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, 117036, . . , . 11. .
E-mail:rozh@endocrincentr.ru
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. 016589 10.09.97. 60x90/8. 5000 . 57.
. ISBN 5-7886-0002-5. , . .
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3/2002

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.

SUMMARY
A prospective investigation of randomized cohort of 521
subjects aged 50 and over (inhabitants of the Moscow City,
211 men and 300 women) was carried out with the aim to
study the incidence of new cases of fractures over the period
1990-1999. The incidence of new cases of fractures reached
on average 0,7 in men and 3,8 in womenper 100 person-years
(p/y), with statistically significant prevalence in women (p <
0,00004). The maximum incidence in women was noted in the
60-69 years age group. The majority of new fractures (40,4%)
were localized in the distal part forearm, of them 90,5% were
registered in women.
The incidence of the new distal forearm fractures in men
calculated per 100 000 population aged 50 years and over
amounted to 195,3 and in women to 1290,8 p/y. Only two
fractures of the proximal femur were registered in women over
the whole period of the prospective study, their incidence
reaching 135,9/100.000p/y. Falls, which were statistically
significantly more frequent in women than in men, are a factor
of high risk of fracture, which was indirectly corroborated also
by a higher incidence of fractures in winter time when the risk
of falls is especially high. Low bone mineral density of the hip
are an important predictor of fractures.

1. .. -
// . 1998. 1:4-7.
2. .., .., .. .
// . 1999.
3: 2-6.
3. Alffram P.A., Bauer C.H. Epidemiology of fractures of the forearm: a
biomechanical investigation of bone strength // J Bone Joint Surg(Am), 1962; 44A:
105-114.
4. Bonar S.K., Tinetti M.E., Speechley M. et al. Factors associated with
short-versus long-term skilled nursing facility placement among community-living
hip fracture patients // J Am Geriatr Soc. 1990; 39: 1139-1144.
5. Campbell A.J., Spears G.F., Borne M.J. Examination by logistic regression
modelling of the variables which increase the relative risk of elderly women compared
to elderly men // J Clin Epidemiol 1990; 43: 1415-1420.
6. Chalmers J., Ho K.C. Geographical variations in senile osteoporosis // J
Bone Joint Sur Br. 1970; 52: 667-675.
7. Chrischilles E.A., et al. A model of lifetime osteoporosis impact // Arch.
Intern Med. 1991; 151: 2026-2032.
8. Cooper C, Campion G., Melton III L.J. Hip fractures in the elderly: a
world-wide projection. Osteoporosis Int. 1992; 2: 285-289.
9. Elffors I., Allander E., Kanis J.A. et al. The variable incidence of hip
fracture in Southern Europe: the MEDOS Study // Osteoporosis Int 1994; 4: 253
263.
10. Grisso J.A., Kelsey J.L., Strom B.L. et al. Risk factors for falls as a
cause of hip fracture in women // N Engl J Med 1991; 324: 1326-1331.
11. Johnell O., Gullberg ., Allander E. et al. Thr Apparent Incidence of
Hip Fracture in Europe: A Study of National Register Sources // Osteoporosis Int
1992; 2: 298-302.
12. Kanis J.A. and MEDOS Study Group. The epidemiology of hip fracture
in Europe: the WEDOS Study // Rev Clin Esp 1991; 188 (suppl 1): 18-20.
13. Kanis J.A., Pitt F. Epidemiology of osteoporosis // Bone. 1992; 13 (suppl.
1); S7-S15.
14. Kanis J.A. Osteoporosis. Blackwell Science, London. 1994; 1-21.
15. Kanten D.N., Mulrow CD., Gerety M.B. et al. Falls: an examination
of three reporting methods in nursing homes // J Am Geriat Soc 1993; 41: 662-666.
16. Lips P. Epidemiology and Predictors of Fractures Associated Wiyh
Osteoporosis // Am J Med. 1997; V. 103, 18: 4S-8S.
17. Maggi S., Kelsey J.L., Kitvak J. et al. Incidence of hip fractures in the
elderly: cross-national analysis // Osteoporosis Int 1991; 3: 232-242.
18. Mallmin H., Ljunghall S. Incidence of Colles' fracture in Uppsala: a
prospective study of quarter-million population // Acta Orthop Scand 1992; 63:
213-215.
19. MeltomJ.L. Epidemiology of hip fractures: implications of the exponential
incrrase with age // Bone. 1996; 3: 113-119.
20. Melton L.J III., Amadio P.C., Crowson C.S., O'Fallon W.M. LongTerm Trends in the Incidence of Distal Forearm Fractures // Osteoporosis Int 1998;
8: 341-348.
21. Nevitt C.N., Cummings S.R., Hudes E.S. Risk factors for injurious falls:
a prospective study // J Gerontol 1991; 46(5): M164-M170.
22. Philips S., FoxN., Jacobs J. etal. The direct medical costs of osteoporosis
for American women aged 45 and older, 1986 // Bone. 1988; 9:271-279.
23. Poyser A. Osteoporotic fracture. MEDOS // Sandorama 1993, Special
1, Bone Disease and Fracture, 23-28.
24. Reeve J. The European Prospective Osteoporosis Study // Osteoporosis
Int. 1996; V. 6, Suppl. 3: 16-18.
25. Wickham C, Cooper C, Margetts B.M. et al. Muscle strength, activity,
housing and the risk of fall in elderly people // Age Ageing 1989; 18:47-51.

