No 2s (2013)

In recent years, the relationship of cardiovascular disease (CVD) and osteoporosis is actively discussing in the scientific literature and the medical community. The results of a number of epidemiological studies that found an associative relationship between vascular calcification and bone health were the basis for the discussion. The article discusses risk factors and pathogenesis of bone diseases and cardiovascular diseases. Rational algorithm for the management of patients with cardiovascular diseases and skeletal system disorders is presented. Particular attention is paid to the preparation Alphadol-Ca, 1 capsule of which contains 0.25 micrograms of vitamin D predecessor analogue alphacalcidol and 200 mg of calcium carbonate. It was found that vitamin D analogues, such as alfacalcidol, have a positive effect on bone remodeling and bone microarchitectonics; moreover, such drugs have a particular advantages as proven immunomodulatory and anticytokine effects, that justifies their use by persons with concomitant pathology of cardiovascular and bone systems.

Secondary osteoporosis is closely associated with a number of endocrine diseases. Steroid-induced osteoporosis is the most common form of secondary osteoporosis. The steroid-induced osteoporosis develops due to endogenous hypercortisolism, rather rare, but severe disease. Osteoporosis as one of the dangerous consequences of treatment with pharmacologic doses of glucocorticosteroids (exogenous hypercortisolism) is a more frequent problem. The article discusses the pathogenetic mechanisms of steroid-induced osteoporosis and the influence of an excess of glucocorticosteroids on bone remodeling processes. It is emphasized that the timely appointment of antiresorptive pharmacotherapy in patients with steroid-induced osteoporosis allows to delay or stop the loss of bone mass, and provides low incidence of bone fractures, and bisphosphonates are considered as a first-line therapy for steroid-induced osteoporosis.

Ivolutive processes in the muscle tissue have been the object of research in connection with the increase of life expectancy in almost all countries and on all continents. Due to the fact that the contribution of sarcopenia in the deterioration of health of the population has become more than obvious, the European Working Group on sarcopenia in the elderly has developed diagnostic criteria and guidelines for the use of methods to measure a decrease in muscle mass, strength and function. The article describes the risk factors and underlying causes of sarcopenia, the methods of diagnosis, prevention and treatment. It is concluded that the introduction of methods of diagnosis of sarcopenia in clinical practice will improve the quality of the specialized geriatric care.

The article analyzes the role of estrogens and androgens in bone metabolism in men and women, as well as the importance of correction their deficits in the treatment of osteoporosis. The data of a randomized trial that compared the effects of monotherapy with estrogens and estrogen-androgen therapy in patients with osteoporosis are presented. The first group of patients received implants containing 50 mg of estrogen, a second group - implants containing 50 mg of estrogen and 100 mg of testosterone. After 3 years of treatment, there were no changes in bone mineral density (BMD) in first group, while metacarpal bone mineral density increased by 2 % in the second group. According to these findings, it was concluded that the use of androgens for the treatment of osteoporosis in women may be a promising direction and a field for further research on this issue.

The evaluation of trace substances status in 30 adolescents with gastroduodenal pathology was performed; osteopenia was revealed in 15 adolescents. The imbalance of boron, copper, manganese and zinc, ie, trace substances directly involved in the process of bone formation was detected. The relationship between the trace substances status and bone mineral density is established. The evaluation of the efficacy of use of combined drug Calcemin for the correction of imbalance of trace substances and achievement of sufficient calcium levels was performed. The data obtained can be used in practice of the pediatricians.