Vol 15, No 3 (2012)

Articles
ABSOLUTE FRACTURE RISK ASSESSMENT IN OUTPATIENTS WITH DISTAL RADIUS OSTEOPOROSIS
Popov A.A., Strunina M.V., Telyushchenko M.V.

Abstract

Objectives: to assess the absolute fracture risk in outpatients with osteoporosis (OP) at distant radius. Methods: individual absolute fracture risk was assessed using FRAX tool without hip neck bone mineral density (BMD) input in 3082 subsequent subjects (2911 females and 171 males) aged from 40 to 95 (median age 60), calculated by Finnish population data. Distant radius BMD was estimated in all patients by DTX200. Results: 774 (25.1 %) patients had had history of low traumatic fractures. BMD≤- .5 SD was detected in 1659 cases, fracture history in 558 (33.6%) of them (OR = 2.21; 95 % CI 1.93-2.55). Median 10-year probability of a major osteoporotic fracture was 4.90 % (25- 75 %; 1.10 - 55.0) and 10-year probability of a hip fracture was 0.8 % (0 - 46), absolute risk 10 % and higher was detected in 434 (64,3 %) patients. Calculated 10-year probability of a major osteoporotic fracture > 10 % was associated with previous low traumatic fractures: OR = 4,55; 95 % CI 4,06- 5,10, test sensitivity being 56.1 % with specificity 89.6 % . The same association was found for 10-year probability of hip fracture >3 %: OR = 3.57 (3.19 - 4.00), test sensitivity being 51,6 % with specificity 86,7 %. Conclusion: FRAX tool for individual absolute fracture risk assessment should be introduced into general practice for clinical decision making in prophylaxis of OP associated fractures.
Osteoporosis and Bone Diseases. 2012;15(3):3-6
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PREVALENCE OF VITAMIN D DEFICIENCY IN PEOPLE OVER 50 YEARS OLD RESIDING IN REPUBLIC OF BASHKORTOSTAN IN PERIODS OF LOW INSOLATION
Nurlygayanov R.Z., Syrtlanova E.R.

Abstract

Objectives. To study the vitamin D levels in the period of minimal sun exposure in individuals older than 50 years residing in the Republic of Bashkortostan. Materials and methods. In the period of low insolation (March) in 188 people (68 men and 120 women) aged over 50 years (mean age 66,1 ± 0,75 years) residing in the city (Ufa) and rural areas of the Republic of Bashkortostan we investigated the levels of 25 (OH) D and parathyroid hormone (PTH) by the indirect ELISA. Level of 25 (OH) D 25-50 nmol/l were considered as mild vitamin D deficiency; 12,5-25 nmol/l-as moderate deficiency, and levels below 12.5 nmol/l - as a severe vitamin D deficiency. Results. The average level of 25 (OH) D was 33,55 ± 1,28 nmol/l; in urban area 43,48 ± 1,59 nmol/l; in rural area 21,25 ± 1,06 nmol/l; 36,29±2,43 nmol/l in men; 32,28± 1,47 nmol/l in women. The levels of vitamin D in the urban population were twice as high as in rural areas. A statistically significant difference by gender in terms of the levels of vitamin D was not found. We saw normal levels of vitamin D only in 18 % of subjects (in the city- 30 %, in the rural areas - 2 %), 43 % of people had a mild vitamin D deficiency (in the city - 59 %, in rural areas - 24 %), 33 % - a moderate deficiency of vitamin D (in the city -11 %, in the rural areas - 60 %), and 6 % of the patients had a severe vitamin D deficiency (in the city - 0 %, in rural areas -14 %). Moderate to severe vitamin D deficiency in rural areas was significantly more prevalent (74 %) than in urban (11 %). Gender was not found to be a risk factor for the development of vitamin D deficit in people over 50 years. There was a negative correlation between vitamin D levels and patient age (r=-0,356, p <0,001) and between levels of vitamin D andPTH (r =-0,313, p <0.001).
Osteoporosis and Bone Diseases. 2012;15(3):7-9
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PREVALENCE AND SEVERITY OF HYPOVITAMINOSIS D IN PATIENTS WITH MULTIPLE SCLEROSIS IN THE SVERDLOVSK REGION
Turova E.L., Lesnyak O.M.

