Pain syndrome in women with osteoarthritis against the background of overweight and hypothyroidism

Objective. To evaluate pain syndrome and its relationship with clinical, laboratory and functional changes in women with osteoarthritis (OA) due to overweight and hypothyroidism. Materials and methods. 43 women diagnosed with OA, with a body mass index (BMI) ≥ 27 kg/m2 aged from 40 to 65 were included in the study. The patients were divided into 2 groups depending on the thyroid gland function: group 1 contained 18 patients with primary medically compensated hypothyroidism, group 2 consisted of 25 patients without thyroid gland disorders. A physical, laboratory and instrumental examination with the assessment of thyroid status (TSH, free T4, free T3) was carried out in all the patients. Indicators of phosphorus-calcium metabolism: total calcium, ionized calcium, phosphorus, parathyroid hormone, b-crosslaps were also taken into account, as well as indicators of nonspecific inflammation: C-reactive protein (CRP), Сomplete Blood Count (CBC). The presence of OA and its severity were confirmed by the radiography of the affected joints in 2 projections. The severity of pain was determined using the visual analogue pain scale (VAS), the algofunctional Lequesne index, and with the help of the McGill questionnaire. Statistical processing was carried out by the integrated package for statistical analysis “Statistica 10”. Results. The study revealed severe pain syndrome according to the VAS scale, the Lequesne algofunctional index and the McGill questionnaire in patients of both groups. However, pain scale scores were higher in women with compensated hypothyroidism and correlated with markers of a nonspecific inflammation, as well as with the duration of hypothyroidism, which proves that the effect of thyroid function disorders on the severity of clinical and functional changes in OA is significant. Conclusions. Despite of drug compensation for hypothyroidism, patients with osteoarthritis and overweight have more pronounced clinical, laboratory and functional changes in the form of increased intensity of pain syndrome and decreased pain sensitivity threshold.