THU0021 CLINICAL SIGNIFICANCE OF WEIGHT LOSS ON THE LEVEL OF PROINFLAMMATORY CYTOKINES IN PATIENTS WITH OSTEOARTHRITIS
Authors: Lilia Arefeva, Vasily Kravtsov, L Seewordova, Gleb Kravtsov, Vitaliy Polyakov
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Obesity is a condition that prolongs chronic inflammation and promotes synthesis and secretion of pro-inflammatory factors by adipose tissue, such as classical cytokines, tumor necrosis factor-α (TNF-α), adipokines (leptin, adiponektin, resistin) and other newly identified proinflammatory factors (hemerin, lipokain, serum amyloid protein 3) [1,2,3,4,5]. Nowadays one of the most actively studied adipokines is nicotinamide phosphoribosyltransferase (visfatin, Nampt). <h3>Objectives</h3> We investigated the relationship the effect of weight loss over 5 kg on the clinical manifestations of OA and Nampt serum levels in patients with OA. <h3>Methods</h3> We observed 160 patients with different forms of OA ranged in age from 36 to 78 years, of whom there were 104 (65%) women (mean age 52.08 ± 1,58 years), and 56 (35%) of men (mean age - 54.07 ± 2,0 years) and the control group (60 healthy persons) with no complaints of pain in the joints over a lifetime, and without clinical signs of OA. Nampt level in serum was determined by ELISA using a commercial test systems. <h3>Results</h3> As overweight patients were recruited in the study, hypocaloric diet low in animal fats and physiotherapy has been recommended to all participants. The positive dynamics in body weight loss over 5kg within 3 months has been achieved by 36 patients (23%). All patients were divided into two groups to study the effect of weight loss on the clinical manifestations of OA. These data proves that obesity may be an important risk factor for OA progression. As a result, weight loss results in decreasing metabolic disorder severity. In the second group of patients we have seen a decrease in all the parameters, but a significant difference has been observed only in the level of CRP, level of pain at rest and during walking according to VAS scale and total index on the WOMAC. However, patients with weight loss over 5 kg had significantly greater positive dynamics of clinical parameters than in the second group without weight loss. This fact is probably explained by the decreased activity of inflammatory process after OA therapy and weight reduction. <h3>Conclusion</h3> Thus, as a result of our study patients with OA with weight loss of more than 5 kg had more obvious pain relief than patients with the original weight. These findings suggest that there is a possible role of visfatin in the pathogenesis of osteoarthritis. All patients with OA with a BMI over 25 kg/m 2 are recommended to lower their weight to decrease the mechanical stress on the joints, and also to reduce the severity of inflammation and metabolic disorders. <h3>References</h3> [1] Akhverdyan, Y. et al. Adipokines as new laboratory markers in osteoarthritis//Ann Rheum Dis 2013. – Vol.72 (Suppls. 3):702. [2] Degtiarev, V.K.; Aleksandrov, A.V. et al. The influence of general magnetic therapy on the psychological status of the patients presenting with osteoarthrosis//Voprosy kurortologii, fizioterapii, i lechebno fizicheskoy kultury 2013, №3, P.27-30. [3] Zavodovsky, B. V. et al. The efficacy and safety of etoricoxib versus meloxicam in the treatment of patients with gonarthrosis//Terapevticheskii Arkhiv Volume: 88 (12), P.: 78-81. [4] Papichev, E. V. et al. Fetuin-a level and secondary osteoporosis in women with rheumatoid arthritis//Osteoporosis International, 2018, Vol.:29 S.239. [5] Polyakova J. et al. Pathogenic relationship between osteoarthritis, overweight and inflammation//Annals of the Rheumatic Diseases. 2015. :. 74. №S2. С. 372. <h3>Disclosure of Interests</h3> None declared