Abstract

The purpose of the study was to investigate the prevalence and severity of vitamin D insufficiency in multiple sclerosis (MS) patients in Sverdlovsk region. Was examined 61 patients with MS of 18 to 61 year old (38,0 ± 10,6). The study was performed in March-April in 2010 and 2011. The control group included 32 healthy volunteers. The groups were comparable in age and sex. All MS patients and 94 % of control group had hypovitaminosis D3. However, patients with MS had clearly lower 25 (OH) D3 concentration as compared to control group (p = 0,01). Half of the patients had vitamin D deficiency, whereas in the control group the deficit was identified only in 21.9% (р = 0,04). We did not found any correlation between concentration of serum 25-hydroxyvitamin D3 and sex, duration and type of MS, degree of disability on EDSS scale, as well as with depression. A moderate direct correlation between patients’age and concentration of 25 (OH) D3 in serum was found.
Osteoporosis and Bone Diseases. 2012;15(3):10-13
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EFFECTS OF INSULIN-LIKE GROWTH FACTOR TYPE I ON BONE REMODELING IN PHYSIOLOGICAL PREGNANCY AND NORMAL LEVELS OF VITAMIN D
Sudakov D.S., Novikova T.V., Bibkova O.S., Galkina O.V., Zazerskaya I.E.

Abstract

During pregnancy the levels of IGF-I increase and in III trimester exceed greatly the values of I trimester. Its significant increase is noted from 22-24 weeks of pregnancy. Correlation analysis revealed a moderate negative correlation between the level of IGF-I in II trimester and distal forearm BMD (r = -0,35, p<0,5). Also a moderate positive correlation between the level of IGF-I and a marker of bone synthesis osteocalcin in the II and III trimesters of pregnancy was revealed (r = 0,46, p <0,05 and r = 0,41, p<0,05, respectively). Conclusions: IGF-I effects bone remodeling of long bones during pregnancy. It is probable that under the influence of IGF-I synthesis of bone matrix is increased, which in the presence of low calcium intake may be associated with reduced BMD at these bone sites.
Osteoporosis and Bone Diseases. 2012;15(3):14-17
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MUSCULOSKELETAL SYSTEM IN THE ENDOGENOUS HYPERCORTISOLISM
Dragunova N.V., Belaya Z.E., Rozhinskaya L.Y.

Abstract

The authors review the current literature data on the pathogenesis, clinical manifestations and treatment of glucocorticoid induced osteoporosis in patients with endogenous hypercortisolism. High levels of glucocorticoids lead to bone loss, bone quality deterioration and low traumatic fractures as a consequence of reduced bone formation. In addition to this, muscle weakness and sex steroids hormone abnormalities increase the risk of falls and fractures. The new available data on possible mechanisms of these changes including the involvement of RANKL/RANK/OPG, Wnt-betacatenin signaling pathway and pathogenesis of myopathy are discussed. This review also outlines the practical recommendation and new questions that should be evaluated in future research.
Osteoporosis and Bone Diseases. 2012;15(3):18-24
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OSTEOPOROSIS, DEPRESSION AND FRACTURES. MODERN ASPECTS OF THE PROBLEM
Zakroeva A.G., Kozhemyakina E.V., Lesnyak O.M.

Abstract

To study the relationship of osteoporosis, depression and fractures analyzed more than 200 publications, selected for analysis 124. Osteoporosis (OP) and depressive disorder (DD) have several common risk factors. Biological, psychological and psychosocial factors associated with both diseases. The pathogenesis of OP and DD are closely correlated. OP and fractures lead to the development of DD., degrades rehabilitation and reduce adherence to OP therapy. DD in turn is associated with a decrease in BMD and an increase the risk offalls and fractures. Early detection and treatment of DD in patients with OP., as well as detection and treatment of OP in patients with depression should be an integral part of general medical practice.
Osteoporosis and Bone Diseases. 2012;15(3):25-31
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COMBINATION THERAPY IN THE TREATMENT OF OSTEOARTHRITIS. THE EFFECTIVENESS OF THERAFLEX
Alekseeva L.I.

