Vitamin D deficiency is associated with rickets in children
and osteomalation in adults. Published data support the role
of vitamin D insufficiency in development of autoimmune,
cardiovascular and oncological diseases. The most precise
method to diagnose vitamin D insufficiency is measuring of
25-hydroxyvitamin D (25(OH)-D). We studded the levels of vitamin
D and calcium-phosphate turnover parameters during
the period of maximal insolation in 140 healthy children and
adolescents permanently living in the central area of Russia.
Vitamin D insufficiency (25(OH)-D < 20 ng/ml) was detected
in 38,6%; in 2,9% of them severe vitamin D deficiency was
diagnosed (25(OH)-D < 8 ng/ml). The results correlate with
data on hypovitaminosis D prevalence in countries with the
same geographical latitude. To clarify the real size of required
prophylaxis we need investigation of the same parameters in
winter period while minimal insolation.

The influence of calcium intake during pregnancy on calcium
and phosphorus metabolism, bone turnover and BMD in postpartum
period was investigated in 35 healthy pregnant women.
The control group included 40 healthy women of reproductive
age. In women with the consumption less than 800 mg of calcium
in the III trimester of pregnancy there was decrease of
calcium excretion by the kidney. In both subgroups of pregnant
bone turnover markers showed increased metabolism in bone
tissue in 1,3-1,5 times in comparison with control group. Measurement
of the BMD made on 4-6 day postpartum period. In
the lumbar spine and distal forearm osteopenia was diagnosed
in 2,5 and 1,5 times more frequently than in the control group
(p<0,05). Women who consumed less than 800 mg of calcium
per day in the lumbar spine and distal forearm osteopenia was
diagnosed in 2,5 and 3,5 times more often than women who ate
more than 800 mg of calcium per day (p<0,05).

Pubertal and reproductive stages of woman's life are
characterized by sex steroids' predominant action. Osteoporosis
and osteopenia can develop in patients with estrogen
deficiency (amenorrhoea). DXA scans are used to evaluate
bone mineral density (BMD) using T-score. Retrospectively,
we examine 234 patients with amenorrhoea. The mean age
was 31,80,7 years, the mean duration of amenorrhoea was
6,41,2 years. The highest rate of osteoporosis was determined
in patients younger then 30 years with gonadal dysgenesia
in 31,7% and in patients with hypogonadotrophic
amenorrhoea in 17,9%. Unaltered mineral bone density and
osteopenia were more common in patients older then 30 years
with premature ovarian failure in 17,2 % (n=16) (p<0.05)
and in 48,4% (n=45), respectively, in comparison with other
groups. The most significant changes in mineral bone density
are detected in lumbar spine LI-LIV and the distal radius
(p<0.05) in all groups compared with femur neck. Less
intense changes in mineral bone density in examined areas
were determined in patients with premature ovarian failure
and hypogonadotrophic amenorrhoea with duration of amenorrhoea
less then 5 years compared with women with amenorrhoea
more then 5 years. Thereby all patients with amenorrhoea
should be examined using DXA. The decrease in BMD
is more often in areas where cancellous bone is predominant,
in lumbar spine and in the distal radius. Mineral bone density
is influenced by duration of amenorrhoea and in time started
hormone therapy.

The study objective: to assess the influence of alfacalcidol treatment
on risk of falling in real clinical practice.
Methods. Prospective cohort study included 46 postmenopausal
women aged from 52 to 78, who had high risk of falling, low bone
mineral density, glomerular filtration rate from 65 to 30 ml/min,
signed informed consent and were naïve to calcium, vitamin D and
antiresorptive agents. All patients have participated in Osteoporosis
Patients School Classes, received prescriptions for daily 1 mcg alfacalcidol
and approved recommendations on lifestyle modifications
including diet, exercises and movement patterns. Individual risk of
falling was assessed with the help of Guralnik Short Physical Performance
Battery Score.
Results. There were no new cases of falling and fractures in the
cohort during 12 months. During the study period 28 women showed
compliance to alfacalcidol 80% or more (group 1), in 15 patients
compliance was less than 80% (group 2) and 3 women decided to
quit the study. Only group 1 demonstrated significant physical function
changes for the better while there were no significant changes
in group 2.
Conclusion. In a group of postmenopausal women with high risk
of falling and fractures, significant positive changes in lower extremity
performance and balance tests were registered only in women
with 80% or higher compliance to alfacalcidol consumption.