Introduction. The incidence of fractures of the proximal femur (FPF), fractures of the forearm and humerus was studied in two cities of the Russian Federation. This index was used to create the Russian model FRAX and to assess the present and future burden of fractures. Objective. So far, little is known about the epidemiology of fractures in Russia. The aim of the study was to determine the incidence of major fractures to create a Russian model of FRAX and evaluate the present and future burden of fractures. Materials and methods. In well-defined populations of two Russian cities, we had determined a number FPF and forearm fractures of the humerus for 2-2-year period. Data were combined and the resulting incidence used to calculate FRAX model for the Russian Federation and to calculate the projected number of fractures in the Russian Federation in 2010 and 2025. Results. A total of 6012 fractures were identified. Among all FPF, 27% of Pervouralsk and 1.8% in Yaroslavl were not registered on the official data of medical institutions. The incidence of fractures increased with age and was higher in women than in men. The probability of experiencing a FPF in later life at the age of 50 years was 4% of men and 7% of women. Total number FPF in 2010 was 112 thousand cases and it is expected to rise by 2025 to 159 thousand a year. The estimated number of major osteoporotic fractures will increase from 590 thousand to 730 thousand cases for the same period. Conclusions. Osteoporotic fractures are a serious health problem for Russia. It is necessary to take urgent measures to improve emergency care at FPF and long-term care for this and other osteoporotic fractures.

Objectives. This study is a part of GLUKOST study hosted and organized by the Russian Association of Osteoporosis. The aim was to estimate the incidence and risk factors of fractures in patients with chronic inflammatory diseases. Materials and Methods. A specially designed questionnaire was introduced to patients with chronic inflammatory diseases in different regions of Russia. The study included 2342 patients aged 18 to 89 years (mean age 53.02 ± 14.03 years, 591 men and 1181 women). The patients were allocated into two groups: group 1 (n = 1402) - patients never prescribed oral long acting glucocorticoids (OGC); group 2 (n = 929) - patients who received oral long acting glucocorticoids for more than 2 months or continue to take at the time of the survey. The median duration of OGC therapy was 3 years, the median daily dose - 10 mg of prednisone or equivalent. Results. Low-energy fractures of the skeleton were identified in 9.0% of patients not receiving therapy OGC, and 15.5% of patients receiving or previously treated with this therapy. Significant risk factor for fractures was the length of a chronic inflammatory disease. OGC therapy increased the risk (adjusted odds ratio (95% confidence interval (95% CI)) of osteoporotic fractures, regardless of their location by 2.2-fold (95% CI 1.63-3.02, p <0,001), vertebral fractures - by 5.0 - fold (95% CI 2.05-12.37, p <0.001), distal forearm 1.8-fold (95% CI 1.10-2.84, p = 0.02). The frequency of fractures in group 2 was increased in men and women of different age groups, but a significant increase in risk was demonstrated only in postmenopausal women and men 50 years and older. We were unable to identify a relationship of fractures with a daily dose of OGC. Conclusion. The main risk factors for osteoporotic fractures in patients with chronic inflammatory diseases are age, duration of the underlying disease, and long-term use of oral glucocorticoids.

The study shows that addition of statins to osteoporotic therapy in postmenopausal women with different cardiovascular risk beside desired hypolipidemic effect and reduction of arterial stiffness also elevates BMD at femoral neck by 4,9% from the baseline (p<0.05). Bisphosphonates therapy in postmenopausal women gives additional reduction of central systolic arterial pressure of 4.1 mm Hg with the tendency to improvement in the arterial stiffness. The dynamics of aortal stiffness was correlated with changers in intensity of bone remodeling (for N-terminal propeptides of type I procollagen (P1NP) p =0.47, p=0.019; for carboxyl-terminal telopeptide of collagen type I (CITP1) p=0.40, p=0.05) as well as systolic blood pressure (r=0.52, p=0.008). Conclusions. Bisphosphonate therapy and its combination with statins may influence the on parameters of blood pressure and aortic stiffness in women with postmenopausal osteoporosis.

Objectives. To analyze clinical data of the first domestic zoledronic acid generic preparation for the treatment of osteoporosis (Rezoclastin PS., 5 mg). Materials and Methods. The study included data from 123 patients (118 women and 5 men) treated with Rezoclastin PS 5 mg in medical centers of Moscow, St.-Petersburg and Krasnodar for primary (91.8%) or secondary(8.2%) osteoporosis, with mean age 27-78 years (61,4 ± 9,1 years). 56.6% of patients had severe osteoporosis with compressive deformations of vertebrae. Duration of medical therapy ranged from 6 to 24 months. Results. Study of changers in bone resorption marker CTx (n = 10) showed decline by 78% after 3 months of treatment compared to baseline (p = 0.027). BMD at the lumbar segment of the spine L 1-L 4 increased after 12 months by 3.4% (p <0.001, n = 87) and 24 months by 5.7% (p <0.05, n = 11) at the femoral neck - by 1.6% (p <0.0001, n = 64) and by 2.5% (p <0.05, n = 11), respectively, and in the total proximal femur - by 2.6% (p <0.01, n = 64) and by 3.8% (p <0.05, n = 11), respectively. The level of back pain in the study group significantly decreased at 6 months (p <0.000001), and after 18 and 24 months the pain in most patients subsided. After the first administration of the drug in 40% of patients had adverse events, mainly due to flu-like syndrome. After the second infusion at 12 months adverse reactions rate decreased to only 22.9%, after the third infusion at 24 months to 1.8 %. Conclusions. The parameters of efficacy and adverse reactions of the generic zoledronic acid as our data show is comparable to the brand version of the drug.

This review shows the role of vitamin D in the regulation of not only the level of calcium, but also in the pathogenesis of chronic systemic inflammation, disruption of insulin sensitivity of tissues. The sufficient levels of vitamin D in the blood can lead to reduced risk of developing type 2 diabetes, obesity, autoimmune destruction of pancreatic β-cells, certain cardiometa-bolic risk factors, and therefore cardiovascular disease. Perhaps preparations of vitamin D in the near future may become additional and necessary nutritional substances for correction of insulin resistance, cardiovascular disease, chronic inflammation and prevention of disorders of glucose metabolism.

Well known that the lack of vitamin D in mother leads to its deficiency in the fetus. Vitamin D deficiency in the fetus significantly increases the risk of disorders of calcium/phosphorus metabolism, decreases of size of ante - and postnatal skeleton of the child, and affects the child ’s growth, bone mineral density and increases the risk of fractures in working age.