Blood Analysis of Patients with Rheumatoid Disease from Kosovo Using Non-Steroidal Anti Inflammatory Drug – Aspirin

Zhubi, Dren; Pavlova, Valentina; Samet, Aksu

Abstract

Bone tissue, one of the body’s most intricate structures, has a unique capacity for spontaneous regeneration and repair under optimal physio logical conditions. Aspirin, a widely used non-steroidal anti-inflammatory drug (NSAID) recognized for its anticoagulant properties, plays a role in bone regeneration by activating cytokines and mediators within osteoclasts, osteoblasts, and progenitor cells at sites of damage. This ac tivation promotes bone repair and stimulates angiogenesis by enhancing endothelial cell migration, which is essential for the formation of new blood vessels necessary for fracture healing. This study analyzed blood samples from 100 Kosovo patients (57 female, 43 male; ages 42–89) with rheumatic osteoporosis who regularly use aspirin. Key biomarkers measured included vitamin D, serum calcium, serum iron, sedimentation rate, glucose, triglycerides, cholesterol, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Findings indicated that 37% of these osteoporosis patients exhibited elevated triglyceride levels (>1.7 mmol/L), while nearly 40% had cholesterol levels exceeding 5 mmol/L. Additionally, AST and ALT levels were elevated (>40 IU/L) in 30% of patients, with aspirin users generally showing statistically significant increases across these blood parameters. Body mass index showed no statistically significant correlation with any blood parameter values. However, increasing patient age correlated with reduced vitamin D levels and elevated triglycerides, cholesterol, sedimentation rate, and glucose levels. Understanding the link between diet and osteoporosis is critical for healthcare professionals, including doctors, nutritionists, and researchers, as it supports efforts to prevent and manage osteoporosis. Given this, synthesizing current evidence and conducting further studies on the diet-osteoporosis interaction is essential.

Keywords

References

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[1] Abrahamsen, B., Rohold, A., Henriksen, J. E., & Beck-Nielsen, H. (2000). Correlations between insulin sensitivity and bone mineral density in non-diabetic men. Diabetic Medicine, 17(2), 124–129. Adami, S. (2009). Bone health in diabetes: considerations for clinical management. Curr Med Res Opin, 25(5), 1057-1072. https://doi.org/10.1046/j.1464-5491.2000.00234.x

[2] Apostolova, G. (2014). The Influence of Bone Markers in the Assessment of Mineralization of Oral Surgical Bone Defects in Patients with Diabetes Mellitus, University “Ss. Cyril and Methodius,” Faculty of Dentistry – Skopje, Doctoral Dissertation. Bach-Faig, A., Berry, E. M., Lairon, D., Reguant, J., Trichopoulou, A., Dernini, S., Medina, F. X., Battino, M., Belahsen, R., Miranda, G., & Serra-Majem, L.; Mediterranean Diet Foundation Expert Group. (2011). Mediterranean diet pyramid today: Science and cultural updates. Public Health Nutrition, 14(12A), 2274–2284. https://doi.org/10.1017/s1368980011002515

[3] Bauer, D. C., Orwoll, E. S., Fox, K. M., Vogt, T. M., Lane, N. E., Hochberg, M. C., Stone, K., & Nevitt, M. C. (1996). Aspirin and NSAID use in older women: Effect on bone mineral density and fracture risk. Journal of Bone and Mineral Research, 11(1), 29–35. https://doi.org/10.1002/jbmr.5650110106

[4] Bibbins-Domingo, K. (2016). Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. preventive services task force recommendation statement. An nals of Internal Medicine, 164(12), 836–845. https://doi.org/10.7326/m16-0577

[5] Blasiak, M., Kuska, J., Kokot, F., & Irzyniec, T. (1989). Selected indicators of calcium-phosphate metabolism in patients with diabetes mellitus. Endocrynol Pol, 40(5), 251-262.

[6] Bouillon, R., Bex, M., Van Herck, E., Laureys, J., Dooms, L., Lesaffre, E., & Ravussin, E. (1995). Influence of age, sex, and insulin on osteoblast function: Osteoblast dysfunction in diabetes mellitus. Journal of Clinical Endocrinology & Metabolism, 80(4), 1194–1202. https://doi.org/10.1210/jcem.80.4.7714089

[7] Brandão, F. R., Vicente, E. J., Daltro, C. H., Sacramento, M., Moreira, A., & Adan, L. (2007). Bone metabolism is linked to disease duration and metabolic control in type 1 diabetes mellitus. Diabetes Research and Clinical Practice, 78(3), 334–339. https://doi.org/10.1016/j.diabres.2007.04.009

[8] Brandi, M.L. (2010). Bone health and diabetes. Medicographia, 32(4), 364-369.

