Vol 18, No 2 (2015)

Articles
ABSORPTIOMETRIC ANALYSIS OF SOME QUANTITATIVE AND QUALITATIVE INDICATORS OF BONE TISSUE STATUS ASSESSED BY A QUANTITATIVE COMPUTED TOMOGRAPHY IN WOMEN OF DIFFERENT AGES
Volkov A.A., Beloselsky N.N., Pribytkov Y.N.
Abstract
Aim. To study the characteristics of the quantitative and qualitative characteristics of bone mineral density in women. Materials and methods. Quantitative computed tomography with additional quantitative and qualitative assessments was performed in 127 women of different ages without clinical signs of osteoporosis. Results. We had calculated the size and the ratio of cortical bone and spongy tissue at the lumbar vertebrae considering the density range characterized as the maximum and minimum of mineralized areas that represent not only quantitative but also qualitative state of the bone tissue. Conclusions. The obtained data can be used to assess the changes in the quality of bone in osteoporosis and osteopenia.
Osteoporosis and Bone Diseases. 2015;18(2):3-5
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CALCIUM AND PHOSPHORUS CONTENT OF THE COMPACT BONE IN RATS WITH ALLOXAN DIABETES
Vyatkin V.A., Sobennikova M.V., Kanunnikova O.M., Butolin E.G., Ivanov V.G., Savinova N.V.
Abstract
Introduction: Most of the socio-economic importance of diabetes is an early disability of patients suffering from it. Among the chronic complications of diabetes, there are also abnormal changes in bone tissue. Aim: The aim of our work was to study the changes in the amount of calcium and phosphorus (the main inorganic constituents of bone) in a compact bone tissue in alloxan-induced diabetes in rats at different stages of the disease. Materials and Methods: The experiment was conducted on 70 white mongrel male rats weighing 180 to 220 g. Using the method of atomic emission spectroscopy with inductively coupled plasma we determined the content of calcium and phosphorus in the samples - femoral shafts weighting 5 mg. In homogenates of samples, we determined the activity of alkaline phosphatase. The entire list of measurements was repeated at 7, 14, 21 and 28 days of experiment. Results: The work revealed the decreases in the content of calcium at 7, 14 and 28 days of observation and phosphorus throughout the experiment with maximum changes on the 7th day of the experiment: 25% (p = 0.00002) and 15% (p = 0.002), respectively, compared with control values (median: 1.9 mg -calcium, 0.73 mg - phosphorus). There was a strong direct correlation between calcium and phosphorus (r = 0.086; p <0.01) and an inhibition of activity of alkaline phosphatase on day 28 of the experiment. Conclusions: For the first time, we show that alloxan diabetes in rats is accompanied by a decrease in phosphorus and calcium content of the compact bone with a maximum change at day 7 of the experiment. There are phase changes in the activity of alkaline phosphatase characterized by an increase at day 7 and inhibition by day 28 of the experiment.
Osteoporosis and Bone Diseases. 2015;18(2):6-8
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OSTEOPOROSIS AND ASSOCIATED FRACTURES IN OLDER PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES
Gladkov E.N., Kozhemyakina E.V., Evstigneeva L.P., Tikhonova V.A., Kamkina L.N., Bannykh O.V., Balueva V.M., Lesnyak O.M.
Abstract
Aim. To estimate the burden of fractures in patients with rheumatic inflammatory diseases. Materials and Methods. A specially designed questionnaire was introduced to patients of rheumatic department of Sverdlovsk regional hospital № 1. The study included 242 patients aged 50 to 79 years (mean age 58.4± 6.5 years, 194 women and 48 men). Results. High incidence of osteoporosis (35.5%) was observed in patients with rheumatic inflammatory diseases. Intervention threshold (FRAX) was identified in 46.8% of patients. Low-energy fractures of the skeleton were identified in 33.9% of patient. Oral glucocorticoid therapy increased the risk (odds ratio (95% confidence interval (95% CI)) of osteoporotic fractures by 2.68-fold (95% CI 1.55 - 4.63, p=0.004). Conclusion. High incidence of osteoporosis and osteoporotic fractures was observed in patients with rheumatic inflammatory diseases.
Osteoporosis and Bone Diseases. 2015;18(2):9-14
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MULTIFACTORIAL PATHOGENESIS OF OSTEOPOROSIS AND THE ROLE OF GENES OF CANONICAL WNT-SIGNALING PATHWAY
Mailyan E.A.
