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To investigate the prevalence of noncommunicable diseases (NCD) risk factors in the Kyrgyz Republic.By using WHO STEPS approach survey findings were estimated from 2623 Kyrgyz residents aged 25-64 years. It was determined the prevalence of behavioral risk factors for NCDs, the prevalence of hypercholesterolemia and hyperglycemia. STEPS survey has covered all regions of the Kyrgyz Republic.NCD-related death rates are the leading causes (76,8%) of mortality among the population of the Kyrgyz Republic. STEPS approach survey showed high prevalence of NCDs main risk factors among 2623 Kyrgyz residents aged 25-64 years.High prevalence of NCDs main risk factors shows that there is necessity to develop effective policy to raise public awareness of healthy life style, health promotion, collaboration with all sectors of civil society.

Background and aims There are no data regarding the real-life picture of SLE in Kyrgyzstan. Methods In a prospective observation included 325 patients with SLE, who were treated in NCCIM (2012 - 2016). Majority of these patients (301) were young women (median - 27 [25;41]), primarily Kyrgyz (284), with disease duration of 3 (median-3,0 [0.7;8.0]) years. Assessed SLEDAI 2K and SDI. Results They were mostly patients with acute variant of SLE-129 (39.7%), 127 (39.08%) were with high and 86 (26.46%) with very high activity. Most of the patients - 283 (87.1%) were registered with immunological activity. In most cases of the desease were: skin lesions (97.23%), serous membrane lesions (65.54%) and kidney lesions (59.38%). The neurological symptoms was noted in 120 patients (36.92%): 99 of 120 patients (82.5%) had a significant CNS lesions; 32 patients of 99 (32.3%) had neuropsychiatric disorders, 27 of these patients had visual and auditory hallucinatory syndrome. Respiratory disorders occurred in 60 (18.46%) patients. The vast majority of these patients were with pulmonary arterial hypertension (46.66%). Acute lupus pneumonitis was detected in 23 (38.33%) patients. At the onset of the study, SDI was identified in 65 patients (20%). These were mainly patients with irreversible changes in the kidney (30,8%), associated with taking GC (27.7%). Conclusions Acute onset of the disease (39.7%) was noted in most Kyrgyz patients. 97.23% of those ones with primary skin lesions, 65.54% with serous membrane lesions and 59.38% with kidney lesions, 39.92% patients had various neurological symptoms, 32.3% of these patients had serious neuropsychiatric disorders.

The tobacco epidemic is the leading preventable cause of death. Aims and objectives -to evaluate the prevalence of smoking and develop measures to control tobacco consumption. Methods: The STEPS survey of surveillance of risk factors for non-communicable diseases in the Kyrgyz Republic is cross-sectional national survey among adults from 25 to 64 years old, totally involved 2,623 persons, 36.1%-men, 63.9%-women; 25-44 years-51.5%, 45-64yo - 48.5%. Results. 25.7% of all respondents aged 25- 64 years smoke, (daily and non-daily. The significantly higher frequency of smoking was found in men than in women (48.2% vs. 2.7%, p Recommendations: intersectoral s trengthening the implementation of laws to protects the health.

Background Systemic lupus erythematosus (SLE) is a devastating disease affecting different organs, ultimately leading to organ failure and death. To date, there are no data regarding the real-life picture of SLE in Kyrgyzstan. Objectives To study of clinical symptoms, course and outcome of SLE according to the prospective study among residents of Kyrgyzstan. Methods An 2-year prospective analysis of patients with SLE with a specially developed research base (BLIPS 8, ADS-Limathon). 60 patients with definite diagnosis of SLE (ACR, 1997; SLICC, 2012), were treated in the department of rheumatology of NCCIM and observed from 2012 to 2015. They were evaluated by sex, age, disease duration, activity of SLE according the SLEDAI-2K, irreversible organ damage by SLICC Damage Index (SDI), quality of life using the SF-36 questionnaire, LupusQoL, HADS, FACIT, therapy, with monitoring of all parameters every six months for 2 years. From the data of the immunological studies immune linear (immunoblot) “ANA-LIA-Max 17” were analyzed with a purpose of detecting the antibodies of double-stranded DNA, Sm D1 antigen and antibodies of double-stranded DNA-linked immunosorbent analyisis (ELISA), C3-C4 components complement, indirect immunofluorescence of the antinuclear antibody cells of line Hep-2. Results Patients were mainly from the northern region of the republic (81.7%). The vast majority were women (86.7%), with average age 30 years old, with disease duration of about 1.0 years. Periods to verify the diagnosis ranged from 1 month to 9 years. The clinical course was dominated by patients with acute version (47%) and high activity (57%). In the debut of the disease most common clinical symptoms were cutaneous and articular syndrome (84.2% and 72.3%, respectively), the defeat of the serous membranes (88%) and kidney (68%). All patients received glucocorticoids (GC), 79% of them in the form of pulse therapy with methylprednisolone. From immunosuppressive drugs most commonly were used CP (48%), AZA (21%), MTX (10.4%) and plaquenil (11%), to a lesser extent MMF (8%). The proportion of patients receiving biologic therapy (rituximab) was only 2%, IVIG (Octagam) - 3.3%.The development of irreversible organ damage was recorded in half the patients (46%), at average of 6 months from the onset of the disease, mostly with low (36.7%) and the average SDI (21.7%). During the period of 2-year prospective study not only a significant reduction in the activity of the pathological process in many patients (p Conclusions In the debut of the SLE acute onset and high disease activity, which led to the rapid development of organ damage in half the patients was recorded. In the structure of mortality among Kyrgyz cohort of SLE patients with renal involvement prevailed, CNS and CNS combined with lungs. Disclosure of Interest None declared

