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 1/2001

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 1/2001
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.

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 1/2001

OR

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52

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: ,
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[11]. ,
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. ,
, ,
J- [14].
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. . - , , ,
,
.

, .
[10,16,17].
,
9704

[10]. , , .

,
:
, , , , 25-50 , , 50 .
SUMMARY
The aims of this study were to determin risk factors for hip
fracture in women aged 50 years and over. We studied women
aged 50 years and over who lived in Electrostal town (suburb
of Moscow). There were investigated 180 women: 60 women
with sustained hip fracture (in period 1992-]999 years) and
120 women were in control group. We found out the next
significant risk factors: Low weight and body mass index,
impairment cerebral circulation, sedative and soporific drugs,
late menarche, early menopause, low physical activity at the
work in 25-50 years, smoking, alcohol intake and history of
maternal hip fracture.

1. .. -
// . 1998. 1. . 4-7.
2. .., .. I // . 1999. 1. . 2~5.
3. Cooper G.S., Sandier D.P., Long-term effects of reproductiveage menstrual cycle patterns on peri-and postmenopausal fracture risk.
Am. J. Epidemiol. 1997; 145; 804-809.
4. Cornaz J.. Fcskanich P. et al. Smoking, smoking cessation and
riskofhip fracture in women. Am. J.Med. 1999; Mar.'106(3): 311-4.
5. Couplarid C.A., Grainge M.J. Occupational activity and bone
mineral density in postmenopausal women in England. Osteoporosis Int.
2000; 11(4): 310-5.
6. Cummings R.G.. Klineberg R.J. Breastfeeding and other
reproductive factors and the hip fractures in elderly women. Int.
J.Epidemiol. 1993 Oct.;22(5):962.
7. Cummings R.G., Klineberg R.J. Case-control study of risk
fractures in the elderly. Am. J. Epidemiol. 1994,Mar.l;139(5):493-503.
8. Cuo Z., Wills P. et al. Cognitive impairment, drug use, and
riskofhip fracture in person over 75 years old: a community-based
prospective stuy. Am. J. Epidemiol. 1998. V. 148:887-892.
9. Feskanich P., Willet W.C. et al. Milk dietary calcium, and
bone fractures in women; a 12-year prospective study. Am.J.Public Health
1997 Jun;87(6):992-7.
10. Fox K.M., Cummings R.G. et al. Family history and risk of
osteoporotic fracture. Study of Osteoporotic Fractures Research Group.
Osteoporosis Int.l998;8(6):55762.
11. Hansen S.A., Folsom A.R. et al. Association of fractures with
caffein and alcohol in postmenopausal women; the Iowa Women's Health
Study. Public.Health Nutr.2000 Sep.;3(3):253-261.
12. Jaglal S.B., Kreiger N. Lifetime, occupational physical activity
and riskofhip fracture in women. J.Epidemiol. 1995Jul;5(4):3214.
13. Joakimsen R.M., Magnus J.H. et al. Physical activity and
predisposition for hip fractures: A review. Osteoporosis Int. 1997:7:503
513.
14. Johnell O., Gullberg B. et al. Risk factors for hip fracture in
european women: The MEDOS studyJ.Bone Min Research. 1995; V. 1
0(11): 1802-1815.
15. Schwab M., Roder F. et al. Psyhotropic drug use, falls and
hip fracture in the elderly. Aging 2000 Jun; 12(3): 234-9.
16. Steven R.C., Cummings M.D. etal. Risk factors for hip fracture
in white women. The New Engl. J. Med.1995 March 23. V. 332 (12):
767-773.
17. Stevart A.. Calder N. etal. Prevalence of hip fracture risk
factors in women aged 70 years and over. Q.J.Med.2000:93:677-680.

 1/2001

.. , ..
-
, -
-, () 1996 . (=711), (=209).
, , 209 (122 87 )
. , , , ,
ADL (activities of daily living - )
IADL (instrumental activities of daily living - ).
, 82,4%
, 13,6%
5% .
, , , ,
(). - ,
,
[4].
,
, ( , , , ),
[1].
, - ,
- ,

,
.
,
, . ,
[2].
-
. , , , ,
[2].
, ,
45
, (. 1) [6].
-.

