Oliinyk M. The clinical and pathogenetic peculiarities of comorbid course of osteoarthritis and type 2 diabetes mellitus.

The thesis is devoted to the solving issues of improving the efficiency of diagnosis and treatment of osteoarthritis associated with diabetes mellitus type 2, based on the study of body mass index, changes of bone metabolism, lipid and carbohydrate metabolism, levels of cytokines, C-reactive protein and radiological studies. The dissertation presents a comprehensive analysis of pathological changes in bone metabolism, cytokine levels in patients with osteoarthritis associated with diabetes type 2. Based on a comprehensive assessment of the level of tumor necrosis factor-? (TNF-?), interleukin-1? (IL-1?), carbohydrate and lipid metabolism and their relationship with clinical and radiological changes it was determined that metabolic disorders lead to the progression of OA. An imbalance of the cytokines levels was determined in patients with OA and type 2 DM that was characterized by increasing levels of IL-1? and TNF-?; and their correlation with the level of C-reactive protein indicates that cytokines can be involved in the implementation of inflammation process and immune reactivity. It was proved, that the peculiarities of osteoarthritis in combination with diabetes mellitus type 2 either with normal body weight or with obesity include the progression of osteoarthritis, as evidenced by indices of WOMAC, Lequesne, radiographic changes, as well as more pronounced disorders of carbohydrate and lipid metabolism. Conducted studies deepen the understanding of the mechanisms of bone metabolism disorders and progression of OA in patients with type 2 DM. This allowed to offer a complex disease-modifying treatment (with the use of diacerein and tocopherol acetate) which favored the reduction of the chronic inflammation, improved the function of the joints and decreased the joint stiffness.