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УЖМБС 2020, 5(4): 189–195
https://doi.org/10.26693/jmbs05.04.189
Clinical Medicine

State of Connective Tissue Metabolism in Mitral Valve Prolapse in Combination with Type 1 Diabetes Mellitus

Nikolenko O. 1, Pavlov S. 2, Pavlova G. 2, Korzh O. 1
Abstract

The purpose of the study was to compare the indicators of connective tissue metabolism in patients with mitral valve prolapse, type 1 diabetes mellitus, and patients with a combination of these pathologies. Material and methods. To study the processes of connective tissue metabolism, we determined the level of free and bound hydroxyproline, as well as the content of sulfatedglycosaminoglycans in the blood serum of patients with mitral valve prolapse, type 1 diabetes mellitus and a combination of these pathologies were determined. The ratio of free and peptide-bound hydr was calculated. Results and discussion. We found violations of the balance of destructive and synthetic processes in the extracellular matrix of connective tissue. They were characterized by an increase in the content of hydroxyproline fractions and sulphated glycosaminoglycans in the blood serum of patients of all groups. The robtained results showed that patients with comorbid pathology had the highest activation of collagen metabolism, as evidenced by high levels of free and peptide-bound hydroxyproline relative to the norm and the values of these indicators in patients with isolated pathology, as well as an increase in the proportion of peptide-bound hydroxyproline. Changes in the content of sulphated glycosaminoglycans in patients with combined pathology were less characteristic, the overall level of their content did not differ from the control. At the same time, the highest values among the fractions of sulfated glycosaminoglycans were found in the group of patients with type 1 diabetes (II fraction – medium-soluble compounds: chondroitin-4-sulfate, dermatan-sulfate). Consequently, in patients with mitral valve prolapse, type 1 diabetes mellitus and a combination of these pathologies changed the functional state of connective tissue, which were manifested by changes in the direction and rate of exchange of collagen and proteoglycans of the extracellular substance of connective tissue. Conclusion. We revealed revealed the imbalance of the destructive and synthetic processes in the extracellular matrix of connective tissue in patients with comorbidity (diabetes mellitus type 1 + mitral valve prolapse). It was manifested by increased blood content of the fractions of free and peptidoglycan hydroxyproline, the changing balance of free and peptidoglycan hydroxyproline an increase in the proportion peptidoglikanov, as well as increased content of sulphated glycosaminoglycans II and III fractions.

Keywords: mitral valve prolapse, type 1 diabetes mellitus, undifferentiated connective tissue dysplasia, hydroxyproline, glycosaminoglycansulfates

