RU2231062C1 - Method for determining biological age of women - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves studying hemostasiogram data, determining fibrinogen level, blood platelets number, activated partial thromboplastin time, fibrinolytic activity , soluble fibrin monomer complexes concentration and anti-thrombin III level. Biological age is calculated from formula BA =k1 x FG + k2 x BP +k3 x APTT +k4 x FA+ k5 x SFMC + k6 x ATIII + Const, where BA is the biological age according to homeostasis system, k1-k6 are decision rule coefficients equal to k1=7.546, k2=-0.039, k3=-381, k4=0.234, k5=0.321, k6=-0.664; Const is the constant value equal to 101.064. FG is the fibrinogen level in g/l; BP is the blood platelets number in 10⁹ /l; APTT is the activated partial thromboplastin time in s; FA is the fibrinolytic activity in min; SFMC is the soluble fibrin monomer complexes concentration in mg/l; ATIII is the anti-thrombin III level in %.

EFFECT: high accuracy in classifying age transformations rate; enhanced effectiveness in selecting therapy methods.

Description

The present invention relates to medicine, namely to hemostasiological aspects in gynecology, and provides for the creation of a method for assessing age-related changes in the vascular system and microvasculature based on informative indicators of the hemostasis system.

The concept of biological age arose as a result of clinicians' awareness of the unevenness and discreteness of the aging process. To assess the aging rate of the whole organism, it is proposed to determine the integral biological age. A typical general biological paradigm is the individual beginning, pace, type and profile of aging of various organs and systems of living organisms (Dilman V.M., 1981; Frolkins V.V., 1975; Krutko V.N., 1999). In this regard, scientists are asked to evaluate the partial biological age of an individual according to certain systems. Thus, the aging profile is described according to indicators of the cardiovascular, respiratory, muscle, neuropsychic, endocrine system, analyzer system, etc. (Podkolozin A.A., Krutko V.N., Dontsov V.I., 1999; Voitenko V .P., Akhaladze M.G., 1996; A.V. Tokar, A.M. Polyukhov, 1984).

An analysis of the literature on this issue allows us to state the absence of informative criteria for calculating the biological age of an individual according to the hemostatic system. At the same time, the hemostatic system is an essential predictor of the age-related physiology of microcirculation and the vascular bed.

Even in ancient times, scientists believed: "The age of a person is the age of his blood vessels" (Democritus), and most modern researchers adhere to this point of view. Therefore, the issue of standardizing the hemostasiological criteria for aging the body is very relevant.

The method can be used by obstetrician-gynecologists, clinical gerontologists, resuscitation anesthetists, general practitioners, clinical laboratory diagnostics doctors.

State of the art

Analogs of the invention were methods for determining the biological age of the body, widely represented in domestic and foreign studies (Anisimov V.N., Krutko V.N., 1996; Belozerova L.M., Vlasova L.N., 1998; Vilenchik M.M. , 1987; Gavrilov L.A., Gavrilova N.S., 1986; Nadzharyan T.D., Mamaev V.B., 1984; Chebotarev D.F., 1984; Balin AK, 1996; Bappit GJ, 1995; Dean W., 1988; Martin GR, Baker GT, 1983, etc.). To date, there is no comparative analysis of these sets for any quality criteria. To determine the biological age in the described tests, pathology indicators, morphological parameters, physiological functions at rest, psychological and neuropsychic indicators, stress tests, biochemical and general clinical indicators are used. However, the literature does not describe methods for determining the biological age of a person according to the hemostatic system. The heterochronism of the aging process implies the unevenness of the aging rate of individual human systems. The hemostatic system in the phylogenetic sense is the most ancient and reflects the generalized changes occurring at the level of the whole organism. It is the most mobile system and highly sensitive to any disturbances in the internal environment of the body. Therefore, in our opinion, the absence of hemostasis system indicators in the structure of diagnostic tests is a significant drawback of the above methods for determining the biological age of a person.

The prototype of the invention was a method for determining biological age, developed by A. Tokar. in modification Voitenko VP, 1996. The method allows to determine the integral biological age, taking into account morphological indicators, physiological functions at rest, psychological and neuropsychiatric indicators. However, the method does not take into account hemostasiological parameters and in this regard cannot fully reflect the rate of age-related changes in the microcirculation system and the vascular bed of the body.

