ARTICULAR SYNDROME AND QUALITY OF LIFE IN PATIENTS WITH OSTEOARTHRITIS DURING COMORBID COURSE WITH NONALCOHOLIC STEATOHEPATITIS AND OBESITY

Aim: to determine the influence of comorbidity of osteoarthritis (OA), non-alcoholic steatohepatitis (NASH), and obesity on the course of the articular syndrome and quality of life of patients.

Material and methods. 90 patients were examined and divided into three groups: group 1 (n=30) included patients suffering from OA, grade II–III according to Kellgren and Lawrence classification,with normal body mass (BMI=21–25 kg/m2), group 2 (n=30) — patients with NASH and obesity without OA (BMI>30 kg/m2), group 3 (n=30) — patients with OA with NASH and obesity (BMI more than 30 kg/m2). The average age of patients was (62.3±5.7) years.

Results. The mean values and changes in the data of the questionnaires of VAS, WOMAC and Leken’s questionnaire in patients of experimental groups were analyzed, and the comparison between them was conducted. In patients with combined pathology, the VAS index and the Leken’s index were significantly higher compared to patients with normal BMI (p<0.05), which indicates a significant contribution of the NASH and obesity overlay to the increased manifestations of the articular syndrome. We found out that the WOMAC index was significantly higher in patients with combined pathology. In particular: severity of pain, stiffness of joints and functional failure were significantly more pronounced, compared to a group of patients with OA only (p<0.05). Besides, when evaluating the groups of comparison, the quality of life of patients with comorbidity in all questionnaires was significantly worse (p<0.05).

Conclusion. The obtained results confirm the negative influence of obesity on the course of OA, which is indicated by the increase in the intensity of pain syndrome for VAS, increase in the severity of pain syndrome, joints stiffness, decreased functionality according to the WOMAC test in the presence of obesity and NASH. The comorbid course of OA, NASH and OB leads to a substantial deterioration in the quality of life of patients and causes mutual burdening in the course of these diseases.