GENDER AND AGE ASPECTS IN THE PATHOGENESIS OF BONE MINERAL DENSITY DISORDERS

OBJECTIVE

The aim: To assess the structural and functional state of bone tissue in terms of gender and age.

PATIENTS AND METHODS

Materials and Methods: 108 people aged 54.7±14.8 years, who were divided into two groups according to gender, participated in the retrospective cohort study. All patients underwent ultrasound densitometry to assess bone mineral density (BMD) on the radial bone with an assessment of T-score, Z-score, and speed of ultrasonic wave propagation (SoS).

RESULTS

Results: The study found that T-score and Z-score values, which corresponded to osteoporosis, were recorded in the age group > 50 years, regardless of the gender of the subjects. All women older than 35 years had a decrease in BMD below -1.0 SD by T-score. It was determined that osteoporosis criteria clearly prevail in women of the > 50-year-old group. In osteoporosis, the SoS is significantly lower than in individuals with normal indicators of the T-criterion. According to the results of the T-score comparison, BMD disorders were determined in postmenopausal women which emphasize the importance of the level of female sex hormones in the formation of osteopenic syndrome, in contrast to men, in whom no changes in the state of bone tissue were recorded.

CONCLUSION

Conclusions: The results of the research prove the prevalence of osteopenic syndrome in terms of age and gender, with an emphasis on women aged 50 years and older. Screening for BMD disorders using ultrasound densitometry is appropriate and allows taking measures to prevent the progression of osteoporosis in the early stages.

Effects of facet joint degeneration on stress alterations in cervical spine C5-C6: A finite element analysis

It has been demonstrated that articular facet degeneration can cause local strain alterations and induce neck pain. This study aims to quantify the biomechanical effects of normal and degenerated C5-C6 articular facets, and evaluate the correlation of mechanical strain between healthy and degenerated spine. A 3-dimensional finite element (FE) model of the C5-C6 cervical spine was developed [Model 0 (M0)]. The asymmetric models of C5-C6 bilateral articular facet joint were established separately to mimic articular facet joint degeneration. The capsule ligament stiffness of C5-C6 unilateral facet joint was altered with minimum and maximum threshold to simulate capsule ligaments' lesion and calcification [Model 1 (M1) and Model 2 (M2), respectively]. Besides, the cervical C5-C6 unilateral articular facet joint direction was changed by 5° and 10° forward to imitate the moderate joint hyperplasia and severe osteophyte (Model 3 and Model 4 respectively). M1 increased the rotation range of ipsilateral side (left), while M2 reduced, and both had limited effect on the contralateral side (right). The angle increased in Model 3 (M3) (61°) and Model 4 (M4) (55°) comparing to M0 during the axial rotation, and the angle of M4 was larger. M3 and M4 increased the nucleus pulposus pressure with and without controlled angular displacement during axial rotation. The pressure of nucleus pulpous increased during M1 rotating to the abnormal side but decreased when rotating to the other side, but the results of M2 were opposite. The capsule ligament stiffness made an impact on segmental mobility and vertebral spatial position, and the sagittal angle of articular facet joint exerted an influence on disc pressure distribution.

Bone tissue lesion in oncological disease (literature review and own research data)

A review of the current literature and our own researches data are presented. Malignant tumors all over the world cause a huge medical social and economic damage, being one of the main causes of people death in all countries. Involving bones in the pathological process occurs in every other patient with cancer. Osteoporosis in patients with malignant tumors is often formed due to disorders of the reproductive and calcium-regulating hormones, we demonstrated the existence of close connection between malignant tumors and bone metabolism disorders. The latter manifests by increase in the synthesis of osteocalcin and osteopontin, the activation of alkaline phosphatase, imbalance of osteo-associated macro elements (calcium, magnesium, phosphorus) and microelements (cobalt, manganese, copper, strontium, chromium, zinc, and others), involving in the pathogenetic constructions of cancer and osteoporosis. We established our data, on the study of osteopontin and other markers of bone metabolism in patients with lung cancer. We found that lung cancer occurs with severe disturbances of bone metabolism, Changes in bone metabolism are aggravated by ongoing chemotherapy and radiation therapy of cancer. These data necessitate the development of anticancer therapy medical technology, which has protective effect toward bone metabolism, and creating of antiosteoporotic treatment, simultaneously directed to the tumor process.

[Clinical characteristics and medicinal analysis for osteoporosis based on real world]

To understand the actual clinical situation of osteoporosis patients in our country, 9 731 hospitalized patients with osteoporosis from HIS system of 20 national 3A-grade hospitals were selected as the research objects to analyze their general information, western medicine combined diseases, diagnostic information, relationship with the onset of 24 solar terms, and the therapeutics application. Results showed that the median age of hospitalized patients with osteoporosis disease was 72 years old, more common in women aged 60 to 74; mainly in manual workers (73.87%); most in general outpatient clinic during the admission; conditions of the most patients (81.61%) were general during hospital admission; patients were more likely hospitalized from orthopaedics department (21.94%); hospital length of stay was mainly of 8-14 days (39.96%); 34.34% of the patients had a total hospitalization cost of 5 000 yuan to 10 000 yuan; 75.01% of the patients were beneficial from national health medical insurance. The complications mainly included hypertension, diabetes, and osteoarthritis, and the complication rate was as high as 34.67% for hypertension; the most common traditional Chinese medicine syndrome was deficiency of liver-Yin and kidney-Yin (36.62%); the patients were admitted to the hospital most during 3 solar terms: beginning of summer, summer solstice and cold dew. Calcitonin salmon and calcium carbonate were most widely used in western medicine and Zhengqing Fengtongning was most widely used in traditional Chinese medicine. In conclusion, osteoporosis is more common in elderly patients, and is closely related to solar terms; integrated treatment strategies of traditional Chinese medicine and western medicine can be widely used in clinical application and have certain advantages.