- ,
. -
1.01.98 60 700 ,
80 - 98438 , 90 - 10565
, 100 - 97 .
90-99
- 1979 .
1999 . . 2.
- , ,
.
, ,

.

1.
-, , (). ,
2. ,
,
.

1996
1999 . .
()
, 1996 .

 1/2001

/>50%
30%< /<50%
/ <30%

. 4.

(/)
7089

/>50%
30%< /<50%
| / <30%

. 5.

(/)
9099
711
60 107 , . -
.
, , , ,
.


. 209
(122 87 ) 90-99- , 1997-1999 . ,
,
,
, ,
, ,
. .
,

 1/2001
[5, 7], , , ADL (activities of daily
living - ) 1ADL
(instrumental activities of daily living -
).

, ,
, . .
. 1.
, 711 , 1996
., 8,2% 60-74 , 13,6% - 75-89
, 22,6% - 90-99 25% - 100- [3].
40
(19,1%) . 50-69 2 - (1,6%), 70-89 - 18 (14,7%) 2 (2,3%), 90-99 - 25
(20,5%) 3 - (3,4%).

6 (15%).
(.
3).

. .
,
90 .

70-89 90-99
. 4 5 .
,
( 70-89 - 52%, 90-99 - 81,4%). 15,4%
.


50%, ( 70-89 23%, 90-99 - 5%).
( , , , )
( 70-89 - 25%, 90-99 - 13,6%).

1. .
2. -
. , 90 .
3. ,
,
9 , -.
SUMMARY
It was studied the abundance of hip fractures among the
inhabitants of St-Petersburg, including elderly people. It was
researched the influence of the complicated osteoporosis on
capacity to self-service of elderly people. The capacity to selfservice was valued on a technique, designed on the basis of
research of functions ADL (activities of daily living) and I ADL
(instrumental activities of daily living).
It is established, that after hip fracture there comes sharp
deterioration of quality of life in forthcoming period of life of
the elderly people. With increase of age the risk of hip fracture
rises (especially among women).

1. .. -
// . 1998.
1. . 4-7.
2. : , , 1996 // . 1997. .
5, 15. . 956-961.
3. .., .. //
. , 1999. . 597
598.
4. Consensus Development Conference: Diagnosis,
prophylaxis, and treatment of osteoporosis. Am. J. Med.
1993; 94: 646-650.
5. Duthie: Practice of Geriatrics, 3rd ed., Copyring
1998 W.B. Saunders Company. 7-8.
6. Kanis J.A., Delmas P. et al. Guidelines for
Diagnosis and Management of Osteoporosis// Osteoporosis
Int. (1997) 7:390-406.
7. Mahoney F.I., Barthel D.W.: Functional evaluation:
The Barthel Index. Md State Med J 1965; 14 (Feb): 6 1 65.

 1/2001

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1,5
[16].
. McCarthy E.F. & Frassica F.J. [13]: ,
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25% ,
2, 18% . ,

,
.
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.

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-

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),
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.

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,
.

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),
, .
( ), -

 1/2001

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 1/2001
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+05

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.
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(): 1-, 2,
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[1].
50
( 26,5) ,

-
( %) ( - , .. ).
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 1/2001

- , , - [8, 11].
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, ,
,
.
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, ,
, .

. 1. ,
.
,
- -
, . .

[15].
, ,
, () -
, ,
, .
. ,
( ). -,
() ,
[7].
( )
, , , - - , .
. . -
[6], : - ().
-
, .
.

-

, .

(peak bone mass) . 6,7.
,
.
( 40-60%),
, ,
, .
Meunier [14],

( , , - ).
, .

