Mathematical formula for predicting the phenotype of comorbidity — erosive-ulcerative lesions of the gastroduodenal zone and arterial hypertension in railway workers

Background. Diseases of the gastrointestinal tract and arterial hypertension (AH) are among the diseases with a high frequency of spread. Their combination is often considered as a comorbid pathology, especially in a population that has an increased risk of their development.

Aims: to study the clinical and laboratory features of the formation of a combination of erosive-ulcerative lesions of the gastroduodenal zone in patients with arterial hypertension and to develop a method for predicting the likelihood of this comorbidity.

Methods: employees were Examined (n=127, male 100%). locomotive crews art. Perm-II of the Sverdlovsk branch of Russian Railways with more than 10 years of experience. Methods of examination included analysis of anamnesis data, physical, laboratory and instrumental examinations of patients. Laboratory tests of General blood analysis were performed on a 3-diffhematological analyzer V–Counter (“West-Medica”, Austria). Traditional biochemical parameters were determined in the blood serum, as well as the concentration of individual proteins: endlotelin-1 (ET-1), monocyte chemotactic protein-1 (MCP-1) and C-reactive protein (hs-CRP).

Statistical processing of the obtained data was performed on a PC using the built-in analysis package of the Excel® 2016 MSO table processor (© Microsoft, 2016), the author’s (©V. S. Sheludko, 2001–2016) package of applied spreadsheets (ppet) “Stat2015”

Results: the diagnostic value of a number of studied indicators was Established: the concentration of plasma proteins ET-1 and MSR-1; the level of glucose and cholesterol, as well as the content of white blood cells and platelets for the diagnosis of comorbidity: erosive and ulcerative lesions of the gastroduodenal system in patients with arterial hypertension.

The obtained data allowed us to develop a mathematical formula for calculating the risk of erosive and ulcerative lesions of the gastroduodenal system in patients with arterial hypertension.

Conclusion: employees of locomotive crews have an increased risk of comorbid pathology-erosive and ulcerative lesions of the gastroduodenal zone in patients with arterial hypertension, which is accompanied by changes in a number of laboratory parameters. The most important of them are: the developed equation using the content of MSR-1 and endothelin-1, glucose and cholesterol, as well as the number of platelets and leukocytes in peripheral blood. Allows you to predict the risk of comorbid pathology.

1. Salive M. E. Multimorbidity in older adults. Epidemiol Rev, 2013, Vol. 35, No. 1, pp. 75–83. doi: 10.1093/epirev/mxs009

2. Nunes B. P., Flores T. R., Mielke G. I., Thumé E., Facchini L. A. Multimorbidity and mortality in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr, 2016, Vol.67, pp. 130–138. doi: 10.1016/j.archger.2016.07.008

3. Rizzuto D., Melis R J F., Angleman S., Qiu C., Marengoni A. Effect of Chronic Diseases and Multimorbidity on Survival and Functioning in Elderly Adults. J Am Geriatr Soc. 2017, Vol. 65, No. 5, pp. 1056–1060. doi: 10.1111/jgs.14868

4. Glushhenko V. A., Irklienko E. K. Serdechno-sosudistaja zabolevaemost’ – odna iz vazhnejshih problem zdravoohranenija [Cardiovascular disease is one of the most important health problems]. Medicina i organizacija zdravoohranenija, 2019, Vol. 4, No. 1, pp. 56–63.

5. Farmanova E., Baker G. R., Cohen D. Combining Integration of Care and a Population Health Approach: A Scoping Review of Redesign Strategies and Interventions, and their Impact. Int J Integr Care, 2019, Vol.19, No. 2, 5 P. doi:10.5334/ijic.4197

6. Maljutina N. N., Eremeev R. B., Taranenko L. A., Tolkach A. S., Kostarev V. G. Nekotorye pokazateli zdorov’ja rabotajushhego naselenija Permskogo kra-ja i zadachi po ego ukrepleniю на ближайшие годы [Cardiovascular disease is one of the most important health problems], 2012, no. 12, pp. 4–8.

7. Khlynova O. V., Tuev A. V., Beresneva L. N., Agafonov A. V. Problema komorbidnosti arterial’noj gipertenzii i kis-lotozavisimyh zabolevanij. [Th e problem of comorbid-ity arterial hypertension and acid dependent diseases]. Kazanskij medicinskij zhurnal, 2013, Vol. 94, No. 1, pp. 80–85.

8. Khlynova O. V., Tuev A. V., Vasilec L. M., Kuznecova E. S. Zabolevanija serdechno-sosudistoj sistemy i vospalitel’nye zabolevanija kishechnika: komorbidnost’ ili polimorbidnost’?[Diseases of the cardiovascular system and infl ammatory bowel diseases: comorbidity or polymorbidity?]. Permskij medicinskij zhurnal, 2017, Vol. 34, No. 2, pp. 94–102.