Abstract

Osteoarthritis (OA) is the most common form of joint damage and a major cause of morbidity and disability. The significant increase in the incidence is due to the rapid aging of the population and the pandemic of obesity. The main clinical symptoms of OA are pain and deformation of joints, leading to functional impairment. OA treatment requires not only accurate diagnosis, but also estimation of the prevalence and severity of articular damage, the general health status of the patient and the presence of comorbid conditions for the correct choice of treatment, and possibly a combination thereof. Proven effectiveness of chondroitin sulfate and glucosamine hydrochloride alone, created the preconditions for the development of complex products. The effectiveness of this combination is supported by experimental and clinical data.
Osteoporosis and Bone Diseases. 2012;15(3):32-35
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PRACTICE NOTES SOFTWARE «VERTEBRAL FRACTURE ASSESSMENT» FOR DUAL-ENERGY BONE DENSITOMETER «DISCOVERY W» IN THE DIAGNOSIS OF OSTEOPOROSIS
Eidlina E.M.

Abstract

The authors studied the feasibility of an additional software application for dual-energy X-ray bone densitometer series «Discovery W» (HOLOGIC inc., USA). 45 patients with osteoporotic vertebral compression fractures underwent technique of «Vertebral Fracture Assessment» in one session with standard densitometry at the lumbar spine and proximal femur. This program is based on a semi-quantitative morphometry of the spine (N.K. Genant; 1993) is an alternative to radiography for the diagnosis of vertebral fractures. Determination of the index values of the vertebral bodies by this method allows identification not only explicit, but subtle compression vertebral fractures of both thoracic and lumbar spine. The methodology should be ordered by an osteoporosis specialist, evaluated by radiologist, it can be performed in one session with standard densitometry procedure. Assessment of the bone structure of the vertebral bodies by this imaging technology is not feasible.
Osteoporosis and Bone Diseases. 2012;15(3):37-39
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EFFECT OF ZOLEDRONIC ACID THERAPY ON FRACTURE RISK IN THE TREATMENT OF MEN WITH OSTEOPOROSIS
Boonen S., Reginster J., Kaufman J.

Abstract

Остеопороз - существенная причина заболеваемости и смертности у мужчин. Среди лиц старше 50 лет примерно 40 % всех остеопоротических переломов, встречающихся в мире, приходится на мужчин. Смертность после остеопоротического перелома у мужчин выше, чем у женщин. Предыдущие исследования, включающие мужчин с остеопорозом, в основном основывались на анализе суррогатных критериев эффективности лечения, а именно на показателях минеральной плотности костной ткани (МПК) и маркерах костного обмена. При этом наблюдались недостаточные данные из двойных слепых плацебо-контролируемых или сравнительных рандомизированных исследований, где первичной точкой эффективности было влияние на переломы. Целью представляемого 2-летнего многоцентрового, рандомизированного, плацебо-контролируемого, двойного слепого исследования в параллельных группах была оценка эффективности терапии золедроновой кислотой 5 мг, вводимой один раз в год, в отношении снижения риска переломов позвонков по сравнению с плацебо.
Osteoporosis and Bone Diseases. 2012;15(3):40-40
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FRACTURE HEALING AND ANTIOSTEOPOROTIC TREATMENT
Lyritis G.P.

Abstract

«Переломы широко распространены у пациентов с остеопорозом. По данным эпидемиологических исследований, частота возникновения переломов длинных костей в популяции экспоненциально увеличивается с возрастом, что является серьезной проблемой в связи с повышением заболеваемости и смертности среди лиц пожилого возраста. Несмотря на доступность препаратов для лечения ОП, достоверно снижающих риск переломов, практически у половины пациентов пожилого возраста на протяжении последующих лет жизни возникает как минимум один перелом. В этой связи, консолидация переломов у пациентов, уже получающих лечение, представляет собой клинически значимую проблему».
Osteoporosis and Bone Diseases. 2012;15(3):41-44
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TO THE 75TH ANNIVERSARY OF THE R.G. OGANOV
- -.

Abstract

Osteoporosis and Bone Diseases. 2012;15(3):45-45
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NOTIFICATION OF CONGRESS
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Abstract

Osteoporosis and Bone Diseases. 2012;15(3):46-46
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