1. .., .., j
.., ..
// 3-
. ., 2000. . 91.
2. .. ; . P.P. Bpe. ., 1999. . 3-12.
3. .. . , 1932. . 1.
. 145.
4. .., .., ..
.
// . 1999. 3. . 2-6.
5. . . //
3- . ., 2000. . 62.
6. .. - // , . 1983. 2. . 12-16.
7. .. . .: , 1993.
8. ..
. . . 40-41.
9. .. - .
.: , 1986. . 81-88.
10. ., . . ., 1995. .
132-138.
11. Collins D. Pathology of Bone. London, 1966. 254 p.
12. Horowitz M.C. Cytokines and estrogenes in bone: antiosteoporotic effects. Science. 1993. 260-626.
13. McCarthy E., Frassica F. Pathology of bone and Joint
Desorders. Philadelphia, 1998, 88-92.
14. Meunier P. J. Bone hystomorphometry in osteoporotic
states. In Barzel U.S. In Osteoporosis 11. Grune & Stratton,
New-York, 1979. P. 27-47.
15. Moller G., Delling G. Age related Bone Changes of
the proximal Femur and its Relation to Hip Fracture. The 8
Congress of the International Society Of Bone Morthometry.
Scottsdale. AZ, 1999, Abstracts 33.
16. Silver J.J, Einhorn T.A. Osteoporosis and aging. Clin
orthop, 1995. 316, 10-20.

 1/2001

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Andersson [14]. 1, 6 12
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.



Andersson [14].
1,6, 12
, - 6
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-
3- - ( 1- 2- 20
, 3- 10 ).
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.

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 1/2001
1

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%

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%

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%

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30-39

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, .

.

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100 , . 200 , (. 1). ,
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<0,05).
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.
,
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,
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. ,
, . ,
(
), ,
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 1/2001

1.
.
2. , .
3.
.

. ,

, , . ,
.
1. , , , .. ,
. , , .

2. ,
. , ,
SUMMARY
, , . 1
Qualitative and grantative analyses of osteoporosis by different , .

forms of COPD were estimated in material of 57 autopsy and in
, ,
experiment as conducted research shows the fact of increase of
. bone tissue resorbtion by COPD, and it is depended ofharolship
, of disese and conducted thesapy.
,
Experimental studies indicates on appointed intercommunication . between character and degree patomorphologic changes in organs
, (35
- , ,
of airway and condition of bone tissie.
, .. ,
).

3. . , . 1, 1. . , . ., . ., ( ),
. . , , . ., 1998. 67 .
, , 2. . ., . ( ).
D. Basle, EULAR Publishers, 1996. S. Y. S.
4. Publishing 1996, Moscow (. .). 140 .
. 3. . ., . . , 2-3%. ,
. , 1989. 208 .
, 50 .
4. . ., . ., . .,
. . //
. 1995. . 73, 6. . 8-10.
5. . ., . ., . ., . ., . . // . 1999.
2. . 76-79.
6. . .
: . ... .
2000.
7. . ., . ., . . . , 1981. 166 .
8. . . // .
1994. 3. . 57-62.
9. . . . .: , 1993. .
367.
10. . . :
- //
. 1998. 5. . 25-32.
. . ., . . . .,
1981. . 311.
12. . ., . ., . .
- . , 1983. . 193.
13. .. . ., 1997. . 1. .
78-113.
14.Andersson P. Antigen-induced bronchial anaphylaxis in
actively sensitized guinea pigs // Allergy. 1980. V. 35. P. 65-71.
15.Pluskiewich W., Rogala E. // Przegl. Lek. 1997. V. 54.
P. 21-24.
16.McEvoy C.E., Ensrud K.E., Bender E. et al. // Am. J.
Respir. Crit. Care Med. 1998. V. 157. P. 704-709.

5. ,
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130 160 . ,
, ,
.
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.
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, ,
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, . , .
, : 1 * - 0,24+0,16
0,390,31, .
8.
, . , , ,
, (
, ). , ,
.

1- , . - .
2 3, ,
, .

 1/2001

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- ( - . AM.
-
17 . 10 , , . 200 ME : 3 . , 3 . .
(12 .) 500 200 D.
3 1,4 , () 2,3%
.
( 0,8%
1,5%). 1,6% 1,1%
. - 12 , (
, 1 ) . , , , . 17 .
() , ,
.
, .

.
[9]
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[8]. 5-6
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). [3], [3,5,6].
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.

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.

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 1/2001
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.
:
12 . .

QDR 1000W Hologic
().
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61,98,6

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13,86,4
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PROOF
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,

 1/2001
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-

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(
0,9%),
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,
.
,

, .

, 2- (2- 1 1 ). 3
2- 2- .
. PROOF
. ,

,
, , , .
2 , 2 .
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, 2- . ,
- D, 1000
400 D,. , , , ' .

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. 2, 1 .

