Primary hyperparathyroidism (PHPT) is the third most
frequent endocrine disorder and has a variable clinical
presentation. Asymptomatic PHPT became the predominant
form of the disease with increase of its incidence after the
introduction of automated serum calcium measurement in
North America and Europe. Data from Russia is lacking. Aim:
To present the clinical profile of PHPT in Russia. Materials
and Methods: This retrospective study was conducted at
endocrinology centers in 8 regions of Russia. We analyzed
the clinical presentation, and treatment options in patients
with confirmed PHPT (1995-2010). Results: 738 patients (F:
M-8:1) with age ranging from 13 to 83,4 years (mean 54,3)
were analyzed. 54% was from Moscow (n=397), 11% - from
Moscow region (n=79) and 35% - from 53 regions of Russia
(n=262). Symptomatic PHPT was the most common form (74%)
and was revealed with osteoporosis in 56%, nephrolithiasis - in
45% and ulcer disease - in 18%. Our data showed an increase
in the incidence of PHPT (especially mild PHPT) after 2005
compared with earlier period. 64,9% of patients were treated
surgically, 17 patients undergone repeated parathyroid surgery.
28,3% received bisphosphonates, calcitonin and/or cinacalcet .
11,5% was observed without treatment. Conclusions: This
data analyzes some causes of delayed diagnosis of PHPT in
Russia, characterized age and gender distribution of patients
with PHPT and demonstrates the changes in clinical profile of
disease from 1995 to 2010. PHPT still remains symptomatic
disorder in our country most frequently with skeletal and renal
manifestations.

The purpose of the work is studying clinico-radiological
features of a combination of postmenopausal osteoporosis
and degenerate-dystrophic changes at the spine (vertebral
column).
Material and methods. It were examined 66 women with
postmenopausal osteoporosis and a dorsodynia syndrome. It
were estimated expression of a dorsodynia on a visually-analogue
scale (VAS), motor performance (function) level, quality of a
life (Qualeffo-41). There was spent X-ray examination of a spine
with an estimation of degenerate-dystrophic changes in points.
Results and conclusions. All patients had degenerate-dystrophic
changes of a backbone with various degree of expression.
Patients with considerable displays of an osteoporosis at
radiological research and overestimate of bone mineral density
were prevailed . The authentic negative interrelation (r =-0,59
is taped; р <0,05) femoral BMD with degree of a spondylosis
and direct correlation between BMD a spine and a expression
of spondylosis (r=0,48, p <0,05). It demands correct approaches
to diagnostics osteoporosis against a spondylosis. Clinical
implications at patients with postmenopausal osteoporosis
and a dorsodynia are interconnected with degenerate changes
of a spine of primary and secondary character, instead of with
changes BMD.

Calcium-sensing receptor (CaSR), a member of G proteincoupled
receptors family, plays a key role in systemic calcium
homeostasis regulation. It is expressed in a variety of tissues, and
is responsible for maintaining plasma calcium concentration.
In addition, the CaSR is known to regulate some important
cellular processes such as apoptosis and proliferation. CaSR is
a drug target for calcimimetics and calcilytics, agents used for
modification of parathyroid cells function and treatment of some
pathologic conditions. Inactivating or activating mutations of
the CaSR gene cause different disorders of calcium metabolism.
Polymorphic variants of the gene have been described in healthy
populations.