Vol 20, No 2 (2017)

Original study
The central aortic blood pressure and arterial stiffness during the daily monitoring procedure in postmenopausal women with osteoporosis
Tsarenok S.Y., Gorbunov V.V., Aksenova T.A.

Aim: to evaluate the data of the central aortic pressure and arterial stiffness during the daily monitoring procedure in postmenopausal women with osteoporosis.

Methods: 79 postmenopausal women (age from 57 to 78) were examined. All patients were divided into two groups: the first group consisted of 36 women with osteoporosis, the second group consisted of 43 women – control group. A daily monitoring of central aortic pressure and arterial stiffness were performed all women by the apparatus BPLab v.3.2.

Results: increase of the mean daily of systolic, diastolic and mean aortic pressure was found out in women with osteoporosis. The main data of arterial stiffness (PWV, ASI, AASI, PPA) were higher in this group of women. The direct correlation between the data of central aortic blood pressure, arterial stiffness and presence of osteoporotic fractures and their number, as well as indicators of absolute ten-year risk of osteoporotic fractures and hip fracture was revealed. Pathological profiles of systolic pressure in aortae were more frequent in patients with osteoporosis. The type of hyperdispers was predominant.

Conclusions: the results obtained may indicate a possible relationship between cardiovascular diseases and osteoporosis.

Osteoporosis and Bone Diseases. 2017;20(2):46-51
Case report
Pachydermoperiostosis: a case report
Fursenko V.A., Grebennikova T.A., Nikitin A.G., Belaya Z.E.

Pachydermoperiostosis (PHO) or primary hypertrophic osteoarthropathy is a rare genetic disease that typically begins during childhood or adolescence. It is characterized by digital clubbing, pachydermia and periosteal reaction and progresses gradually over the years prior to disease stabilization. Two genes are reported to be associated with PHO – HPGD and SLCO2A1. These genes are involved in prostaglandin E2 metabolism.

We present a description of a 19-year-old patient with PHO. We found two mutations in the SLCO2A1 gene: p.Gly183Ar (chr3:133673888, NM_005630.2:c.547G>A) and p.Cys444Gly (chr3:133664070, NM_005630.2:c.1330T>G) through molecular genetic analysis. The mutation (p.Cys444Gly) has never been recorded in previous studies.

This work expands our knowledge of the mutation spectrum of PHO, which will facilitate faster genetic diagnosis and interpretation of genetic information in prenatal diagnosis and genetic counseling.

Osteoporosis and Bone Diseases. 2017;20(2):52-57
Denosumab treatment in patients with different courses of osteoporosis
Rozhinskaya L.Y., Mamedova E.O., Lutsenko A.S., Malygina A.A., Belaya Z.E.

We present three clinical cases of successful osteoporosis treatment with denosumab in patients with different courses of osteoporosis: postmenopausal with bisphosphonates ineffectiveness, osteoporosis of mixed etiology in patient on thyroid stimulating hormone suppression and aromatase inhibitor therapy and a case of osteoporosis in a male caused by primary hyperparathyroidism. Mechanism of denosumab action is different from bisphosphonates: denosumab prevents osteoclast differentiation by binding to receptor activator of nuclear factor kappa-B ligand (RANKL) and thus suppressing bone resorption. Clinical trials showed that denosumab promotes further increase of bone mineral density after bisphosphonate treatment. Denosumab has been used in Russian Federation since 2012. Clinical effectiveness and safety profile make denosumab one of the first-line drugs for osteoporosis treatment.

Osteoporosis and Bone Diseases. 2017;20(2):58-62
Secondary and tertiary hyperparathyroidism in chronic kidney disease
Egshatyan L.V., Mokrisheva N.G., Rozhinskaya L.Y.

In the treatment of secondary hyperparathyroidism of end-stage chronic kidney disease, vitamin D receptor activation and allosteric modulators of the calcium-sensing receptor – inhibit glandular hyperplasia, reduce parathyroid hormone levels, impact on bone turnover and mineral density. But the use of calcimimetic and vitamin D analogs or mimetics did not reduce the need for parathyroidectomy for refractory hyperparathyroidism. The enlarged parathyroid gland and gland nodular transformation became refractory to medical therapy and patient need for parathyroidectomy. Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone after a long period of secondary hyperparathyroidism and renal transplantation.

In this article, we present the case of a Caucasian male with chronic kidney disease (end-stage on chronic hemodialysis and after kidney transplantation) and different forms of hyperparathyroidism (secondary and tertiary). Our case study shows that only a multi-interventional strategy is likely to be more effective treatment in cases of severe and refractory to medical therapy hyperparathyroidism.

Osteoporosis and Bone Diseases. 2017;20(2):63-68
The role of calcium and vitamin D medications in prevention and treatment of osteoporosis
Lutsenko A.S., Rozhinskaya L.Y., Toroptsova N.V., Belaya Z.E.

This article considers the role of calcium and vitamin D in body functions, with focus on skeletal system. We reviewed the results of studies on calcium and vitamin D supplementation worldwide and in Russia. According to these studies, there is insufficient dietary intake of these nutrients, irrespective of geographical, ethnic features and physiological conditions. We also reviewed the data on safety of calcium supplementations for urinary and cardiovascular systems, regimens and doses for vitamin D deficiency treatment in various age groups. The article also contains data on calcium, vitamin D and combined medications, available in Russia, for prevention and treatment of osteoporosis, with highlight on combined ones for better compliance and more convenient dosage frequency.

Osteoporosis and Bone Diseases. 2017;20(2):69-75

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