Osteoporosis and Bone Diseases

Primary hyperparathyroidism (PHPT) is a common disorder often associated with reduced bone mineral density (BMD) and osteoporosis. The main goal in treating patients who refuse surgery is the correction of bone complications. The aim of this study is to evaluate safety and efficacy of alendronate treatment in patients with PHPT and osteoporosis. Eligible patients were postmenopausal women suffering from PHPT who did not meet surgical guidelines or ignored surgery due to different reasons. 55 osteoporotic or osteopenic women received alendronate 70 mg weekly and 43 were leaved under medical observation for the reasons of not being osteoporotic or financial unable to comply with treatment/ Results: After 2 years of treatment alendronate group showed statistically significant gain in BMD at L24 +4,0±4,2%, Neck +2,2±4,4%„ TH +2,3±4,5%. At the same time observational group showed decrease in BMD at L24 -4,2±4,0%, TH -3,5±3,8%, R33% -4,0±6,5%, [95% CI -7,6; -0,4]. On the whole BMD dynamics in groups differed at the following sites: L2 (p=0,00004), Neck (p=0,005), TH (p=0,001), R33% (p=0,006). ' Alendronate intake was accompanied by serum Ca decrease (at 1 year point -4,3±5,4%, p=0,00005, at 2 year -2,7±6,4%, p=0,04), 24 hours'Ca excretion decrease from (Me) 8,5 to 6,3 mmol/day at 1 year point, (p=0,007) without PTH elevation. As well as CTx fell at Me: 66% at 1 year and at 60% at 2 year point and OK at 39% and at 27%, correspondingly, p<0,01. In the observation group PTH, serum Ca were stable, 24 hours 'Ca excretion increased from 7,0 to 7,7 at 2 year, p=0,003, as well as CTx level that increased 53%, p=0,01 at 2 years. Conclusions: alendronate treatment in postmenopausal women improves BMD in trabecular bone sites and prevents BMD decrease in cortical sites. At least 2 years of therapy is needed to get the significant increase BMD in cortical bone . All patients should be under medical control for timely revelation of disease progression.

Despite the relatively low incidence of acromegaly (60-70 cases per I million inhabitants), this disease has a special place among the heterogeneous group of diseases that lead to the defeat of the locomotor apparatus. The slow growth of the clinical manifestations of acromegaly and as a consequence, late diagnosis, the cause of early disability and premature death of patients. In order to improve the quality of life and social adaptation of patients to date is an obvious need to identify groups of patients with acromegaly, requiring additional therapy for osteoporosis and osteoarthritis. We performed the search in bibliographic bases MEDLINE and Cochrane Collaboration from 2000 on 2009. Key words were the following: acromegaly, acromegaly and arthropathy, osteoporosis and acromegaly, the bone mineral density and acromegaly, fractures and acromegaly. In this article the data about role of risk factors for the defeat ofosteoarticular apparatus, the dynamics of the articular syndrome and the state of bone tissue in acromegaly.

Osteoporosis is one of the most socially significant chronic noninfectious diseases. This is due to its high prevalence and medical, social and economic consequences from osteoporotic bone fractures. The problem of osteoporosis is intensively studied in Russia for the past 15 years. Taking into account the peculiarities of the osteoporotic process (gradual, protracted, oligosymptomatic beginning, multifactorial origin, need for prolonged treatment to achieve effectiveness, wide range of drug treatment options etc.) and remaining lack of knowledge and experience of practitioners in view of the swift progress in osteoporosis research, we consider the importance of unity in approach to diagnosis, prophylaxis and treatment of osteoporosis for doctors of all specialities. These prompted Russian experts to develop the first Russian Clinical Recommendations for osteoporosis that were published in 2005 and reviewed in 2009.