SUMMARY OF THE INVENTION

The purpose of the invention is to develop a method for determining the biological age of women using a hemostasis system, focused on the laboratory diagnostic equipment available in the arsenal of medical institutions.

The method is as follows. The study of hemocoagulation is carried out on an empty stomach in the morning. To perform hemostasiograms, 3 to 5 ml of venous blood is taken by puncture of a vein on the upper limb using a vacuum tube for the study of hemocoagulation. The stabilizer, a 3.8% sodium citrate solution, is preliminarily placed in a test tube. The time from the moment of blood sampling to the start of the study is 5-15 minutes (E.P. Ivanov, 1983). The following parameters are determined.

1. The content of fibrinogen in plasma (FG) - by the Clauss chronometric method (Barkagan ZS, Mamont AP, 1998).

2. The number of platelets in the blood (Tr) by phase contrast microscopy according to the method of C. Brecher et al. (1983) using a Standart-20 phase contrast microscope from K.Zeizz (Germany).

3. Activated partial thromboplastin time (APTT) - using the unified method on a CL4 coagulometer and the Thrombosoluzer Chrom automated analyzer (Benk Elektronik, Germany), the time required for the formation of a fibrin clot in a platelet-poor plasma to which a calcium chloride solution and kaolin are added is studied -kefalin suspension.

4. Fibrinolytic activity (FA) is studied by the unified method of lysis of the euglobulin clot (Kowaryk, Buluk, 1954).

5. The concentration of soluble fibrinmonomer complexes (RFMCs) is determined by the orthophenanthroline method (AP Mamont, ZS Barkagan).

6. The level of antithrombin III is investigated by a unified method on a CL-4 coagulometer and a Thrombolyzer Chrom automated analyzer (Behnk Elektronik, Germany).

Using mathematical processing of the results by multiple linear regression and discriminant analysis, a decisive rule for determining the biological age of women according to the hemostasis system is derived:

BVg = k1 × Fg + k2 × Tr + k3 × APTB + k4 × FA + k5 × RF MK + k6 × ATIII + Const,

where Bvg - biological age according to the hemostatic system;

k1, k2, k3, k4, k5, k6 are the coefficients of the decision rule, which are equal to: k1 = 7.546; k2 = -0.039; k3 = -0.381; k4 = 0.234; k5 = 0.321; k6 = -0.664;

Const is a constant value equal to 101.064;

FG - fibrinogen level (g / l);

Tr is the number of platelets (10%);

APTT - activated partial thromboplastin time (sec);

FA - fibrinolytic activity (min);

RFMC - soluble fibrinmonomeric complexes (mg / ml);

ATIII - antithrombin III (%).

The specificity level of the method is 96.26%.

The sensitivity level of the method is 95.28%.

Example 1. Nechaeva Tatyana Fedorovna, 46 years old. Case history No. 2001. Was admitted to the gynecology department for surgical treatment of multiple rapidly growing uterine fibroids. Somatically, the patient is burdened with stage II hypertension, xp. cholecystitis, hr. pancreatitis. When examined before surgical treatment, the integral biological age (A.V. Tokar, V.P. Voitenko) was 50.4 years; Partial biological age for hemostasis by our proposed method is 57.6 years. Thus, an accelerated rate of aging of the microcirculation system and vascular bed was revealed.

06.04.2001 year performed gluttony, panhisterectomy. The postoperative period was uneventful. Discharged 10 days after surgery in satisfactory condition. A turnout for menopause counseling is recommended. The patient addressed only three months later with complaints of dyspareunia, periodic pulling pains in the lower abdomen. Survey conducted. Pelvic vein thrombosis was revealed, confirmed by ultrasound of the pelvic vessels. Topically prescribed anticoagulants, antiplatelet agents and venotonics orally followed by systemic enzyme therapy. At the follow-up appointment in a month: the patient's health improved, there are no complaints according to the ultrasound scan of the pelvic vessels - positive dynamics. The biological age for hemostasis after treatment was 46.7 years.