9. Schmidt B. M., Durao S., Toews I., Bavuma C. M., Hohlfeld A., Nury E., Meerpohl J. J., Kredo T. Screening strategies for hypertension. Cochrane Database Syst Rev. 2020, 5, CD013212. doi: 10.1002/14651858

10. Wolf D., Ley K. Immunity and Inflammation in Atherosclerosis. Circ Res, 2019, Vol.124, No. 2, pp. 315‐327. doi:10.1161/CIRCRESAHA.118.313591

11. Wu C. Y. Initiatives for a Healthy Stomach. Curr Treat Options Gastroenterol. 2019, Vol.17, No.4, pp. 628–635. doi: 10.1007/s11938–019–00266-x

12. Kravcova T. Ju., Zarivchatckij M. F., Aleeva N. G., Blinov S. A., Repin V. N. Klinicheskaja kartina sochetan-nogo techenija arterial’noj gipertenzii i jazvennoj bolezni DPK v ambulatornoj praktike uchastkovogo vracha – terapevta i hirurga polikliniki [Clinical picture of the combined course of arterial hypertension and peptic ulcer disease in the outpatient practice of a district General practitioner and a polyclinic surgeon]. Permskij medicinskij zhurnal, 2017, Vol.34, Nо.1, pp. 12–18.

13. Klester E. B., Belova I. I., Balickaja A. S., Klester K. V. Kliniko-jepidemiologicheskie osobennosti zabolevanij organov pishhevarenija u bol’nyh s komorbidnoj patologiej dyhatel’noj i serdechnososudistoj sistem [Clinical and epidemiological features of digestive diseases in patients with comorbid pathology of the respiratory and cardiovascular systems.]. Bjulleten’ medicinskoj nauki, 2019, Vol. 13, No. 1, pp. 46–51. doi:10.31684/2541–8475.

14. Basile-Borgia A., Abel J. H., Mahloogi H. Molecular advances in cardiac and cardiovascular disease. Perfusion, 1999, Vol. 14, No. 2, pp. 89–99. doi: 10.1177/026765919901400202

15. Epstein J. A., Rader D. J., Parmacek M. S. Perspective: cardiovascular disease in the postgenomic eralessons learned and challenges ahead. Endocrinology, 2002, Vol.143, No. 6, pp. 2045–50. doi: 10.1210/endo.143.6.8910

16. Sedinin A. L., Maljutina N. N., Shhjokotova A. P., Sedinina N. S., Mihajlov V. I., Sergeev V. N. Geneticheskie de ter minanty razvitija psihosomaticheskih zabolevanij [Genetic determinants of psychosomatic diseases]. 33 Математическая формула прогноза фенотипа коморбидности | Mathematical formula for predicting the phenotype of comorbidity Vestnik nevrologii, psihiatrii i nejrohirurgii, 2018, No. 7, pp. 58–63.

17. Deter H. C., Kruse J., Zipfel S. History, aims and pres-ent structure of psychosomatic medicine in Germany. Biopsychosoc Med, 2018, 12, 1. doi:10.1186/s13030–017– 0120-x

18. van der Feltz-Cornelis CM, Elfeddali I, Werneke U, Malt UF, Van den Bergh O, Schaefert R, Kop WJ, Lobo A, Sharpe M, Söllner W, Löwe B. A European Research Agenda for Somatic Symptom Disorders, Bodily Distress Disorders, and Functional Disorders: Results of an Estimate-Talk-Estimate Delphi Expert Study. Front Psychiatry, 2018;9:151. doi: 10.3389/fpsyt.2018.00151.

19. Luzina S. V., Malutina N. N. Ulcer damage to the gastrointestinal path associated with hypertension as a manifestation of comorbidity among railway workers. Experimental and Clinical Gastroenterology. 2016;(6):23–27. (In Russ.)

20. Maljutina N. N., Luzina S. V. Svjaz’ uslovij truda i zabole-vaemosti rabotnikov Permskogo lokomotivnogo depo v formirovanii boleznej, svjazannyh s rabotoj [Th e r elationship of working conditions and morbidity of workers of locomotive depot Perm in the formation of diseases related to work]. Sanitarnyj vrach, 2015, No. 7, pp. 20–24.

21. Prevention of chronic non-communicable diseases. Recommendations, M. 2013, 128 p.

22. Trukhacheva N. V. Matematicheskaya statistika v mediko-biologicheskikh issledovaniyakh s primeneniem paketa Statistica [Mathematical statistics in biomedical research using the Statistica package], M.: GEOTAR-Media, 2012, 384 p.

23. Afifi F. Eizen S. Statisticheskii analiz: podkhod s ispol’zo-vaniem EVM: per s angl.: monografi ya. [Statistical anal-ysis: a computer-based approach: a monograph.] M. Mir, 1982, 488 P.

24. Rodriguez-Iturbe B., Pons H., Johnson R. J. Role of the Immune System in Hypertension. Physiol Rev, 2017, Vol. 97, No.3, pp.1127‐1164. doi:10.1152/physrev.00031.2016

25. Ritter AMV, Faria APC, Sabbatini A, Corrêa NB, Brunelli V, Modolo R, Moreno H. MCP-1 Levels are Associated with Cardiac Remodeling but not with Resistant Hypertension. Arq Bras Cardiol, 2017, Vol.108, No. 4, pp. 331–338. doi: 10.5935/abc.20170033.