Vol 20, No 1 (2017)

Original study
Polymorphism of some genes of bone tissue metabolism (VDR Bsm1 c.IVS7G>A, LCT 13910 T>C, COL1A 12046 G->T) among the representatives of Russian and Buryat nationalities
Verkhoturova S.V., Tsarenok S.U., Gorbunov V.V., Aksenova T.A.

Aim: to study the frequency of genotypes of the polymorphous markers of bone remodeling (vita-min D receptor gene Bsm1 c.IVS7G> A, the lactase gene LCT 13910 T> C and collagen gene COL1A 12046 G-> T) in healthy people and patients with osteopo-rosis (OP) among the indigenous population of Trans-baikalia of Russian and Buryat nationalities.

Methods: 97 women with OP were examined: 49 Russian and 48 Buryat women aged from 50 to 80 years. 123 healthy women of the same age group were included in the control group. DNA sam-ples for molecular genetic analysis were taken from peripheral venous blood.

Results: The recessive allele A of the VDR – Bsm1c.IVS7G> A polymorphism was accumulated in women of Buryat nationality, but the statistical significance was not observed (OR = 1.04, CI [0 68, 1.6]). C al-lele of LCT -13910 T> C polymorphism was associated with the development of OP among the representa-tives of Buryat nationality.

Conclusion: The gene allele VDR Bsm1 c.IVS7G> Aand the LCT -13910 T>C leads to a higher risk of OP in women of Buryat nationality. The genotypes G/Tand T/T of COL1A12046 G-> T are associated with the development of OP in people of both nationalities.

Osteoporosis and Bone Diseases. 2017;20(1):3-6
Osteoporosis and osteoporotic fractures risk factors in men aged 50 years and older
Nikitinskaya O.A., Toroptsova N.V.

Cross-sectional screening of random samples of men aged 50 years and older living in five cities (Arkhangelsk, Murmansk, Tyumen, Krasnoyarsk, and Chelyabinsk) from three Federal Districts (FD) of the Russian Federation was conducted to evaluate the frequency of individual risk factors (RF) of osteoporotic fractures among them. Total 1330 men were included in the study.  We found that the most common were the following RF: smoking, prior fragility fractures after age 40, secondary causes of OP, insufficient calcium intake. Significantly more smokers were among males in Siberian (S) FD and North –Western (NW)FD compared with those from Ural (U) FD (p=0,0011 and p=0,047, respectively), the frequency of other RF did not differ depending on region. The рprevalence of osteoporosis according to peripheral x-ray densitometry of the proximal forearm was higher among residents of the UFD (26%) than among men in the NWFD (17%) and SFO (19%). More than 50% of men in each region had 2 or more RF, while those with 3 or more RF were significantly more in the UFD at any age, and at the age of 50-59 years - in the NWFD. Calcium intake was inadequate in 85% of the respondents in these regions.

Osteoporosis and Bone Diseases. 2017;20(1):7-11
Subchondral bone condition and total knee arthroplasty in patients with knee osteoarthritis
Murylyov V.U., Sorokina G.L., Kurilina E.V., Ivanenko L.R.

Background: 6% of adults suffer from knee joint osteoarthritis. In some cases, the method of choice of treatment is knee arthroplasty. The etiology of osteoarthritis remains largely unclear, but the question of involving the subchondral bone in the pathological process is beyond doubt. One of the causes of pain and other adverse effects after knee replacement may be subchondral bone pathology of the femur and tibia.

Aims: To study the changes in the condyles of the tibia in osteoarthritis and to determine the possible impact of these changes on the development of instability of the knee joint endoprosthesis.

Methods: From December 2014 to February 2016, 56 patients were examined. They underwent total arthroplasty of the knee joint. The average age of the patients was 63 years (from 55 to 78 years). Women were 52 (93%), men - 4 (7%). A histological examination of the resected tibial condyles was carried out to reveal bone pathology.

Results: Typical changes for osteoarthritis were found microscopically. In all cases the signs of osteoporosis were present. A clear histological picture of osteomalacia in the non-calcinated bone was found in 15 women.

Conclusions: Having studied the subchondral bone in these patients we can conclude that the knee endoprosthesis is implanted into a weakened bone, which can lead to adverse effects. To improve the long-term results of surgical treatment, medical correction of bone tissue pathology in the perioperative period is suggested.

