Densitometry of cosmonauts following long duration missions revealed different types of site specific changers of human skeleton. So, theoretically, the expected a decrease in bone mass according with gravity vector reflected the local specificity of bone genes expression connected with the mechanical history of Homo erectus evolution. High individual variability of bone mass changes may be a manifestation of genetic polymorphism. We show the individual stability of bone mass changes at different sites of skeleton after repetitive spaceflights. This phenomenon may be considered as an illustration of phenotypical characteristics of local bone metabolism in the form of specific for this locus spatial structure of non-collagenic proteins distribution.

The aim of this study was to analyze the medical care and determinants of outcomes in patients with hip fracture. Epidemiological data was received from official statistic for cases of hip fractures and from primary care physicians. 208 cases of hip fractures were revealed during 2008-2009 (52 men and 156 women). The part of the hospitalized patients comprised 37,0%. Other patients either didn‘t apply to a hospital (57 people), or were refused in hospitalization (74 people). Operative treatment was received by 12,5% of patients with hip fracture. The lethality after a hip fracture within 1 year was high — 41,4°%. Thus, the low level of surgical care and the serious consequences of hip fractures and low level of the surgical help dictate the need for the development of the Russian standard to help these patients.

We evaluated the effect of serum Vitamin D level on bone mineral density in 270 women of reproductive age. Insufficiency and deficiency of vitamin D were found in 86.8% of women regardless of the season when the examination was performed. The DXA results showed that every 5th woman had a decreased BMD. Correlation analysis revealed a significant direct relationship between serum vitamin D level and BMD in women up to 40 years old (r=0,48, p=0,04), whereas in those over 40 years this relationship could not be seen. Additional studies are required for further assessment of vitamin D role in bone remodeling

Objective. To determine a bone mineral density (BMD) changes in patients with ankylosing spondylitis (AS) depending on demographical data, clinical and laboratory findings. Materials and methods. 42 patients (male - 36 (85,7%), female - 6 (14,3%), 21 to 47 years of age, mean age 33,2±8,4, mean disease duration 7,8±5,9 years) with proven diagnosis of AS were included in the study performed at the Centre of osteoporosis treatment and prevention. All patients were HLA-B27 positive, 23 (54,8%) had peripheral arthritis. Evaluation included back pain assessment with VAS scale, morning stiffness duration assessment, modified Schober’s test, limitation of chest expansion assessment, calculation of BASDAI, BASFI and ASDAS-CRP scores, ESR and CRP levels. To evaluate BMD all patient underwent dual-emission X-ray absorptiometry (DXA) at lumbar spine (L1-L4) and hip neck. Results. Among male patients normal BMD was found in 6 (16,7%) patients, 19 (52,8%) had osteopenia, 11 (30,5%) -osteoporosis. Among male patients normal BMD was found in 1 (16,7%) patients, 1 (16,7%) had osteopenia, 4 (66,6°%) — osteoporosis. BMD at the lumbar spine in male patients was significantly higher compared to females (p<0,05). Patients with high disease activity and peripheral arthritis had significantly lower BMD at lumbar spine. Patients with osteoporosis and osteopenia had higher pain score on VAS compared to patients with normal BMD. We observed an association between BMD and duration of AS, Schober’s test results, disease activity and CRP. Conclusion. High clinical activity, presence of peripheral arthritis, significant changes in spinal movement were found to be predictors of BMD decrease in patients with AS. Patients with AS and osteopenia had more pronounced pain syndrome.