Example 2. Degtyareva Marina Shimonovna, 49 years old. The medical history No. 7277 for 2002. I went to the clinic for examination and selection of therapy for menopausal syndrome. Surgical menopause for 1 year 4 months. At the place of residence, hormone replacement therapy with the drug Klimara (50 mcg / day of estradiol) is recommended. After 3 months, the patient complained of headaches, loss of visual fields. After the examination, retinal vein thrombosis was diagnosed, hormone replacement therapy was discontinued. The woman complained to the clinic of frequent flushing, sweating, sleep disturbances, dizziness, irritability and dysphoria. Somatically burdened with stage II hypertension, obesity II degree, chronic cholecystitis, enterocolitis. After the examination, the integral biological age (A.V. Tokar, V.P. Voitenko) was 65.2 years; partial biological age for hemostasis - 50.9 years. Thus, the patient's rate of vascular aging did not exceed the general rate of aging of the body. It follows that the complications are associated with side effects of therapy against the background of general accelerated aging of the body. The woman was recommended a calorie-restricted plant-milk diet, gymnastics, phytoestrogens, systemic enzyme therapy, preparations of gingo biloba extract and artichoke leaves. Two months later, at the control appointment, the patient noted a significant improvement in well-being, normalization of sleep and mood, weight loss of 10 kg (initial weight of 97 kg with an increase of 168 cm), and stabilization of blood pressure. The integral biological age was 50.6 years; biological age for hemostasis is 40.8 years.

Thus, the proposed method allows to classify the rate of age-related changes in microcirculation and the vascular bed according to the hemostatic system, to develop a therapy algorithm and evaluate the effectiveness of the treatment.

Sources of information

1. Anisimov V.N. Krutko V.N. Fundamental problems of studying life expectancy. // News. Ross Acad. sciences. - 1996. - T.66. - N6. - S. 507-511.

2. Belozerova L.M., Vlasova L.N., Anokhina S.A. Ontogenetic approach in assessing biological age. // Wedge. gerontology. - 1998. - No. 3. - P.57-58.

3. Vilenchik M.M. Biological foundations of aging and longevity. M .: Knowledge, 1987.

4. Voitenko V.P., Akhaladze M.G. The biologic vik people i metdi yy znoznachennya // Likuvannya and Diagnostics. - 1996. - No. 1. - S. 45.

5. Gavrilov L.A., Gavrilova N.S. Life expectancy biology. M .: Nauka, 1986.

6. Dilman V.M. Big biological clock. M.: Knowledge, 1981.

7. Krutko V.N., Mamai A.V., Slavin M.B. Classification, analysis and application of indicators of biological age to predict life expectancy. // Human physiology. - 1995. - N6. - S. 42.

8. Mammoth A.P., Barkagan Z.S. The main methods for diagnosing disorders of the hemostatic system. - Barnaul. - 1998.

9. Nadzharyan T.D., Mamaev V.B. // The problem of determining the biological age. Results of science and technology. M .: VINITI, 1984. - V.4. - S.81-134.

10. Podkolozin A.A., Dontsov V.I. Aging, longevity and bioactivation. M .: 1997.

11. Tokar A.V., Voitenko V.P., Polyukhov A.M. etc. The use of methods for determining the biological age of a person in prenosological diagnosis. // Guidelines. Institute of Gerontology, USSR Academy of Medical Sciences. - Kiev, - 1990.

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17. Martin G.R., Baker G.T. Aging and the Aged: Theories of Aging and Life Extension. // Encyclopedia of Bioethics. - New York: MacMillan, 1993.

Claims (1)

A method for determining the biological age of women by blood testing, characterized in that they study a hemostasiogram, determine the level of fibrinogen (FG), platelet count (Tr), activated partial thromboplastin time (APTT), fibrinolytic activity (FA), the concentration of soluble fibrin-monomer complexes ( RFMC), the level of antithrombin III (ATIII) and calculate the biological age according to the formula BVr = k1 · Фr + k2 · Tr + k3 · APTB + k4 · ФА + k5 · RFMK + k6 · ATIII + Const, where BVr is the biological age according to the hemostatic system; k1, k2, k3, k4, k5, k6 are the coefficients of the decision rule, which are equal to: k1 = 7.546; k2 = -0.039; k3 = -0.381; k4 = 0.234; k5 = 0.321; k6 = -0.664; Const is a constant value equal to 101.064; FG - fibrinogen level, g / l; Tg is the number of platelets, 10 ⁹ / l; APTT - activated partial thromboplastin time, s; FA - fibrinolytic activity, min; RFMC - soluble fibrinmonomeric complexes, mg / ml; ATIII - antithrombin III,%.