[9] Campos Pastor, M. M., López-Ibarra, P. J., Escobar-Jiménez, F., Serrano Pardo, M. D., & García-Cervigón, A. G. (2000). Intensive insulin therapy and bone mineral density in type 1 diabetes mellitus: A prospective study. Osteoporosis International, 11(5), 455–459. https://doi.org/10.1007/s001980070114

[10] Carbone, L. D., Tylavsky, F. A., Cauley, J. A., Harris, T. B., Lang, T. F., Bauer, D. C., Barrow, K. D., & Kritchevsky, S. B. (2003). Association between bone mineral density and the use of non steroidal anti-inflammatory drugs and aspirin: Impact of cyclooxygenase selectivity. Jour nal of Bone and Mineral Research, 18(10), 1795–1802. https://doi.org/10.1359/jbmr.2003.18.10.1795

[11] Chaudhary, P., Janmeda, P., Docea, A.O., Yeskaliyeva, B., Abdull Razis, A.F., Modu, B., Calina, D., & Sharifi-Rad, J. (2023). Oxidative stress, free radicals and antioxidants: potential crosstalk in the pathophysiology of human diseases. Front Chem, 11, 1158198. hen, D., Shen, J., Zhao, W., Wang, T., Han L., Hamilton, J.L., & Im, H.-J. (2017). Osteoarthritis: Toward a comprehensive understanding of pathological mechanism. Bone Res, 5, 16044. https://doi.org/10.3389/fchem.2023.1158198

[12] Chin, K.Y., & Ima-Nirwana, S. (2018). The role of vitamin E in preventing and treating osteoar thritis—A review of the current evidence. Front Pharmacol, 9, 946. https://doi.org/10.3389/fphar.2018.00946

[13] 77 IJTNS International Journal of Technical and Natural Sciences Cicuttini, F.M., & Spector, T.D. (1996). Genetics of osteoarthritis. Ann Rheum Dis, 55, 665–667. https://doi.org/10.1136/ard.55.9.665

[14] Dehmer, S.P., Maciosek, M.V., Flottemesch, T.J., LaFrance, A.B., & Whitlock, E.P. (2016). Aspirin for the primary prevention of cardiovascular disease and colorectal cancer: a decision analysis for the U.S. preventive services task force. Annals of Internal Medicine, 164(12), 777–786. https://doi.org/10.7326/m15-2129

[15] DeLuca, H.F. (1986). The metabolism and functions of vitamin D. Adv Exp Med Biol, 196, 361–375.

[16] Deng, W., Yi, Z., Yin, E., Lu, R., You, H., & Yuan, X. (2023). Effect of omega-3 polyunsaturated fatty acids supplementation for patients with osteoarthritis: A meta-analysis. J Orthop Surg Res, 18, 381. https://doi.org/10.1186/s13018-023-03855-w

[17] Downey, P.A., & Siegel, M.I. (2006). Bone biology and the clinical implications for osteoporosis. Phys Ther, 86(1), 77-91. https://doi.org/10.1093/ptj/86.1.77

[18] Dunlap, B., Patterson, G.T., Kumar, S., Vyavahare, S., Mishra, S., Isales, C., & Fulzele, S. (2021). Vitamin C supplementation for the treatment of osteoarthritis: Perspectives on the past, present, and future. Ther Adv Chronic Dis, 12. https://doi.org/10.1177/20406223211047026

[19] Ekegren, C. L., Edwards, E. R., Page, R., Hau, R., de Steiger, R., Bucknill, A., Liew, S., Oppy, A., & Gabbe, B. J. (2016). Twelve-month mortality and functional outcomes in hip fracture pa tients under 65 years of age. Injury, 47(10), 2182–2188. https://doi.org/10.1016/j.injury.2016.05.033

[20] Epstein, F.H., & Harris, E.D. (1990). Rheumatoid arthritis: pathophysiology and implications for therapy. N Engl J Med, 322, 1277-1289. https://doi.org/10.1056/nejm199005033221805

[21] Feng, X., & McDonald, J.M. (2011). Disorders of bone remodeling. Annual Review of Pathology: Mechanisms of Disease, 6, 121–145. Furst, D.E., Ulrich, R.W., & Prakash, S. (2012). Nonsteroidal anti-inflammatory drugs, dis ease-modifying antirheumatic drugs, nonopioid analgesics, & drugs used in gout. In Basic and Clinical Pharmacology, 12th edition, chapter 36. McGraw-Hill, New York, NY.

[22] Fuster, V., & Sweeny, J.M. (2011). Aspirin: a historical and contemporary therapeutic overview. Circulation, 123(7), 768–775. https://doi.org/10.1161/circulationaha.110.963843

[23] Gambari, L., Cellamare, A., Grassi, F., Grigolo, B., Panciera, A., Ruffilli, A., Faldini, C., & Desan do, G. (2023). Targeting the inflammatory hallmarks of obesity-associated osteoarthritis: towards nutraceutical-oriented preventive and complementary therapeutic strategies based on n-3 polyunsaturated fatty acids. Int J Mol Sci, 24, 9340. https://doi.org/10.3390/ijms24119340

[24] Gil, A. (2002). Polyunsaturated fatty acids and inflammatory diseases. Biomed Pharmacother, 56, 388–396. https://doi.org/10.1016/s0753-3322(02)00256-1

[25] Gupte, P.A., Giramkar, S.A., Harke, S.M., Kulkarni, S.K., Deshmukh, A.P., Hingorani, L.L., Maha jan, M.P., & Bhalerao, S.S. (2019). Evaluation of the efficacy and safety of capsule longvida® optimized curcumin (solid lipid curcumin particles) in knee osteoarthritis: A pilot clinical study. J Inflamm Res, 12, 145–152. https://doi.org/10.2147/jir.s205390

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