This study describes bone metabolism in children withjuvenile idiopathic arthritis (JIA), association between disturbances of bone metabolism with inflammatory activity, juvenile arthritis disease course and therapy in 198 children. Low bone mineral density (BMD) for chronological age was detected by dual-energy X-ray absorptiometry of lumbar spine L1-L4 (densitometer Hologic QDR 4500C, with pediatric reference database) than Z -score < -2 SD in 36 children (18,2%), in 18 girls (15,5%) and in 18 boys (21,9%). Girls with low BMD received glucocorticoids (GCS) in 66,7 % cases, and girls with normal BMD received it in 26,5% cases (р=0,002). Girls with low BMD had lower height, weight, earlier age of disease onset and higher clinical and laboratory parameters of arthritis activity. Girls with low BMD had higher osteocalcin and tendency to decreased parathyroid hormone levels compared to the girls with normal BMD. Children who received GCS had specific stereotypic changes: boys had significantly lower bone mineral density and total Ca and girls had significantly lower bone mineral content and BMD (g/cm2 and Z-score), total Са, non-organic phosphate and total alkaline phosphatase activity. Patients with systemic arthritis had significantly lower mineralization and bone metabolism turnover compared to children with oligoarticular and polyarticular JIA subtypes. Independent predictors of skeletal mineralization were age onset f JIA (р<0,0001), duration of the disease (p<0,0001), hemoglobin level (р=0,004), total calcium level (р=0,024), a2-globulins level (р=0,046). Independent predictors of low BMD were physician’s assessment VAS (р=0,024), C-reactive protein (р=0,04), inorganic phosphate (р=0,05). Systemic glucocorticoids exposure elevated the risk of low BMD for chronological age realization in JIA patients (OR=1,96, 95%CI=0,76-5,05). Enhanced risk of low BMD was in polyarthicular (OR=2,53, 95%CI=0,66-9,65) and systemic JIA (OR=3,16, 95%CI=0,73-13,76). Thus, parameters of inflammation have negative influence on bone metabolism velocity, linear growth and accordingly bone mineralization. Described factors explain heterogeneity of mineralization disorders.

Expediency of the application of adequate osteosynthesis in combination with Ca + vitamin D intake for the treatment of pseudarthrosis (PA) complicated by regional immobilization osteoporosis was proved by the results of comparative study (treatment group - 23, control group - 33 subjects). Reliable decrease in time of consolidation by 15.3% was noted in treatment group as compared to controls. That decrease resulted from the transition of “lazy bone ” state typical for regional immobilization to a more active state of bone remodeling. Activization of remodeling process on with intake of Ca D3 Nycomed was proved by sigificant increase in the activity level of alkaline phosphatase and its isoenzyme acid phosphatase. Predominance of osteogenesis process over resorption in the early postoperative period was demonstrated by significant (p=0.004) increase in phosphatase index in the treatment group within first three months after operation as compared to the control group.

Aim of the study. To examine the quality of treatment of postmenopausal osteoporosis (OP), the level of commitment to therapy and the factors on which it depends, and the amount of social and economic costs associated with the treatment of OP in the Moscow Region (MR). Material and Methods. The study was conducted by questionnaire of 362 postmenopausal women aged 55 and older (median 65 (59, 70) years) from 17 districts and municipal entities of MR with verified diagnosis of postmenopausal OP. The questionnaire included a survey “Attitudes to the therapy of OP” and the scale of attitudes «Factors hindering receive quality medical care for OP. « Results. During the past year, respondents appealed to the medical facilities for OP treatment up to 15 times inclusive (an average of 2 (1, 4) times), 30.4% of patients were hospitalized or were unable to work due to the OP, in 14.3% of respondents disability leaf has lasted for more than six months. OP therapy in most cases was not assigned due to lack of adequate advice from the doctor, who did not insist on compulsory treatment (in reply to 50% of respondents) did not give clear recommendations (43.8%) or did not explain the specific instructions for the drug use ( 25.0%). When choosing a method of treatment 84% of respondents relied on the recommendations of the endocrinologist and the remaining 16% - of a gynecologist, rheumatologist, orthopedist, or trauma specialists who are not directly related to the treatment of OP. The major part in the treatment of postmenopausal OP is occupied by well-known brands of combination therapy with calcium and vitamin D, whereas strontium ranelate was used only by 13.9% of respondents, alendronate - 11.1°%, zoledronic acid — 8.8%. Despite the identified high adherence to therapy, most patients treated previously believe that efficient and convenient for the administration drug for the treatment of OP does not exist (39.1% and 34.8% respectively). Average monthly costs for patients treated OP are 1700 (300, 2000) rubles, while the high cost of antiosteoporotic drugs is the most important cause of the irregular treatment and the most significant factor of poor quality medical care to patients with OP. Conclusion: OP is associated with more visits to medical facilities and long periods of disability; the quality of treatment of OP in MR needed to be improved.

At thepresent time there is a great interest in médical researche devoted to investigation the role of cytokines (interleukins) in the pathogenesis of cardiovascular diseases (atherosclerosis, arterial hypertension, ischemic heart disease, etc.), and osteoporosis. The review provides data on the conducted research on the importance of cytokines in the event of these diseases.