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 1/2001

1. .. ( ) // . 1998. 1. . 39-40.
2. .., .. : . 1998. .49.
3. .. 5- PROOF // . 1999. 8(2).
4. .., ..,
.. . .:
. . 140-147.
5. .., .., ..
.
: .
. 1999. 3. . 23-27.
6. .., ..,
.. - : // . 1999.
2. . 13-15.
7. Abellan-Perez M., Bayina-Garcia F.J., Calabozo
. et al. Multicentre comparative study of Synthetic
salmon calcitonin administered nasally in the treatment
of established postmenopausal osteoporosis. An.

Med.lnterna 1995,12:12-16.
-
(3 , 3 8. Clissold S.P., Fitton A., Chrisp P. Intranasal
) salmon calcitonin. A review of its pharmacological

properties and potential utility in metabolic bone disorders
, associated with aging. Drugs & Aging 1991,1:405-423.
2,3%,
9. Dempster D.W. The bone quality concept the
0,8%
impact of bone remodeling on skeletal integrity. 3rd
,
Miacalcic expert meeting. Abstr. 2.
. ,
10. Ellerington M.C. et al. Intranasal salmon
,
calcitonin for prevention and treatment of postmenopausal
(2 , 2 ),
osteoporosis. Calcif. Tissue Int.. 1996,59:6-11.

ll.Gennary C, Agnusdey D., Camporeale A. Effect
salmon calcitonin nasal spray on bone mass in patients
. with high turnover osteoporosis. Osteoporosis Int. 1993.
3: Suppl. 208-210.
.
12. Overgard R. and Christiansen. A new biochemical
.
marker of bone resorbtion for follow-up on treatment
with nasal salmon calcitonin. Calcif.Tissue Int. 1996.
59: 12-16.
SUMMARY
13. Peichl P., Rintelen ., Kumpan W and Broil H.
In the present study we assessed the efficacy and safety of
intranasal salmon calcitonin (Miacalcic, Novartis pharma) Increase of axial and appendicular trabeculaf" and cortical
bone density in established osteoporosis with intermittent
in a group of 17 women with established osteoporosis (Tscore<-2,5SD). The patients of the main group were treated nasal salmon calcitonin therapy. Gynecol. Endocrinol.
1999,13:7-14.
with 200 IU nasal salmon calcitonin daily for 3 month with
subsequent pause of 3 month (2 cycles) and 500 mg calcium
14. Silverman S.L., Chtsnut et al. Salmon
daily over total 12 months in open controlled study. The
calcitonin nasal spray in osteoporosis: 5-year worldwide
patients were compare with an age matched control group of data of the PROOF study. Bone. 1998. 23 (Suppl). S174.
10 women of a similar clinical status. Our results demonstratedAbstr. 1108 (2-nd Joint Meeting of the Amer.Soc. for Bone
that intranasal treatment with 2001U daily effectively influenceand Mineral Res. and Internet. Dec. 1-6,1998).
on the back pain, reduces bone turnover and significantly
increase BMD in lumbar spine and trochanter. There was
nonsignificant change in BMD in femoral neck, Ward's
triangle and total hip. We did not reveal side effects in
intranasal calcitonin's treatment.

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 1/2001
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 1/2001

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.

and osteocalcin () vs. baseline and vs. controls at all

treated women, and a significant increase in serum tartrateresistant acid phosphatase vs. baseline in treated Cushing 's
patients. No significant mean BMD and calcaneal Stiffness
changes were found both in treated and control groups, but
spinal BMD increased in 74% of treated women vs. 30% of
controls. We compared 4-months changes of bone markers in
responders and non-responders to Ossin treatment by spinal
BMD.
There were an increase in AP (p<0.05 vs. Baseline),
and a decrease in TmP/GFR (p<0.001 vs. baseline and vs.
non-responders after 4 months) and iP (p<0.05 vs. baseline)
in responders. There were no any significant changes in
biochemical picture in non-responders.