Osteoporosis and Bone Diseases. 2017;20(1):12-16
Pharmacotherapy of cardiovascular comorbidities in osteoporotic postmenopausal women
Izmozherova N.V., Popov A.A.

Aim: to assess tolerability and efficacy of cardiovascular comorbidities pharmacotherapy in osteoporotic postmenopausal women.

Methods: cross-sectional study included 112 osteoporotic postmenopausal women aged from 49 to 85.

Results: 95 persons (84.8%) had indications for angiotensine-convertising enzyme inhibitors (ACEI) prescription. Cough was associated with significantly higher odds of coronary heart disease, congestive heart failure and a trend to multiple bone fractures. Valsartan was initiated in 32 coughing patients. Target blood pressure level was reached in 15 women. In 15 cases blood pressure levels decreased by 30% of baseline level.

Conclusion: efficacy of cardiovascular diseases in osteoporotic postmenopausal women treatment needs to be assessed in specially designed clinical trials.

Osteoporosis and Bone Diseases. 2017;20(1):17-21
Trabecular bone score for the diagnostics of osteoporosis in subjects with type 2 diabetes mellitus: a clinical case
Grebennikova T.A., Belaya Z.E.

Type 2 diabetes mellitus (T2DM) is associated with higher fracture risk but, better bone mineral density (BMD). Alteration of the skeletal material or microstructure may be an underlying mechanism for the discrepancy between BMD and fracture risk in diabetes. The trabecular bone score has been proposed as an indirect measurement of bone microarchitecture with the routine dual energy absorptiometry.  We present a clinical case of diagnosis and treatment of osteoporosis associated with T2DM in patient with a low-trauma fracture and concomitant endocrine disorder.

Osteoporosis and Bone Diseases. 2017;20(1):22-27
Acute and chronic pain in vertebral fractures as systemic osteoporosis complication. Literature review
Rodionova S.S., Darchia L.Y., Khakimov U.R.

A literature review is devoted to acute and chronic pain mechanisms in vertebral fractures complicating osteoporosis. The data of pharmacological and non-pharmacological methods of pain relief for vertebral bodies fractures, which precede the pathogenetic therapy of osteoporosis or could be combined with it.

Osteoporosis and Bone Diseases. 2017;20(1):28-31
Novel treatment options for secondary hyperparathyroidism in end-stage kidney disease patients on hemodialysis therapy
Rozhinskaya L.Y., Belaya Z.E., Lutsenko A.S.

Pathogenesis of secondary hyperparathyroidism is based on D-hormone deprivation, leading to bone remodeling impairment, increase in FGF-23, PTH levels, changes in blood calcium and phosphorus levels. Taken together with alteration of calcium-sensing receptor (CaSR) sensitivity, these changes result in alteration of bone structure and cardiovascular complications. CaSR agonists are one of the most important medications for treatment of secondary hyperparathyroidism in dialysis patients. Until recently, there was only one CaSR agonist with proven effectiveness – cinacalcet, which is administered per os, daily. Now, a new drug is registered in US, Europe and Russia – etelcalcetide, which is administered intravenously 3 times a week. In this review we focus on results of clinical trials regarding etelcalcetide effectiveness and possible compliance benefits.

Osteoporosis and Bone Diseases. 2017;20(1):32-38
Case report
Complex approaches to rehabilitation of patients with osteoporosis
Lukyanchikova N.S., Sharapova E.I.

Prophylaxis of bone fractures in patients with osteoporosis should not only consist of pharmaco-therapeutical intervention targeting to increase the bones strength, because improving bone tissue quantity does not affect the risk of falls. Additionally, physical factors could have an impact on bone mineral density (BMD). A complex of approache directed to modification of structure and strength of bone tissue together with decrease of falls risk in elderly patients with osteoporosis should become optimal. It’s very important that physical exercise programs developed for osteoporosis patients should include strength and power load exercises as well as flexibility an coordination and balance trainings. Special attention should be paid to the fact that a number of physical exercises are contraindicated as an excessive load can cause inadequate impact on the on the bones with compromised density.

Osteoporosis and Bone Diseases. 2017;20(1):39-43

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