3/2002



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3/2002

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.
SUMMARY
The purpose of this study was to examine how
osteoporosis have influence on quality of life of women
with RA in postmenopausal period.
Subjects and methods: 134 women with RA in
postmenopausal period were included in this study
Patients were divided into two subgroups (osteoporotic,
normal) according to their X-ray-morphometric results.
Quality of life survey included 13 questions about:
family, parents, children, relatives, friends, colleaques,
chief, job, sex, financial state, conditions of life, physical
state, emotional state. Each question was ranked on a
five-point scale, in which a rating of 1 respresented the
worst possible answer- and rating of the 5 - the best possible
answer. The total score could vary from 13 to 65 (we used
the mean value). Patients could exclude the questions,
which they considered not important.
Results: The state did not show significant relationship
with some of these parameters (BMI, duration of
menopause, number of children, education, menarche
age, severity of RA).
Comparativly well-being was found in relationship
with children, relatives, parents and friends of total
patients.
Summary quality of life of patients with osteoporosis
(osteoporotic fractures) was significantly low.
The factors, which worsen the quality of life
(p<0,05):
- age < 60 years;
- duration of RA > 10 years;
- therapy of corticosteroid, especially > 6 years;
- lead a lonely life (widows and, especially,
divorced);
- osteoporosis and osteoporotic fractures.
Conclusion: Quality of life of women with RA in
postmenopausal period significantly worse
with
osteoporosis and, especially, with osteoporotic fractures.

1. ..
// 43- -
. , 2001. . 10-11.
2. .., .. // . . . ., 2002.

3. .., ..,
.. // . : , 1981.
. 175.
4. .. // - . .,
1990. . 94-99.
5. .. // //
- . ., 1990. . 145-151.
6. . //
: . .
. ., , 1983. . 214-215.
7. .., .., ..
. // , . 1999. 12. . 9-11.
8. .., ..
// 43- -
. , 2001. . 32-34.
9. Baker G.H.B. // Psychological Management.
Clinics in Rheumatic Disease, 1981, 7, 2, 455-467.
10. Barnet-Connor E., Brenneman S. Quality of life
in women with osteoporosis. Osteoporosis Int. V. 13.
Suppl. 1, 2002. S 2.
11. Bolgen-Cimen O., Bagis S. et al. Resalts of
administration of mini Osteoporosis Quality of Life
Questionnaire in Turcish postmenopausal osteoporotic
patients. Osteoporosis Int. V. 13. Suppl. 1, 2002. S 93.
12. Brown G.M., Dare ., Smith P.R. Important
problems identified by patient with cronic arthritis. S. Afr.
Med. J., 1987, 72, 2, 126-128.
13. Jongjit J. Functional outcome and quality of life
after hip fracture in the elderly community - dwelling.
Osteoporosis Int. V. 13. Suppl. 1, SI38.
14. Hren R., Breznik M., Strah D., Cokolic M.
Patients perspective on impared quality of life due to
osteoporosis. Osteoporosis Int. V. 13. Suppl. 1, 2002. S
89.
15. Glueer M.G., Minne H., Lazarescu D. et. al.
/ Four Healht Related Quality of Life aspects and their
association to fracture status in women with postmenopausal
osteoporosis. Osteoporosis Int. V.13. Suppl. 1, 2002. S
37.
16. Gold D.T., Drezner M.K. : , http://www.osteoporosis.ru/ .07.02.
17. Gupta V.P., Ehrlich G.E. Organic brain syndrome
in rheumatoid arthritis following corticosteroid withdrawal.
- Arthritis and Rheumatism, 1976, 19, 1333-1338.
18. Moldofsky H., Chester W.J. Pain and mood
patterns in patients with rheumatoid arthritis. Psychocom.
Med., 1970, 32, 309-312.
19. Newman S., Fitzpatrick R. et. al. Factors
precipitating depressed mood in rheumatoid arthritis. Brit. J. Rheumatol., 1987, 26, Suppl. 2, 121.
20. Olcenler S., Cerrahoglu L. To assess the quality
of life in postmenopausal osteoporotic women with and
without vertebral fractures. Osteoporosis Int. V. 13. Suppl.
1, 2002. S 94.

3/2002

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1).
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1. D 3 ,
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2. D3 ,
, ,
.
3.
.
SUMMARY
The level calcium, calcidiol and calcitriol in blood
86 patients with reumatoid artritis (20 men, 66 women)
in the age of from 23 till 57 years were investigated.
The majority of the patients had seropositive rheumatoid
varthritis with slowly progressing current of disease, III
IV stage of disease. The relationship between level
calcium, calcidiol and calcitriol with a degree of activity
and character progress of disease was revealed, that
allows to use them as diagnostic criteria progress
osteoporosis at rheumatoid arthritis.

