ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2019, 4(4): 158–164
Clinical Medicine

Prognostic Value of Undifferentiated Connective Tissue Displazia in the Development of Comorbidal Pathology

Sherstiuk L. L.

The purpose of our study was to investigate the possibility of using clinical manifestations of undifferentiated connective tissue dysplasia as a prediction of the development of arterial hypertension in patients with type 2 diabetes. Material and methods. 90 patients aged 35 to 45 years old were diagnosed with type 2 diabetes, duration of no more than 10 years. The average age of the patients included in the study was (37.8 ± 3.3). The average duration of diabetes mellitus was (4.7 ± 2.5), including 66 (73.3%) with duration of diabetes up to 5 years and 24 (26.7%) with diabetes duration from 5 years or more. Among patients there were 54 (60.0%) women and 36 (40.0%) men. All patients performed a comprehensive clinical-laboratory and instrumental study in accordance with the current protocols for the provision of assistance for diabetes type 2 and hypertension. Diagnosis of undifferentiated connective tissue dysplasia was carried out through a comprehensive examination and evaluation of the presence of internal (visceral) and external (skeletal, skin, articular) signs according to T. I. Kadurina. Results and discussion. Patients with type 2 diabetes and signs of undifferentiated connective tissue dysplasia had certain differences increasing the specific gravity of women, reducing age, increasing growth, weight reduction and reducing the incidence of obesity (by body mass index). A frequent complication of diabetes in the analyzed sample of patients was diabetic nephropathy. In group I, it was diagnosed in 38 (79.2%) patients, in the II group it was present in 20 (47.6%) patients (χ2 = 8,401, p = 0.004). In this case, microalbuminuria was observed in 17 (35.4%) patients in group І and in 6 (14.3%) patients in group ІІ (χ2 = 4,205; р = 0,040). The most frequent concomitant pathology was hypertension, which was detected in 45 (93.7%) patients in group I, including: AG 1 in 25 (52.1%), AG 2 in 17 (35.4%) and AG 3 in 3 (6.3%). In group 2, hypertension was detected in 22 (52.4%), including: AG 1 in 16 (38,1%) patients, AG 2 in 5 (11,9%) patients and AG 3 in 1 (2.4%) (χ2 = 21.783; p <0.001). Conclusions. As a result of the analysis of general clinical data, features of the course of type 2 diabetes and concomitant pathology, we found out that patients with signs of undifferentiated connective tissue dysplasia, had a younger age, even in the age group of 35-45 years, less weight, with a tendency to decrease body mass index and decrease in the number of obese patients, increase in the frequency of diabetic nephropathy, retinopathy and neuropathy, and the frequency of hypertension. In this case, the development of hypertension in patients with type 2 diabetes in combination with undifferentiated connective tissue dysplasia occurred earlier, but almost did not depend on the duration of diabetes. More pronounced hypertension was observed in patients with visceral and skeletal signs of undifferentiated connective tissue dysplasia. This is the evidence of the role of undifferentiated connective tissue dysplasia in the pathogenesis of hypertension in patients with type 2 diabetes.

Keywords: arterial hypertension, type 2 diabetes, undifferentiated connective tissue dysplasia

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  1. Alimova IL, Pashinskaya NB, Pleskachevskaya TA. Features of the course of diabetes mellitus type 1 in children and adolescents against dysplasia of connective tissue. Medical Herald of the North Caucasus. 2016; 11(2): 272-5. [Russian]
  2. Zemtsovsky EV, Maleev E. G. Small anomalies of the heart and dysplastic phenotypes. SPb: Publishing House IVESEP; 2011. 60 p. [Russian]
  3. Martynova AI, Nechaeva GI: ed. National recommendations of the Russian scientific medical community of therapists on the diagnosis, treatment and rehabilitation of patients with connective tissue dysplasia. M: LLC "Bionika-Media"; 2016. 80 p. [Russian]
  4. Kadurina TI, Gorbunova VN. Connective tissue dysplasia Manual for doctors. SPb: Elby-SPb; 2009. 704 p. [Russian]
  5. Baron-Franco B, McLean G, Mair FS, Roger VL, Guthrie B, Mercer SW. Comorbidity and polypharmacy in chronic heart failure: a large cross–sectional study in primary care. Br J Gen Pract. 2017; 67(658): e314-e320.
  6. Kendir C, van den Akker M, Vos R, Metsemakers J. Cardiovascular disease patients have increased risk for comorbidity: A cross-sectional study in the Netherlands. Eur J Gen Pract. 2018 Dec; 24(1): 45-50.
  7. Knowles S, Hays R, Senra H, Bower P, Locock L, Protheroe J, et al. Empowering people to help speak up about safety in primary care: Using codesign to involve patients and professionals in developing new interventions for patients with multimorbidity. Health Expect. 2018; 21(2): 539-48.
  8. Nibouche WN, Biad A. Arterial hypertension at the time of diagnosis of type 2 diabetes in adults. Ann Cardiol Angeiol (Paris). 2016; 65(3): 152-8. [French]
  9. Shad B, Ashouri A, Hasandokht T, Rajati F, Salari A, Naghshbandi M, Mirbolouk F. Effect of multimorbidity on quality of life in adult with cardiovascular disease: a cross–sectional study. Health Qual. Life Outcomes. 2017; 15(1): 240.
  10. Vetrano DL, Calderón-Larrañaga A, Marengoni A, Onder G, Bauer JM, Cesari M, et al. An international perspective on chronic multimorbidity: approaching the elephant in the room. J Gerontol A Biol Sci Med Sci. 2018; 73(10): 1350-6.