Voloshyna L. Clinico-pathogenetic features of comorbidity and hypothyroidism development in patients with osteoarthrosis: age, gender and metabolic aspects of prognostication, improvement of treatment and prevention.

The thesis is designed to improve the diagnostics and the treatment results in patients with osteoarthrosis (OA) against the background of comorbid processes and hypothyroidism. The study involved 312 patients with osteoarthrosis of І-ІІІ clinical-radiological stages and three-year monitoring with improvements in standard therapy according to clusters of comorbid diseases, osteoarthrosis and hypothyroidism phenotypes. The revealed age and gender peculiarities of comorbid diseases were their quantitative and burdensome progression from 2-3 at the age of up to 50 years – to 6-9 nosologies in patients with osteoarthrosis older than 60 years, including manifest and subclinical hypothyroidism, predominantly in women with diverse burdensome effects on osteoarthrosis, systemic metabolic disorders. It has been established that the use of medications L-arginine (dominant cluster of vascular comorbidities), quercetin (a mixed cluster of vascular and gastrointestinal diseases), a thyro-stabilizing multicomponent remedy of vegetable origin in case of subclinical hypothyroidism, a multicomponent phytochondroprotective means (with a dominant cluster of digestive system damage), as addition to standard therapy improve the general condition of patients, the results of treatment of major and comorbid ailments, quality of life of the diseased. Implementation of developed improvements in standard therapy for osteoarthrosis has allowed reducing the incidence of relapses and lengthening the duration of remission of both major and comorbid diseases. Key words: osteoarthrosis, comorbidity, hypothyroidism, clusters, metabolic disorders, treatment, prevention. Branch - medicine.