COMORBID CONDITION - DIABETES MELLITUS WITH CO-EXISTENT RAYNAUD'S SYNDROME IN PATIENTS WITH RHEUMATOID ARTHRITIS.

The most common comorbidities in patients with rheumatic diseases include cardiovascular diseases (CVD), liver and biliary tract infection, lung diseases, amyloidosis, fractures of different localizations, malignant neoplasms, metabolic disorders and diabetes mellitus (DM). The aim of study was to investigate the clinical course of DM and rheumatoid arthritis (RS) in patients with RA using laboratory and instrumental research methods. There were examined 85 patients with RA who were treated in the rheumatology department of Ivano-Frankivsk Central City Clinical Hospital. The patients' age ranged from 40 to 70 years. Endothelial dysfunction (ED) signs were observed in 76 (89.4%) patients. ED was diagnosed in all patients with RA, co-existent RS and DM. In the patients with RA and those with RA and co-existent RS, impaired EDVBA was detected. In the patients of Group II, the indicator of EDVBA (6.5±0.2%) was significantly lower as compared to the patients of Group I (8.8±0.3%) (р<0.05). The levels of both CRP and TNF-α, serving as non-specific inflammatory markers, were significantly higher (29.37±3.56 mg/l, p<0.01) in the patients with RS as compared to the patients with RA only (23.89±1.77 mg/l). A detailed study of the pathophysiological and immunological features of the clinical course of secondary RS will allow us to optimize its treatment schemes in patients with RA, reduce clinical and laboratory manifestation of RA and improve quality of life in such patients, especially those with a comorbidity.