ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 22 of 67
УЖМБС 2020, 5(4): 167–172
Clinical Medicine

Biochemical Markers of Connective Tissue in the Laboratory Diagnosis of Orthopedic Human Diseases

Leontieva F. S. 1, Morozenko D. V. 1,2, Vorontsova M. P. 1,3, Gliebova K. V. 2, Doluda Y. A. 1, Leontieva L. V. 3

The use of laboratory methods makes it possible to objectify the results of clinical and instrumental examination, in particular, to establish the activity of inflammatory and destructive processes on the basis of determining the clinical and diagnostic significance of individual biochemical markers of the exchange of collagen and proteoglycans of the connective tissue of the affected joints and spine. Material and methods. The studies were carried out during 2012-2019 based on the Department of Laboratory Diagnostics and Immunology, Sytenko Institute of Spine and Joint Pathology (Kharkiv). The clinical and diagnostic significance of biochemical markers of blood and urine of patients with various orthopedic diseases was analyzed. Results and discussion. The patients with coxarthrosis of stages I-II had the content of glycoproteins in the blood 0.83 ± 0.013 g/l, and the patients with stages III-IV – 1.06 ± 0.018 g/l; with hernias of the lumbar spine, the content of glycoproteins in the blood was 1.06 ± 0.03 g/l, with spinal stenosis – 1.09 ± 0.10 g/l, with spondylolisthesis – 0.98 ± 0.022 g/l, instability of the vertebral segments – 1.16 ± 0.043 g/l, with bacterial arthritis of the knee joints – 1.34 ± 0.011 g/l. Glycosaminoglycan fractions are important indicators for the diagnosis of terminal stages of osteoarthrosis of the hip and knee joints: at stages III-IV of osteoarthrosis, the sum of glycosaminoglycan fractions in the blood serum was 14.33 ± 0.74 U, I fraction – 9.72 ± 0.31, II fraction – 1.90 ± 0.20 g/l; III fraction – 2.71 ± 0.23 U. In case of coxarthrosis of stages I-II, the content of chondroitin sulfates was 0.136 ± 0.013 g/l, stages III-IV – 0.343 ± 0.012 g/l, with hernias of the lumbar spine – 0.216 ± 0.016 g/l, with spinal stenosis – 0.204 ± 0.017 g/l, with spondylolisthesis – 0.237 ± 0.010, with instability of the vertebral segments – 0.214 ± 0.020 g/l, with bacterial arthritis of the knee joints – 0.185 ± 0.025 g/l. The content of sialic acids at stages I-II of osteoarthrosis of the hip and knee joints was 2.52 ± 0.067 mmol/l, stages III-IV – 3.54 ± 0.094 mmol/l, with bacterial arthritis of the knee joints – 3.76 ± 0.034 mmol/l. The level of urinary oxyproline excretion is a marker of collagen catabolism of the connective tissue of the affected joints with osteoarthritis: the oxyproline at stages I-II stages of osteoarthrosis of the hip and knee joints was 39.400 ± 1.800 mg/day, stages III-IV – 49.600 ± 1.300 mg/day. In osteochondrosis of the lumbar spine, the level of oxyproline excretion was 39.20±2.80 mg/day. The urinary acid excretion in urine at stages I-II of osteoarthrosis of the hip and knee joints was 5.490 ± 0.370 mg/day; stage III-IV – 4.340 ± 0.320 mg/day. In osteochondrosis of the lumbar spine, the level of uronic acid excretion was 6.10 ± 0.34 mg/day. Conclusion. Biochemical markers of connective tissue reflect disorders of collagen and proteoglycan catabolism in patients with orthopedic diseases: osteoarthritis of the large joints, bacterial arthritis of the knee joints, as well as degenerative diseases of the lumbar spine, instability of the spinal segments and hernias, hernias. The content of glycoproteins and chondroitin sulfates in the blood increases in the case of inflammatory and degenerative processes in the joints and intervertebral discs, increased excretion of oxyproline is associated with catabolism of collagen, uronic acids with the catabolism of proteoglycans of cartilage and bone tissue.

Keywords: biochemical markers, diagnosis, osteoarthrosis, bacterial arthritis, degenerative diseases of the spine

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