1. .., .. .
-
// . 1999. 1. . 33-36.
2. .., . , .. // . 1999. 1.
. 30-32.
3. .., III . : . . .
- .: , , 2000.
560 .
4. .. - : . ... . /. , 1990.
5. ., . : . . .: , 1995. 304 .
6. Baylink D., Duane P.B. et al. Monofluorophosphate physiology:
the effects of fluoride on bone // Caries Res., 1983. V.17 (suppl. 1). P.
56-76.
7. Baylink D., Wergedal J. et al. Effects of fluoride on bone
formation, mineralization, and resorption in the rat. In: Vischer T.L.
ed. Fluoride and medicine. Bern: Hans Huben, 1970. P. 37-69.
8. Charles P., Mosekilde L. et al. Effects of sodium fluoride,
calcium phosphate, and vitamin D: for one to two years on calcium and
phosphorus metabolism in postmenopausal women with spinal crush
fracture osteoporosis // Bone, 1985. V. 6. P. 201-206.
9. Eriksen E.F., Mosekilde L., Melsen F. Effects of sodium
fluoride, calcium phosphate, and vitamin D: on trabecular bone balance
and remodeling in osteoporotics // Bone, 1985. V. 6. P. 381-389.
10. Farley J.R., Wergedal J.E., Baylink D.J. Fluoride directly
stimulates proliferation and alkaline phosphatase activity of bone-forming
cells // Science, 1983. V. 222. P. 330-332.
11. Ivey J.L., Farley J.R., Baylink D.J. Alkaline phosphatase
response in sodium fluoride-treated osteoporotics // Clin. Res., 1981.
V. 29. P. 95 (abstr.).
SUMMARY
12. Kassern M., Risteli L. et al. Formation of osteoblast-like cells
from human mononuclear bone marrow cultures // APM1S, 1991. V.
The aim of this study was to investigate the effectiveness
99. P. 269.
of OssinT in the treatment of glucocorticoid-induced
13. Lane J.M., Healey J.H. et al. Treatment of osteoporosis with
osteoporosis in postmenopausal women and to assess the
sodium fluoride: Effects on vertebral fractures incidence and bone
usefulness of bone turnover markers for monitoring fluoride histomorphometry // Orthop. Clin. North Amer., 1984. V. 15. P.
729-745.
treatment efficacy.
14. Nordin B.E.C. Calcium, phosphate and magnesium metabolism.
Methods: 11 osteoporotic women used corticosteroids and Edinburgh, 1976. P. 469-500.
9 women suffered from Cushing's disease received 80 mg/
15. O'Duffy J.D., Wahner H.W. et al. Mechanism of acute lower
day of Ossin for 6 months. Two control groups consisted of 10 extremity pane syndrome in fluoride-treated osteoporotic patients // Am.
J. Med., 1986. V. 80. P. 561-566.
women with glucocorticoid-induced osteoporosis did not receive
16. Pak C.Y.C., Sakhaee K. et al. Treatment of postmenopausal
any treatment for study period. BMD, calcaneal Stiffness,
osteoporosis with slow-release sodium fluoride: Final report of randomized
controlled trial // Ann. Intern. Med., 1995. V. 123. P. 401-408.
clinical and laboratory picture were assessed.
17. Riggs B.L, Hodgson S.F. et al. Effect of fluoride treatment on
Results: The bone pain significantly improved after 3 month
fracture rate in postmenopausal women with osteoporosis // N. Engl. J.
and the asthenia diminished after 6 months in treated women. Med., 1990. V. 322. P. 802.
We found a significant decrease in serum inorganic phosphorus 18. Riggs B.L., O'Fallon W.M. et al. Clinical trial of fluoride therapy
in postmenopausal osteoporotic women: Extended observations and
(iP) and renal tubular maximum reabsorption of phosphate
analysis // J. Bone Miner. Res., 1994. V. 9. P. 265-275.
relative to glomerularfiltration rate (TmP/GFR) vs. baseline, additional
19. Suzuki Y., Ichikawa Y. et al. Importance of increased urinary
and 24-hour urinary calcium on a standard limited calcium calcium excretion in the development of secondary hyperparathyroidism
intake vs. controls in treated patients. There were a significant of patients under glucocorticoid therapy // Metabolism. 1983. V. 32.
increase in serum total alkaline phosphatase (AP) vs. controls P. 151-156.

