№ 2s (2012)

Proximal femoral fractures are the most serious complications of osteoporosis. Their incidence varies in different countries. In the Russian Federation, epidemiology of this type of fractures was investigated in two multi-center studies. According to a recent study, in Russia high incidence of femoral fractures among men and modest among women was noted. Knowledge of the actual incidence of fractures should be the basis for the development of healthcare system for patients with proximal femoral fractures in our country.

Osteoarthrosis is the most common chronic disease of the joints. The pain and deterioration of joint function are main manifestations of osteoarthrosis, requiring their treatment. Currently, non-steroidal anti-inflammatory drugs, opioid analgesics, glucosamine and chondroitin sulfate, and application of unsaponifiable compounds of avocado and soybean are used for the treatment. The possibility of therapy with antiosteoporotic drugs, such as bisphosphonates, calcitonin, strontium ranelate, is discussed.

Data on the main calcium-regulating hormones (parathyroid hormone, calcitonin) and their role in the regulation of bone remodeling are presented. These processes are also influenced by sex steroids, growth hormone, insulin, cortisol, thyroid hormones, and various local growth factors. In this regard, osteopenia and osteoporosis are closely linked with a number of endocrine diseases, some of which are common (diabetes mellitus, thyrotoxicosis), others - quite rare (endogenous hypercortisolism). The osteoporosis associated with diabetes, steroid osteoporosis, osteoporosis associated with thyroid function abnormalities are discussed in detail. It is emphasized that timely diagnosis and adequate treatment of endocrine diseases associated with decreased bone mineral density contribute to slowing or termination of bone loss, normalization of bone remodeling, can reduce the incidence of fractures and improve quality of life.

Osteoporotic fractures occur in 27 % of men aged 50 years and older, their risk further increases, but the problem of osteoporosis in men has been insufficiently studied. Purpose of study: evaluation of endocrine profiles in 128 men with proximal femoral fractures (PFF) aged 40-69 years in the cross-sectional study. Assessment of hormone levels was performed by electrochemiluminescence ECLIA., Elecsys 2010 (Roche). Statistical analysis was performed using Statistica 10.0 software. A significant decrease in testosterone levels and high levels of 17-estradiol and prolactin, as well as the high frequency of 25(OH)-vitamin D deficiency compared with controls, were observed in patients with PFF in study groups. Thus, PFF in men occur against the background of reducing the concentration of testosterone and the presence of 25 (OH)-vitamin D deficiency.

Osteoporosis is one of the most prevalent and socially significant diseases in the world. The article presents current data on the epidemiology, classification, pathogenesis and risk factors for osteoporosis. Particular attention is paid to the diagnosis - radiography, osteodensitometry, and laboratory methods. Drug treatment of osteoporosis using data from evidence based medicine is presented.