[Osteoporosis: Current state of the art]

[The effect of internal course intake of selenium-modified mineral water on bone mineral density after long-term diet-induced metabolic disorders in the experiment. (Randomized controlled trial)]

INTRODUCTION

The phenomenon of therapeutic and prophylactic effect of natural mineral waters (MW) used to restore tissue tolerance to glucose and normalize basal insulin secretion in metabolic syndrome is well known. At the same time, the use of selenium-enriched MW is promising due to its multitarget action including participation in the regulation of the protein-synthesizing function of cells.

AIM

To study the effect of internal course intake of selenium-modified mineral waters of different composition on bone mineral density after long-term diet-induced metabolic disorders in the experiment.

MATERIAL AND METHODS

The study was carried out on outbred male white rats that were distributed into 3 control groups (CG) and 4 main groups (MG). In CG1 14 animals received laboratory food and drinking water; in CG2 14 animals were modeled for diet-induced metabolic disorders, and they were withdrawn from the experiment the day after the cancellation of the hypercaloric diet (180 days); after the cancellation of the hypercaloric diet 180 days later 14 animals with diet-induced metabolic disorders in CG3 had a standard diet (laboratory food and drinking water) for 30 days. In the experimental groups (EG), the animals similarly to CG3 were modeled diet-induced metabolic disorders, after the cancellation of the diet they had a standard diet and watering with MW. In MG1 18 animals were given MW1 (Essentuki-4); in MG2 19 animals had a course of MW1Se (Essentuki-4 enriched with selenium); in MG3 14 animals had a course of MW2 (Slavyanovskaya); in MG4 18 animals had a course of MB2Se (Slavyanovskaya enriched with selenium). The weight (body weight) of the animals was monitored monthly. Biochemical studies, densitometry and computed microtomography were used to determine the effectiveness of MW.

RESULTS

The characteristics of spongy bone tissue of femoral metaphysis of the rats of the control groups revealed disorders of varying degrees, but, despite this, the bone tissue structure of the examined vertebral bodies in animals without a hyper caloric diet (CG1) was preserved. The analysis of the study results demonstrated a significant effectiveness of selenium-enriched MW in regulating metabolic processes (p<0.05-p<0.01), bone mineral density (p<0.05), reduced bone resorption (p<0.05), that is, the characteristics of spongy bone tissue of femoral metaphysis and vertebral bodies of animals showed a clear tendency to restore bone structure.

CONCLUSION

The results of this study make it possible to predict an increase in the effectiveness of medical rehabilitation of patients with somatic diseases when selenium-enriched MW is included in the programmes.

[The impairment of bone-mineral metabolism in the development of benign paroxysmal positional vertigo]

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of systemic vertigo in clinical practice. The results of recent research demonstrated the decrease of bone mineral density, level of vitamin D and estrogen in blood serum in patients with BPPV. In summary these data points at the relationship between osteoporosis/osteopenia and BPPV. This association is most obvious in menopausal women and in those with recurrent BPPV. Patients with recurrent BPPV should undergo investigation for osteoporosis/osteopenia. Treatment of bone-mineral metabolism allows decreasing the frequency of BPPV recurrence, however more research is needed in this area.

OSTEOPOROSIS IN RUSSIAN FEDERATION: EPIDEMIOLOGY, SOCIO-MEDICAL AND ECONOMICAL ASPECTS (REVIEW)

The authors performed an analysis of published stadies devoted to osteoporosis situation in Russian Federation including epidemiological, social, medical and economical aspects of this pathology. The analysis demonstrated that osteoporosis is reported in every third woman and every forth man of 50 years old and older. Seven vertebra fractures happen every minute and one fracture of proximal femur — every 5 minutes in Russia. An overall number of all key osteoporotic fractures will increase from 590 thousand up to 730 thousand cases by the year 2035. Osteoporosis is financially demanding for healthcare due to high treatment cost of fractures that are accompanied by life quality deterioration, high mortality and invalidization of patients. Epidemiological studies demonstrated that due to high fracture risk the osteoporosis therapy should be assigned to 31% of female and 4% of male patients over 50 years old. Such factors of osteoporosis risks are widespread in the society: smoking, low food calcium consumption, vitamin D deficit, low physical activity. The authors analyzed the problems in organization of medical care to patients with osteoporosis and osteoporotic fractures and possible solutions to existing issues. The organization of healthcare should be addressed at identification of high risk patient groups, early diagnosis and assignment of corresponding treatment aimed at decreasing potential fracture risk as well as at pathology prophylaxis.