Background. A vitamin D deficiency is a global wide health problem. Inadequate vitamin D status leads to serious medical, social and economic consequences and requires timely diagnosis and adequate correction.

Aim: to assess the incidence of vitamin D deficiency among the population living in regions of the Russian Federation located at latitudes from 45° to 70° and to study its relationship to various factors (demographic, socio-economic, geographical, etc.).

Materials and methods. A multicenter, cross-sectional, randomized study of individuals of both sexes aged 18 to 50 years. The study of 25ОНD level in the blood serum was carried out by INVITRO LLC laboratories using chemilumescent analysis in two stages: in the period from March to May 2020 and from October to November 2020. The first stage of the study involved 500 volunteers (77% women, 23% men). Demographic and socioeconomic characteristics, factors associated with vitamin D levels, were assessed using a specially designed questionnaire.

Results. In this article we present the results of the first stage. A countrywide high prevalence of vitamin D deficiency (56.4%) and insufficiency (27.9%) was revealed, that is, 84.3% of the population aged 18–50 years requires cholecalciferol supplementation. The lowest vitamin D status was found in St. Petersburg, Arkhangelsk, Kyzyl and Rostov-on-Don (over 90% of participants had inadequate levels). A decrease in the level of 25ОНD was observed to a greater extent in men than in women (p <0.05), as well as in young people aged 18–25 years (p <0.05). No major association of vitamin D status with anthropometric parameters, the number of days of disability, were not found. However, those who went to tanning beds or were in direct sunlight for at least 30 days a year had higher levels of 25ОНD, and those using sunscreens had lower levels.

Conclusion. The data obtained confirms the widespread prevalence of vitamin D deficiency and insufficiency in the country (84.3% of participants), generally not related to the geographical latitude of residence, which indicates the need for vitamin D supplementation in a significant part of the population.

Background: Osteoporosis and cardiovascular disease (CVD) are among the most common causes of morbidity, disability and death worldwide. In recent years, more and more data have been accumulating on the presence of an age-independent relationship and general pathogenetic mechanisms of a decrease in bone mineral density (BMD) and the development of CVD. It has been shown that a decrease in BMD is an important independent predictor of the risk of atherosclerosis of the great arteries and is associated with increased calcification of the aorta and other vessels. The strongest relationship between these parameters was observed in the study of the female population, in connection with which we selected a group of middle-aged women for analysis.

Objective: to investigate the association between bone mineral density and carotid intima-media thickness in middle-aged women.

Results: 35 women were included in the study. The mean age was 44,74±4,32 years. We found the following changes in arterial wall characteristics: atherosclerosis — 21,9% women, increased carotid intima thickness — 15,7% women. Low bone mineral density for chronological age (Z-criteria -2,0 and less) was found in 7 patients at the age of 35±2,7 years. We discovered a negative correlation between the markers of subclinical atherosclerosis and bone mass: Ccarotid intimamedia thickness negatively correlated with bone mineral density in hip (p<0,05), and presence of atherosclerosis plaques was associated with lower bone mineral density in the proximal part of hip (p<0,05).

Conclusion: The findings about negative association between bone mineral density of hip with preclinical markers of atherosclerosis allow us to make a conclusion about their interaction.

The public health burden of osteoporosis estimated by the results of clinical and population-based researches in most of the former USSR is uncertain for today. The objective of this audit (Audit-2020) was the epidemiological, medico-social and economic analyse of current and future osteoporosis challenges for the future years for eight countries of the Eurasian region.

Methods. We did a search and critical analysis of the publications, including of regional in English, Russian or national languages, did organize a structured survey among national osteoporosis societies members in Armenia, Belarus, Georgia, Kazakhstan, Moldova, Uzbekistan, Kyrgyz Republic, Russia, as well as explored the demographic trends in these countries.

Results. Scientific researches including the wide population-based EVA project discovered that the expected number of patients with osteoporosis varies from 240,000 in Armenia to 16 million in Russia. All the countries should be categorized as a moderate risk of hip fractures for women (200–300 cases /100,000 per year). Belarus, Moldova, Armenia, Georgia and Kyrgyzstan have moderate risk for men (100–150/100,000), as well as Russia, Uzbekistan and Kazakhstan are distinguished by a high risk for men (over 150 cases/100,000). Population aging trends are predicting the future growth in the osteoporosis-associated health challenges throughout the region. It is likely the number of osteoporotic fractures to rise in Uzbekistan, Kazakhstan and Kyrgyzstan the most: 2.5–3.5 times by 2050. However current hospitalization rates for hip fracture persons are low in most countries (33–80%), the diagnostic equipment is insufficient (0.2–1.3 per million), DXA testing are expensive. Although modern treatments are available, the cure expenses remain high. Hereby, immediate action is required in each country of audit, including admit osteoporosis is a priority public health problem.

Conclusion. Osteoporosis is a challenge for the countries of the Eurasian region. Its burden is about to get worse due to the expected demographic changes.

The prevalence of osteoporosis, especially among the elderly, is increasing exponentially, leading to an increase in the number of fractures and disability. As a result, new requirements for anti-osteoporotic therapy appear, associated with its influence not only on the remodeling of healthy bone, but also on the acceleration of fracture consolidation. The article provides a brief overview of the effect of various anti-osteoporotic drugs on the healing of bone fractures. An assessment of the consolidating effect of antiresorptive drugs — bisphosphonates and denosumab, and anabolic drug — teriparatide, monoclonal antibodies blocking the protein sclerostin, strontium ranelate is given. The use of antiresorptive drugs did not affect, according to the literature, the slowing down of consolidation after fractures of various parts of the skeleton (hip, vertebrae, distal radius). The introduction of anabolic drugs, in particular teriparatide, is accompanied by faster healing of fractures in comparison with the timing of natural bone regeneration or the intake of bisphosphonates, causing an improvement in the formation of callus. The use of drugs that block sclerostin also increases bone formation and bone strength. Based on the available data, it can be concluded that fractures should not be considered as a contraindication to the use of these drugs and be the reason for the late initiation of drug treatment of osteoporosis.