SAT0521 EVALUATION OF LIPID PROFILE IN PATIENTS WITH AVASCULAR NECROSIS
Authors: K. Gudkevich, N. Martusevich, E. Dashkevich
Journal: Annals of the Rheumatic Diseases (2020)

Background: Avascular necrosis (AN) is a disabling disease affecting predominantly young men. It steadily progresses to secondary osteoarthritis. The rate of disability is high, because hip joint is most commonly affected by AN; moreover, the rate of bilateral hip joint involvement is also high. The key event in the pathogenesis of AN is circulation disorder which results in ischemia and, furthermore, death of bone tissue. Nowadays the data about lipid metabolism in patients with AN. Besides, there is contradictory data about the role of homocysteine in the risk of cardiovascular events. Based on these, it is topical to investigate lipid metabolism and endothelial function in patients with AN. Objectives: The aim of the present study was to investigate lipid metabolism and endothelial function in patients with different stages of AN in order to find risk factors for incidence and progression of this disease. Methods: We recruited 41 patients with AN of the femoral head or femoral condyles aged 51 (35-64) years, 56,1% (n=23) were male. The inclusion criteria was diagnosis of AN confirmed by X-Ray, CT or MRI. The exclusion criteria were: traumatic AN, Legg-Calve-Pertes disease, connective tissue systemic diseases. Also we divided patients into subgroups with early (39% (n=16)) and late (61,0% (n=25)) stages of AN. Patients of the control group (n=32) were comparable by age and gender. The data was proceeded using non-parametric and descriptive statistics. We evaluated the following parameters: homocysteine, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, cholesterol ratio, apolipoprotein A1, apolipoprotein B. Results: In patients with AN we observed higher level of homocysteine (12,119 (7,771-14,38) vs. 7,911 (6,612-10,54) mcmol/l, p=0,05). The results are consistent with the data that higher homocyseine level is associated with higher risk for cardiovascular events (1). There is literature data about elevated homocysteine level in patients with AN, which was associated with lower levels of vitamin B12 and folic acid. Thus, interpretation of homocystene significance is more reliable in association with vitamin B12 and folic acid levels. Also, we observed that level of HDLP-C is higher in patients with early stages than in pate stages of AN (1,55 (1,31-1,57) vs. 1,23 (1,04-1,36) mmol/l, р=0,04). Thus, HDLP-C can be interpreted as a protective factor against contralateral joint involvement in AN patients. The data obtained is consistent with the existing data that HDLP-C lowers the risk for cardiovascular events. Conclusion: The data obtained indicate a significant role of dyslypidemia in the pathogenesis of AN in the context of vascular theory. References: [1]Steven G. Chrysant &amp; George S. Chrysant (2018) The current status of homocysteine as a risk factor for cardiovascular disease: a mini review, Expert Review of Cardiovascular Therapy, 16:8, 559-565, DOI: 10.1080/14779072.2018.1497974. [2]Narayanan, A., Khanchandani, P., Borkar, R.M. et al. Avascular Necrosis of Femoral Head: A Metabolomic, Biophysical, Biochemical, Electron Microscopic and Histopathological Characterization. Sci Rep 7, 10721 (2017). https://doi.org/10.1038/ . Disclosure of Interests: Katsiarina Gudkevich: None declared, Natalia Martusevich Shareholder of: k, Elena Dashkevich: None declared