Background Systemic lupus erythematosus (SLE) is a devastating disease affecting different organs, ultimately leading to organ failure and death. To date, there are no data regarding the real-life picture of SLE in Kyrgyzstan. Objectives To define retrospectively the pattern of clinical features, disease course and outcome of patients with SLE in Kyrgyzstan. Methods The retrospective study comprised of 107 consecutive patients with confirmed SLE, who underwent inpatient care in the department of rheumatology of the National Center of Cardiology and Internal Medicine (NCCIM) from 2001 to 2011. Subsequently enrolled patients were followed-up on a regular basis. Study protocol included clinical, instrumental, laboratory and immunological parameters obtained from specially designed registry database of NCCIM (BLIPS 8, ADS-Limathon). All patients fulfilled the revised ACR criteria for SLE. Age, gender, disease activity index (SLEDAI-2K), SLICC Damage Index (SDI) and other parameters obtained at the time of first hospitalization and subsequently in 75 cases out of 107 after 5 years of follow-up observation were included for the statistical analysis. Immunological analysis included determination of anti-dsDNA and anti-Sm antibodies “ANA-LIA-Max 17”. Date and cause of death were determined according to the primary medical records. Results Vast majority of patients (79.4%) enrolled in this study were from the northern part of the country. The study included 91.5% women and 8.4% men with a mean age 30 years and mean disease duration - 2.0 years. It took from 6 months to 3 years since the onset of symptoms to the verification of the diagnosis. Majority of patients (49.5%) were with subacute variant of the disease. Based on disease activity index, patients with moderate and high grade of disease activity were 46.7% and 44%,respectively. Within 5-year follow-up observation of 75 out of 107 patients the remission was achieved in 3.7%, and the low grade disease activity in 6.4% patients. In all cases upon a significant decrease in disease activity, there was a statistically significant increase in SDI score for 1 or higher points. Various irreversible organ damages were found in almost half of the cases (47.6%) at a mean of 2.0 years from the onset of the disease. Majority of patients showed low (28.7%) and moderate (28.3%) SDI score. During observation 27 (36%) of 107 patients died. The main causes of death were active SLE and its complications involving different organ damages: kidney (29.6%), lung (22%) and combined central nerves system (CNS) and kidney (11%). Overall mortality from the concomitant infection was 18.7%, prominently from the infection of the respiratory system, among them 42.7% with severe pneumonia and progressive respiratory failure. Conclusions The study identified that progressive organ damages and infectious complications involving respiratory system were associated with poor prognosis and outcome of patients with SLE in Kyrgyzstan. Disclosure of Interest None declared

