Clinical-molecular and nutritional-metabolic characteristics of vibration disease in combination with arterial hypertension
Authors: Gorbunova Alena M. , Gerasimenko Oksana N. , Shpagin Ilya S. , Belyaeva Tatyana M. , Maksimov Vladimir N. 
Published: June 2024

Introduction. Vibration disease (VD) in Russia consistently ranks second or third among all occupational pathology caused by physical factors of the production environment. The disease is characterized by polysyndromicity with the frequent development of polymorbid conditions, including arterial hypertension (AH), characterized by a persistent course even after the elimination of the causal factor, and the frequent development of persistent disability. Therefore, clarifying the nutritional-metabolic and molecular-genetic mechanisms of the formation of VD in combination with AH will optimize the diagnosis and evaluation of the effectiveness of the treatment, which is promising for the clinic of occupational medicine and internal diseases.
The study aims to determine additional diagnostic markers of the comorbid variant of vibration disease in combination with arterial hypertension based on the study of clinical and functional, nutritional and metabolic and molecular genetic indicators.
Materials and methods. The authors studied a range of clinical, anthropometric, laboratory, functional, molecular and genetic parameters in 431 employees of the aviation plant: 104 patients with stage I vibration disease; 101 patients with stage I comorbid vibration disease with arterial hypertension of stage I–II; 107 patients with arterial hypertension of stage I–II, not in contact with vibration; and 119 people from the same company, out of contact with vibration, without signs of hypertension.
Results. In the group of vibration disease in combination with arterial hypertension, we have found an increase in the frequency of general and specific complaints compared with the groups of isolated vibration disease and arterial hypertension. Body mass index indicators in the comorbid group correspond to obesity of stage 2 and 3 in 27.1%; 15.8%; whereas in the isolated groups of vibration disease and hypertension, patients with obesity of stage 1 prevail; There was a decrease in active cell mass and phase angle in the group of vibration disease combined with arterial hypertension in comparison with the control group by 1.4 and 1.3 times, respectively (p<0.001). In the comorbid group, compared with the control, the parameters of the adipocytokine profile were significantly changed: resistin was increased by 1.5 times, leptin-binding receptor and adiponectin were reduced by 1.5 and 1.6 times, respectively (in all cases, p<0.001). In the vibration disease group with hypertension, we have found lower vitamin D levels compared to other groups, and also have noted significant differences in the molecular profile of inflammation, oxidative stress, and endothelial dysfunction. In the comorbid group, the frequency of occurrence of the T/T rs4880 genotype of the SOD2 superoxide dismutase gene turned out to be characteristic of oxidative stress, whereas the carriage of the G/C rs20417 genotype of the cyclooxygenase SOH2 gene did not affect the course of vibration disease combined with arterial hypertension.
Conclusion. Comorbid vibration disease with arterial hypertension is realized in conditions of nutritional and metabolic changes in relation to clinical and functional criteria, changes in the adipocytokine profile, systemic inflammation, endothelial dysfunction, oxidative stress, a decrease in vitamin D and an increased incidence of the polymorphic variant of the T/T locus Ala16Val (rs4880) of the MnSOD (Superoxide Dismutase) gene. The conducted study, taking into account the study of correlation and regression analysis of the results obtained, made it possible to develop additional diagnostic criteria for nutritional and metabolic disorders.
Ethics. The authors have carried out the scientific research in accordance with the standards of Good Clinical Practice and the principles of the Helsinki Declaration. The protocol of the study was approved by the Ethics Committee of the Novosibirsk State Medical University of the Ministry of Health of the Russian Federation (Protocol No. 139 dated 11/25/2021). Before starting the work, all participants gave written informed voluntary consent to participate in the study.