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References
  1. Khvysyuk OM, Pavlov SB, Pavlova GB. Do pytannya pro rol funktsionalnogo stanu spoluchnoyi tkanyny v realizatsiyi systemnoyi vidpovidi na poshkodzhennya [On the question of the role of the functional state of connective tissue in the implementation of the systemic response to damage]. Problemy bezperervnoyi medychnoyi osvity ta nauky. 2016; 3: 55-61. [Ukrainian]
  2. Goncharova AV, Pavlov SB, Kumetchko MV. Interactions of RANKL, osteoprotegerin and adipokinesin regulation of bone remodeling in experimental chronic kidney function disorder. Georgian medical news. 2018; 7-8 (280-281): 168-73.
  3. Pavlov SB, Babenko NM, Kumetchko MV, Litvinova OB. Violations of cell-molecular mechanisms of bone remodeling under influence of glucocorticoids. Regulatory Mechanisms in Biosystems. 2018; 9(1): 124-9. https://doi.org/10.15421/021818
  4. Zemtsovskyy EV, Tymofeev EV, Malev EG. Nasledstvennye narushenyya (dysplazyy) soedynytelnoy tkany. Kakaya yz dvukh deystvuyushchykh natsyonalnykh rekomendatsyy predpochtytelna? [Hereditary disorders (dysplasia) of connective tissue. Which of the two current national recommendations is preferable?]. Pedyatr. 2017; 8(4): 6-18. [Russian]. https://doi.org/10.17816/PED846-18
  5. Klynycheskye rekomendatsyy Rossyyskogo nauchnogo medytsynskogo obshchestva terapevtov po dyagnostyke, lechenyyu y reabylytatsyy patsyentov s dysplazyyamy soedynytelnoy tkany (pervyy peresmotr) [Clinical recommendations of the Russian Scientific Medical Society of Therapists in the diagnosis, treatment and rehabilitation of patients with connective tissue dysplasia (first review)]. Medytsynskyy vestnyk Severnogo Kavkaza. 2018; 13(1-2): 137-209. [Russian]. https://doi.org/10.14300/mnnc. 2018.13037
  6. Chernyshova TE, Kurnykova YA, Maslova YS. Dysplazyya soedynytelnoy tkany: prognostycheskoe znachenye v dyabetologyy [Connective tissue dysplasia: prognostic value in diabetology]. Kubanskyy nauchnyy medytsynskyy vestnyk. 2009; 6: 76-9. [Russian]
  7. Alymova YL, Pashynskaya NB, Pleskachevskaya TA. Osobennosty techenyya sakharnogo dyabeta 1 typa u detey y podrostkov na fone dysplazyy soedynytelnoy tkany [Features of the course of type 1 diabetes in children and adolescents on the background of connective tissue dysplasia]. Medytsynskyy vestnyk Severnogo Kavkaza. 2016; 2(2): 272-5. [Russian] https://doi.org/10.14300/mnnc.2016.11053
  8. Arsentev VG, Sereda YuV, Tykhonov VV. Dysplazyy soedynytelnoy tkany − konstytutsyonalnaya osnova polyorgannykh narushenyy u detey y podrostkov [Connective tissue dysplasia - the constitutional basis of multiple organ disorders in children and adolescents]. Pedyatryya. Zhurnal ym GN Speranskogo. 2011; 90(5): 54-7. [Russian]
  9. Sherstyuk LL, Nykolenko EYa. Morfologycheskaya kharakterystyka pochky bolnykh SD 2 typa sredney stepeny tyazhesty na fone dysplazyy soedynytelnoy tkany [Morphological characteristics of the kidney of patients with type 2 diabetes of moderate severity against the background of connective tissue dysplasia]. Visnyk problem biologiyi i medytsyny. 2013; 4: 302-6. [Russian]
  10. Klemenov AV. Prolaps mytralnogo klapana: sovremennye predstavlenyya y nereshennye voprosy (obzor) [Mitral valve prolapse: current views and unresolved issues (review)]. Sovremennye tekhnologyy v medytsyne. 2017; 9(3): 126-37. [Russian]. https://doi.org/10.17691/stm2017.9.3.17
  11. Eguchi K, Boden-Albala B, Jin Z, Rundek T, Sacco RL, Homma S, et al. Association between diabetes mellitus and left ventricular hypertrophy in a multiethnic population. Am J Cardiol. 2008 Jun 15; 101(12): 1787-91. https://doi.org/10.1016/j.amjcard.2008.02.082. https://www.ncbi.nlm.nih.gov/pubmed/18549860. https://www.ncbi.nlm.nih.gov/pmc/articles/2486269
  12. Nakaz MOZ Ukrayiny N 1021 vid 29 grudnya 2014 roku «Pro zatverdzhennya ta vprovadzhennya medyko-tekhnologichnykh dokumentiv zi standartyzatsiyi medychnoyi dopomogy pry tsukrovomu diabeti 1 typu u molodykh lyudey ta doroslykh» [On approval and implementation of medical and technological documents for standardization of medical care for type 1 diabetes in young people and adults]. [Ukrainian]. Available from: https://ips.ligazakon.net/document/view/moz24121?an=7&ed=2014_12_29
  13. Freed LA, Benjamin EJ, Levy D, Larson MG, Evans JC, Fuller DL, et al. Mitral valve prolapse in the general population. The benign nature of echocardiography features in the Framingham Heart Study. J Am Coll Cardiol. 2002 Oct 2; 40(7): 1298-304. https://doi.org/10.1016/S0735-1097(02)02161-7
  14. Sharaev PN, Sakhabutdynova EP, Lekomtseva OY, Koshykova SV. Opredelenye svobodnogo y peptydno-svyazannogo gydroksyprolyna v syvorotke krovy [Determination of free and peptide-bound hydroxyproline in blood serum]. Klynycheskaya laboratornaya dyagnostyka. 2009; 1: 7-9. [Russian]
  15. Patent 960626 SSSR, MPK G 01N 33/48. Sposob opredelenyya glykozamynoglykansulfatov v syvorotke krovy [The method for determination of glycosaminoglycan sulfates in blood serum] / Shtern MR, Tymoshenko OP, Leonteva FS. (SSSR); zayavl 23.10.80; opubl 23.09.82. Otkrytiya. Izobretenyya. 1982; 35: 163. [Russian]
  16. Furtseva LN. Byokhymyya kostnoy y khryashchevoy tkany. In: Aktualnye problemy teoretycheskoy y klynycheskoy osteoartrologyy [Biochemistry of bone and cartilage. In: Actual problems of theoretical and clinical osteoarthrology]. Pod red YuY Denysov-Nykolskyi, SP Myronov, YuP Omelyanenko, YV Matveychuk. M: OAO Typografyya-Novosty; 2005. 336 s. [Russian]
  17. Bekkers JE, Creemers L, Dhert WJ, Saris DB. Diagnostic modalities for diseased articular cartilage - from defect to degeneration are view. Cartilage. 2010; 1(3): 157-64. https://doi.org/10.1177/1947603510364539. https://www.ncbi.nlm.nih.gov/pubmed/26069547. https://www.ncbi.nlm.nih.gov/pmc/articles/4297075
  18. Serov VV, Shekhter AB. Soedynytelnaya tkan (funktsyonalnaya morfologyya y obshchaya patologyya) [Connective tissue (functional morphology and general pathology)]. M: Medytsyna; 1981. 312 s. [Russian]
  19. Gorbach EN, Matveeva EL, Romanenko SA. Sostoyanye vnekletochnogo matryksa kozhy eksperymentalnykh zhyvotnykh pry udlynenyy goleny po Ilyzarovu [The state of the extracellular matrix of the skin of experimental animals with lengthening of the tibia according to Ilizarov]. Genyy ortopedyy. 2011; 3: 137-41. [Russian]