. Pelletier J-P. Osteoporosis and osteoarthritis: similarities and 108 differences in experimental models. Osteoporosis Int. 2013; 24 (1): S71.