Clinical significance of genetic and inflammatory markers of bone metabolism in patients with chronic obstructive pulmonary disease and osteoporosis


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Abstract

Background. Pulmonogenic osteopenia, which develops in patients with chronic obstructive pulmonary disease (COPD), is the result of systemic inflammation. It leads to the production of pro-inflammatory cytokines that contribute to a decrease in bone mineral density; and in genetically predisposed patients, the development of osteoporosis leads to early disability due to low-energy fractures and a decrease in the quality of life. Objective. Determination of correlations between bone density and genetic, inflammatory and metabolic markers in patients with COPD and osteoporosis. Methods. The study involved 100 patients: 80 with a confirmed diagnosis of COPD and osteoporosis, and 20 were included in the control group. The studied groups underwent a genetic study for the detection of vitamin D receptor (VDR3) gene and the calcitonin receptor gene CALCR polymorphisms; determination of indicators of systemic inflammation: tumor necrosis factor alpha (TNF-а), C-reactive protein (CRP), interleukin-2 (IL-2), interleukin-4 (IL-4); determination of markers of bone resorption: terminal C-telopeptide of type 1 collagen (ß-CTx) and parathyroid hormone (PTH). The reliability of the results obtained was confirmed using the Statistica 13.2 software. Results. In patients with COPD and osteoporosis, a high pathological allele frequency was revealed: Bb - 49.1%, bb - 26.7% for VDR3; TS - 26.7%, CC - 53.9% for CALCR. The levels of markers of systemic inflammation and bone metabolism were significantly higher in the group of patients with COPD and osteoporosis, and there was a clear tendency to an increase in serum concentrations of TNF-а, CRP., IL-4, IL-2, ß-CTx and PTH with advanced COPD. Significant strong relationships between FEV1, T-criterion, TNF-а, IL-2, VAS, ß-STx, PTH, lumbar compression fractures and functionally defective alleles were revealed in COPD patients with osteoporosis. Conclusion. The data obtained confirm the important role of genetic, metabolic, inflammatory factors in the development of osteoporosis in COPD, which may be important for identifying a predisposition to this disease at an early stage of patient follow-up.

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About the authors

L. V Vasilyeva

Voronezh State Medical University n.a. N.N. Burdenko

Voronezh, Russia

Ekaterina N. Bezzubtseva

Voronezh State Medical University n.a. N.N. Burdenko

Email: bezzubtsewa.ekaterina@yandex.ru
Postgraduate Student at the Department of Propedeutics of Interna! Diseases Voronezh, Russia

E. F Evstratova

Voronezh State Medical University n.a. N.N. Burdenko

Voronezh, Russia

E. V Gosteva

Voronezh State Medical University n.a. N.N. Burdenko

Voronezh, Russia

I. B Zubkova

Voronezh City Clinical Emergency Hospital № 10

Voronezh, Russia

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