Objective. To characterize metabolic syndrome (M S) in pts wit h systemic lupus erythematosus (SLE) and determine contribution of immune inflammation to the development of MS. Material and methods. 156 females with SLE (mean age 35 years, mean disease duration 99 months) were included. Control group consisted of 69 people of comparable age without rheumatic diseases. MS was diagnosed according to ATP III criteria, \fascular atherosclerotic damage was assessed by carotid sonographic evaluation. Serum cholesterol (CS), triglycerides (TG) and high-density lipoprotein (HDLP) CS concentration was assessed with colorimetric and photometric methods, hs CRP level — with nephelometric immunoassay. Results. MS was revealed in 29 from 154 (19%) pts with SLE and in 5 from 69 (7%) controls (p=0,02). MS components (hypertension, TG elevation and a lipoprotein decrease) in SLE were significantly more frequent than in control group. TG, HDLP CS and CRP levels in SLE were higher than in control. Thickness of carotid intima-media complex did not differ in SLE and control. Frequency of atherosclerotic plaques (15%) and coronary heart disease (14%) in SLE was higher than in control (4% and 2% respectively), p=0,01. Pts with SLE and MS were older, had higher disease activity and maximal glucocorticoid dose during disease period (p<0,05). CRP concentration in SLE with MS was significantly higher. Subclinical signs of atherosclerosis in SLE with MS were more frequent than in SLE without MS (p<0,05). Frequency of clinical signs of atherosclerosis did not differ in these groups. Conclusion. Autoimmune inflammation in SLE plays an important role in the development of MS.

Objective. To analyze prevalence and structure of psychiatric disorders in pts with systemic lupus erythematosus (SLE) examining in the Institute of rheumatology of RAMS. Material and methods. 115 pts with SLE with median age 34 [24; 45] years and median disease duration 8 [4; 17] years were included. SLE activity was assessed with SLEDAI. Psychiatric disorders were diagnosed by a psychiatrist according to ICD-10 using some psychiatric and psychological scales. Results. Psychiatric disorders were revealed in 76 from 115 (66%) pts. Anxiety-depressive spectrum disorders prevailed (83%): depressive episode (40%), adjustment disorders (24%), generalized anxiety disorder (10%), dysthymia (9%). Severe cognitive dysfunction was revealed in 7% of pts. Pts with and without psychiatric disorders did not significantly differ in age, sex, duration and activity of the disease, duration of treatment and cumulative dose of prednisolone and cytotoxic drugs. Conclusion. Psychiatric disorders are frequent in pts with SLE (66%). Anxiety-depressive disorders prevail among them (83%). Relationship between SLE and psychiatric disorders requires further examination.

Objective. To assess association of low back pain (LBP) in women with hypertension (H), coronary heart disease (CHD), chronic heart failure (CHF), vascular incidents, carbohydrate metabolism disturbances, osteoarthritis (OA), osteoporosis (OP), digestive tract diseases, depression and anxiety. Material and methods. 1194 women aged 28 to 64 years (median 51 years |48;55] ) visited an outpatient department were included in the cross-sectional study. Diagnosis was done according to latest national guidelines. Odds ratio (OR) and 95% confidence intervals (Cl) were calculated. Results. 671 cases of LBP were revealed, 523 women did not have back pain. Age and menopausal status did not differ between these groups. LBP group had significantly higher body mass, waist and hips circumferences and more severe menopausal symptoms. LBP was associated with higher frequency of H (OR 1,40; Cl 1,10-1,79), CHD (OR 2,03; Cl 1,373,03), CHF (OR 1,74; Cl 1,35-2,25), OA (OR 2,43; Cl 1,91-3,09), chronic cholecystitis (OR 1,87; Cl 1,46-2,39), depression (OR 1,83; Cl 1,42-2,36) and anxiety (OR 1,69; Cl 1, 33-2,14). No association of LBP with OP was found. Conclusion. LBP is a marker of increased risk of socially important diseases. Pts visited the doctor due to LBP need timely diagnosis and management of comorbidity.

Objective. To assess utility of East European diagnostic criteria of juvenile rheumatoid arthritis (J RA) in the modern conditions. Material and methods. 260 children with juvenile arthritis aged 2 to 18 years (mean 8,5±1,1 years) were included. Disease duration varied from 6 months to 15,5 years (mean 5,4±0,9 years). JRA was diagnosed in 94, juvenile chronic arthritis (JCA) — in 107 and other arthritides — in 12 cases (44,1%, 50,2% and 5,6% respectively). Pts with J RA were included in the main group. Group of comparison consisted of 107 pts with JCA, 12 pts with other arthritides, 35 pts with mixed connective tissue disease, 6 pts with Wissler-Fanconi syndrome, 4 — with Still’s disease and 2 - with primary Sjogren’s syndrome. All pts were assessed according to East European diagnostic criteria of JRA. Sensitivity and specificity were determined for every single criterion as well as for combinations of signs. Results. 35 from 260 pts had less than 3 criteria. This group included 2 children with JCA and 33 — with other rheumatic diseases (RD). 207 pts fulfilled criteria of definite or classical JRA (presence of 4 or more criteria but in fact JRA was diagnosed in only 94 (45,4%) from them. Most of remaining pts had JCA (44,9%) or other arthritides (4,8%). 10 pts with other RD also fulfilled criteria of definite or classical JRA (4,8%). Probable JRA could be diagnosed in 17 pts but no one of them had this disease. Combination of 8 or more signs was most sensitive (74,5%) and specific (76,6-100%) and presence of 4-7 criteria was common in other diseases. 9 signs were sensitive for JRA in comparison with JCA (20,2-96,8%). Only 4 from them (small joints symmetric arthritis, rheumatoid factor, bone growth disturbance, cervical spine damage) had high specificity (86,9-99,1%). Conclusion. At the present time East European diagnostic criteria of J RA need modification. They allow to differentiate JRA from other RD but do not help to reveal intra-group differences in pts with juvenile arthritis. Quality features of every criterion are more important for the diagnosis than their quantity combination. It is necessary to develop diagnostic criteria of JRA allowing to differentiate it from JCA and to develop criteria for JCA itself.