Abstract
Nowadays, multifactorial nature of osteoporosis does not raise any doubts. Besides, it should be noted that about 90% disease cases are determined genetically. In 1990-s a number of candidate genes mutations were established which increase the risk of osteoporosis development. VDR, ESR1, ESR2, COLIA1, PTH, CT, CTR, BGP, AR, GCCR, TGFB1, IL-6, IGF1, IL-1ra, OPG were considered to be this kind of genes. New genetic analysis technologies (GWAS, etc.) gave the opportunity to expand our conception about multi genomic pathogenesis of osteoporosis and to point out a new group of genes candidate - a canonical Wnt-signaling pathway genes (CTNNB1, SOST, FOXC2, FOXL1, LRP4, LRP5, WNT1, WNT3, WNT16, DKK1, AXIN1, JAG1, etc.). Extreme importance of canonical Wnt-signaling pathway and genes given above in skeleton formation and its strength necessitate the need for further scientific research and opens perspective to improve osteoporosis diagnostics, treatment and prognosis.
Osteoporosis and Bone Diseases. 2015;18(2):15-19
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THE RELEVANCE, BENEFITS AND CLINICAL PERSPECTIVES OF THE COMBINED TREATMENT OF OSTEOPOROSIS BASED ON BONE-ANABOLIC THERAPY
Marchenkova L.A., Martynova E.Y.
Abstract
Combination therapy of osteoporosis based on bone-anabolic and antiresorbtive agents has a great clinical perspective. An analysis of available publications shows that combination therapy is appropriate from the standpoint of increasing the effectiveness of treatment. Combination therapy can be executed as a simultaneous use of teriparatide with denosumab, raloxifene or hormonal therapy, and the subsequent administration of bisphosphonates, denosumab or raloxifene after treatment with teriparatide. The review presents the evidence-based data on the effect of combined and sequential regimens for osteoporosis fracture risk.
Osteoporosis and Bone Diseases. 2015;18(2):20-24
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HYPOPHOSPHATASIA IN ADULTS: CLINICAL CASES AND LITERATURE REVIEW
Rodionova S.S., Zakharova E.Y., Buklemishev Y.V., Khakimov U.R., Lapkina S.V.
Abstract
Hypophosphatasia is a rare inborn error of metabolism caused by mutations in the gene encoding tissue-nonspecific isoenzyme of alkaline phosphatase. Inexpressive clinical picture of the disease in adults is often difficult to diagnose. We present two clinical observations: in one case, the patient was treated for a long time with alfacalcidol and calcium supplementation due to misdiagnosis of systemic osteoporosis with pathologic fractures of the vertebras, although at the presentation the patient had a typical for hypophosphatasia decrease of alkaline phosphatase. In another case, a patient with diagnosis of aseptic necrosis of the femoral head had a sharp decrease in alkaline phosphatase levels at presurgical evaluation. In both cases, the diagnosis was confirmed by genetic testing. For patients with aseptic necrosis the confirmation of the diagnosis of hypophosphatasia determines the need for treatment with asfotase alfa in the postoperative period to preserve the stability of the endoprosthesis.
Osteoporosis and Bone Diseases. 2015;18(2):25-28
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SUMMARY OF CLINICAL GUIDELINES OF THE RUSSIAN ASSOCIATION OF ENDOCRINOLOGISTS VITAMIN D DEFICIENCY IN ADULTS: DIAGNOSIS, TREATMENT AND PREVENTION
Pigarova E.A.
Abstract
Vitamin D belongs to the group of fat-soluble vitamins. It is naturally present in only a very limited amount of food, and the synthesis in the human body is possible only under certain conditions - when the UV rays of sunlight fall on the skin. National and foreign studies show that the insufficiency of vitamin D, defined as levels of 25(OH)D less than 30 ng/ml or less than 20 ng/ml, is widespread throughout the world. This publication is a shortened version of the guideline «Vitamin D deficiency in adults: diagnosis, treatment and prevention» which was approved on February 27th, 2015 at the session «National clinical guidelines for the diagnosis and treatment of endocrinopathies» at the VIIth All-Russian Congress of Diabetes.
Osteoporosis and Bone Diseases. 2015;18(2):29-32
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CONTEMPORARY DIAGNOSIS OF BONE FORMATION DISORDERS IN INFANTS AND YOUNG CHILDREN USING ULTRASONOGRAPHY (METHODOLOGICAL GUIDELINES)
Krutikova N.Y., Ryabukhin Y.V.
Abstract
The article presents data on tibia and tubular bones density, obtained with quantitative ultrasonometry in 2316 children aged 0 - 3 years. The paper devoted to up-to-date methods of diagnostics to reveal bone-metabolism in newborns and younger children. Certain clinical recommendations have been desined on the basis of the results obtained with ultrasound osteodensitometry. New percentile data base has been created for the device «Omnessense 7000S».
Osteoporosis and Bone Diseases. 2015;18(2):33-35
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RULES FOR PREPARING MANUSCRIPTS FOR THE JOURNAL «OSTEOPOROSIS AND OSTEOPATHY»
- -.
Abstract
Osteoporosis and Bone Diseases. 2015;18(2):36-37
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