1.
.
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 1/2001

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SUMMARY
The benefits of calcium and vitamin D supplementation in
elderly institutionalized women is well documented. But the
results of such therapy for prevention osteoporosis in
postmenopausal women are controversial. To determinate the
effect of 1-year treatment by 1000 mg calcium and 400 ED
vitamin D3 on bone mineral density (BMD) and parameters
of Ca-P homeostasis 58 women with osteopenia aged 52-70
years were studied. They were divided in 2 groups: treated
group - 28 women, who had received 2 tablets CaD3 Nycomed
daily (1000 mg Ca and 400 ED vitamin D3); control group ~
30 women did not take any medicine for 1 year. Current Ca
intake without Ca supplement was calculated in both groups:
652 79 mg and 638 94mg respectively
There was no significant difference between groups and
between baseline and after 1 year in each group in Ca,
P, alkaline phosphatase. BMD did not change significantly
from baseline in both groups. But we revealed significant
difference in vertebral and femoral BMD between control
and treated group after I year and decrease ofPTH level
in treated group

Conclusion. Calcium and vitamin D supplement prevents

bone loss in vertebrae and proximal femur in postmenopausal
women with osteopenia; such intervention is safety.

1. .., .. - ( ) // .
2000. 1. . 35-39.
2. .. D:
( ) // . 1998. 3. . 42-47.
3. ..
// .
1998. 1. . 43-45.
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Calcium supplementation with and without hormone
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 1/2001

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The material and method.

The calcimax has been produced by the Artlife company
(Tomsk, Russia). The calcium hydroxiapatit (200 mg per 1
capsule) It is balanced with the microelements and vitamins.
31 women, who suffer from the osteoporosis disease, at
the age of 47 to 64,took place in the prospective randomised
investigation. All the patients were subdivided in two groups
(16 and 15 patients).
The basic group patients, exempt prophylaxis and following
the recommendations, took two capsules after light supper before
going to bed within 6 months.
The comparative analysis of the monthly monitoring of the
average number of the PS intensity has shown the
tmstworthy(p<0.05)lowering of them. The Calcimax rises the
(1) level in the blood plasma also.
So the Calcimax may used as the common preventive
remedy.

1. ..
,
. . .
1993. 3. . 7-12.
2. .. , 1999.
9-10. . 549-555.
3. . . . // . 1999. 4. . 19-23.
4. .. :
( ) // . 1998.
3. . 42-47.
5.
: . //
. 2000. 9 (2). . 1-4.
6. : . //
. 1999. 4 . . 2-6.
7. .. (, , ). : -, 1996. . 198.
8. .. -.
. , 1999. . 130-131, 134-142.
9. ., . ( .). .: , 1995. . 299.
10. Annefeld M. et al. The influence of ossein-hydroxyapatite
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15. Spenger H. et al. Calcium reguirements in humans, Clin.
Orthop. 184 (1984): 270-279.

( , ) .

.
,
, . ,
SUMMARY
, The purpose of the investigation: to study the biological
active addition(BAA) Calcimax influence on the pain
,
syndrome(PS) dynamics and the psycho-emotional breaches, on the Ionized calcium level in the blood plasma of the
, osteoporosis patients.
.

 1/2001

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1. ..
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141-142.
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11. .., .., ..
60- //
- . . . 1985. 7208--85. . 93-99.
12. .., ..
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. ., 2000. . 119-120.
13. ., ., ..,
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3. . 51-56.
14. .. :
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16. ., .., .. :
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17. ., .., .. :
2029550.
18. ., .., ..,
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: 2155588.

20. .., .., .., ..

// .
., 1997. . 116-118.
21. .., .., .., ..
- : . .: , 1997.
22. .., .., .. . //
. , 1988. . 272-273.
23. .., . // - ,
. ., 1990. . 24-28.
24. ..
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25. .., .., ..,
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:
2101015.
26. .., ..
// . ., 1994. . 10-11.
27. .., .. . // . . . . .: .
. 1986. 1.
28. Altman R.D., Johnston , Khairi M. et al. Influence of
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Disease of Bone (Osteitis Deformans) // N. Engl. J. Med. 1973. V.
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29. Fleisch H. Bisphosphonates in Bone Disease. From the
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30. Fogelman I., Smith M., Mazess R. et al. Absorption of Oral
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31. Hughes D.E., Wright K.B., Uy H.L. et al. Bisphosphonates
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zoledronate induce apoptosis in breast cancer cells in vitro - evidence
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2000. V. 26, 3 (Suppl.). P. 42 s.




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