CALCIUM-PHOSPHORUS EXCHANGE AND BONE METABOLISM IN GENERALIZED PERIODONTITIS, WHICH OCCURS ON THE BACKGROUND OF RHEUMATOID ARTHRITIS IN PATIENT, WHO LIVE IN ENVIRONMENTALLY UNFAVORABLE TERRITORIES

Abstract

Object and methods. A biochemical research was performed on 123 patients, including 70 patients with RA in remission with GP of the I and II degree of development. Two groups of patients with RA were formed: group I – 35 patients who live in environmentally unfavorable areas and group II – 35 patients who live in environmentally favorable areas. From patients with GP without concomitant somatic pathology, group III was formed – 35 people. Each of the groups, depending on the severity of GP was divided into subgroups: A – GP of the I degree; B – GP of the II degree of severity. The control group consisted of 18 healthy individuals with intact periodontium (K). The diagnosis of periodontal tissue diseases was established according to the classification by MF Danilevsky (1994). Patients of groups I, II and III underwent comprehensive treatment. Topically prescribed: rinsing the oral cavity with a solution of “Furasol” applications on the gums with the drug “Holisal”. For general treatment, patients of all groups received “Osteogenon”, “E 200-Zentiva”. Enterosorbent “Enterosgel” was additionally prescribed for patients of group I. Alkaline and acid phosphatase activity were determined using standard «SPL» kits. The concentration of total, ionized calcium and inorganic phosphorus was determined with reagents from «Simko LTD». The obtained results were statistically processed using computer programs Microsoft Excel and Statistica 7. Research results and their discussion. Analysis of the obtained results before treatment showed a decrease in calcium, phosphorus, LF activity and an increase in CF activity in the oral fluid in all subgroups of patients with GP. In GP of the II degree of severity, these deviations were more significant than in I degree. Among those examined with the II degree of severity of GP, the highest activity of CF was detected in the IB subgroup, which is 2.74 times significantly higher than the result of the control group (*p<0.001). The greatest decrease in LF activity in oral fluid is observed in the IIB subgroup, namely 2.28 times the value of the healthy group (*p<0.001). Calcium and phosphorus levels in the IB subgroup were the lowest. In particular, the level of calcium in the IB subgroup was 1.63 times, and the level of phosphorus 1.68 times lower compared with the healthy group (*p<0.001). After conducted comprehensive treatment in patients of all subgroups normalization of bone metabolism. However, the approximation of the researched indicators to the results of the healthy group after 6 months was mostly noted. Conclusions. The negative impact of concomitant somatic pathology and unfavorable environmental situation on bone metabolism in patients with GP has been established, which is confirmed by significantly higher acid phosphatase activity, lower concentration of calcium, phosphorus and LF in the oral fluid of such patients compared with patients of groups II and III. After conducted treatment, normalization of bone metabolism and calcium-phosphorus metabolism is observed during all observation periods, which is confirmed by an increase in calcium, phosphorus, increased alkaline phosphatase activity and decreased acid phosphatase activity in the oral fluid.

Keywords

• generalized periodontitis
• calcium-phosphorus metabolism
• bone metabolism
• rheumatoid arthritis
• environmentally unfavorable areas.