Background Systemic lupus erythematosus (SLE) is a devastating disease affecting different organs, ultimately leading to organ failure and death. To date, there are no data regarding the real-life picture of SLE in Kyrgyzstan. Objectives The goal of the study is evaluation of the quality of life among Kyrgyz cohort of patients with SLE according to the prospective study. Methods 60 patients with definite diagnosis of SLE (ACR, 1997; SLICC, 2012) were treated in the department of rheumatology of NCCIM and observed from 2012 to 2015. They were evaluated by sex, age, disease duration, activity of SLE according the SLEDAI-2K, irreversible organ damage by SLICC Damage Index (SDI), quality of life using the SF-36 questionnaire, LupusQoL, HADS, FACIT, therapy, with monitoring of all parameters every six months for 2 years. From the data of the immunological studies immune linear (immunoblot) “ANA-LIA-Max 17” were analyzed with a purpose of detecting the antibodies of double-stranded DNA, Sm D1 antigen and antibodies of double-stranded DNA-linked immunosorbent analyisis (ELISA), C3-C4 components complement, indirect immunofluorescence of the antinuclear antibody cells of line Hep-2. Results Patients were mainly from the northern region of the republic (81.7%). The vast majority were women (86.7%), with average age 30 years old, with disease duration of about 1.0 years. Dates of illness onset to verify the diagnosis ranged from 1 month to 9 years. The clinical course dominated patients with acute one (47%) and high activity (57%). The clinical symptoms of were cutaneous and articular syndrome (84.2% and 72.3%, respectively), the defeat of the serous membranes (88%) and kidney (68%). Before the treatment, according to the overall SF-36 questionnaire all SLE patients had lower QOL revealed. Marked limitation of life activity of patients was due to the presence of physical and emotional problems with severe anxiety and depression affects on their social functioning. After 2 years significant improvement in quality of life on many scales, except for the scale of mental health is noted. Attention is drawn to the deterioration of quality of life on the scale of “viability”, which characterizes the patient a sense of lack of strength and energy for the period of the disease. The lowest quality of life is reported among Kyrgyz patients in the comparative analysis to QOL of patients with SLE in other 3 countries of Europe (UK, France and Italy) and Russia. Despite the reduction of disease activity (p Conclusions The low quality of life among Kyrgyz cohort of patients with SLE is associated with poor physical, emotional and social functioning. Despite the reduction of disease activity during the treatment, quality of life on the scale of “viability, lack of improvement of mental health component is identified as declining”. Disclosure of Interest None declared

Background Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the synovial joints, often with a progressive and destructive course, associated with the production of wide range of autoantibodies, and their detection has diagnostic and prognostic implication. Objectives This study was to estimate the diagnostic value of antibodies against cyclic citrullinated peptide (ACCP) and nuclear antigen RA33 of the IgA rheumatoid factor (RF) versus the value of routinely used profile of autoantibodies in diagnostic work-up of RA. Methods We identified 230 patients with RA prehistory of varying duration. The control group was comprised of 96 patients, including patients with seronegative spondyloarthropathies (SpA), Psoriatic Arthritis (PsA) and diffuse connective tissue diseases, as well as sex and age matched healthy controls. Serum levels of IgM and IgA RF, antibodies against cyclic citrullinated peptide (ACCP), antibodies against RA33 antigen (ARA33) and antinuclear factor (ANF) were measured in all patients and controls. Results Diagnostic sensitivity of ACCP equaled 81%, IgM RF - 76%, IgA RF - 46%, ARA33 - 36% and ANF - 29%. ACCP was significantly more commonly associated with IgM RF. Among RF seronegative patients ACCP were found in 37% cases with 26 IU/Ml detection threshold, and in 26% - with 32 IU/Ml, allowing to increase diagnostic specificity of the test up to 93% with the increment of diagnostic threshold. Incidence of ARA33 was not significantly different among the RF and ACCP positive or negative subgroups, thus making ARA33 an independent RA marker. Specificity of this marker was 83,4%, thus making it inferior to RF and ACCP by a composite of diagnostic characteristics. Conclusions The measurement of RA33 is a rational approach at the next second stage of serologic testing work-up in suspected cases of RA onset, when initial RF and ACCP tests were negative. References Emery P., Breedveld F.C., Dougados M. et al. Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide. Ann Rheum Dis 2002;61(4):290-7. Malakoutikhah M., Gomara M.J., Gomez-Puerta J.A. et al. The use of chimeric vimentin citrullinated peptides for the diagnosis of rheumatoid arthritis. J Med Chem 2011;54(21):7486-92. Schneeberger E., Citera G., Heredia M. et al. Clinical significance of anti-Ro antibodies in rheumatoid arthritis. Clin Rheumatol 2008;27(4):517-9. Pincus T., Sokka T. Laboratory tests to assess patients with rheumatoid arthritis: advantages andlimitations.Rheum Dis Clin North Am 2009;35(4):731-4. Aletaha D., Neogi T., Silman A.J. et al. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010;69(9):1580-8. Metz C.E. Basic principles of ROC analysis. Semin Nucl Med 1978;8(4):283-98. Nell V.P., Machold K.P., Stamm T.A. et al. Autoantibody profiling as early diagnostic and prognostic tool forrheumatoid arthritis. Ann Rheum Dis 2005;64(12):1731-6. Nell-DuxneunerV., Machold K., Stamm T. et al. Autoantibody profiling in patients with very early rheumatoid arthritis: a follow-up study. Ann Rheum Dis 2010;69(1):169-74. Acknowledgements All employees of Department of Rheumatology National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyz Republic Disclosure of Interest None declared