1. .., ..,
.. // , . 2002. . 8, 45. . 17-18.
2. .., , .., .. -

// . 1999.
31. . 14-17.
3. .., .. .
1-- (-3-) // . 1996. 1. . 75-78.
4. ..
// .
1998. 1. . 43-45.
5. Avioli L.V.
: . . ., 1982. . 136-147.
6. D Angelo A., Fabris A., Sartory L. et al. Mineral
metabolism and bone mineral content in rheumatoid
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1985. V. 3. P. 143-146.
7. Dawson-hughes ., Harris S.S., Dallas G.E.
Plasma calcidiol, season, and serum parathyroid hormone
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8. Gumming R.G. Gummings S.R. et al. Calcium
Intake and Fracture Risk: Results from the Study of
Osteoporotics Fractures // Am. J. Epidomiol. 1997. V.
145. P. 929-934.
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therapy) // Dtsch. Med. Wochenschr. 1994. V. 119 (43).
P. 1479^1485.
lO.Kroger H. Pentilla I. M., Alhava E.M. et al.
Serum vitamin D metabolites in women with rheumatoid
arthritis // Scand. J. Rheumatol. 1993. V. 22. P. 172
177.
ll.Oelzner P., Hein G. Inflammation and bone
metabolism in rheumatoid artritis. Pathogenetic viewpoints
and therapeutic possibilities // Med. Clin. 1997. V. 92.
P. 607-614.
12.0elzner P., Franke S., Muller A., Hein G., Stein
G. Relationship between soluble markers of immune
activation and bone turnover in post-menopasual women
with rheumatoid arthritis // Rheumatology (Oxford). 1999.
V.38 (9). P. 841-847.
13.Sambrook P. N., Abayaskere G., Ansell B.M. et
al. Calium absorpcion in rheumatoid artritis // Ann.
Rheum. Dis. 1985. V. 44. P. 585-589.
RScharla S.H., Ziegler R. (significance of vitamin
D and its metabolites in the pathogenesis and therapy of
osteoporosis) // Dtsch. Med. Wochenschr. 1994. V. 119
(23). P. 847-851.
15.Ueyoshi A., Kiura Y., Ota K. et al. The study of
parathyroid hormone and osteocalcin with rheumatoid
arthritis // Ryumachi. 1987. V. 27. P. 277-281.
16. Ushiyama O., Hiida M., Toyoshima H. et al. A
case of malignant rheumatoid artritis with long-term
improvement by regular use of cryofiltration plasmaferesis.
// Ryumachi. 1993. V. 33. P. 149-155.
17.Van Leeuwen J.P., Van driel M., Van Den Bemd
G. J., Pols H.A. Vitamin D control of osteoblast
function and bone extracellular matrix mineralization
// Crlt. Rev. Eukaryot. Gene Expr. 2001. V. 11 ( 1 3). P. 199-226.
18.Van Soesbergen R.M., Lips., Van Den Ende A.,
Van Der Korst J. K. Bone metabollism in rheumatoid
artritis compared with postmenopausal osteoporosis // Ann.
Rheum. Dis. 1986. V. 45. P. 149-155.

3/2002




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// -
. 2002. 1. . 19-21.
2. .. //
. ., 2002. .
3. .. //
8 , 21-24 , ,
2001. . 123.
4. ..
. , 1991. 344 .
5. .., .., P.P. . / . . .. .
.: , 1995. 432 .
6. ., . D: , . /
EULAR Publishers, Basle, 1996; . . . ,
S.Y.S. Publishing, Moscow, 1996, 140 .
7. .., .., ..
// : : . 1- ..
., 1994. . 110-111.
8. .., . , ..,
.. (-3)
: . .:
., 1998. 35 .
9. .. D: // Consilium Medicum. 1999. . 1, 5. . 212-213.
10. .. . 2- .,
. . .: , 2000. 196 .
11. .. , . .: , 2000. 189 .
12. .., .., ..

. // , . 1997. 3.
. 31-36.
13. .. , - : -
// . 1998. 3. . 2-7.
14. .. : // . 2001. 2. . 3944.
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18. Gallagher J.C., Fowler S.E., Detter J.R., Sherman
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niwum II xi} I (ii uixi: Kin

()

( )
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,


,
,
,

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, . - ,


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. (
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).
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. 304 , 60 ()

27 /2 39% (185) [48].
.
Ben Serdine et al. (2002) [4] ,
65
23% , .
. , -, Gluer Felsenberg [11] ,
1996 . .
: ) , ; ) ,
; ) ; )
, .
.

,
(bone
, mineral density, BMD) [14], ,
,
. , , , ,
(dual [26, 30, 32, 35, 47].
energy X-rays absorbtiometry, DXA) - , , [6,21].
80
[20], , - | ( > 2) [23, 24, 36, 47],
: 60 ,
, (<20-25 /2 40 ), . DXA
10%, ,
[23, 24, 36, 47],
, , , , . 15% - - . 18%
. DXA : , ,
, , ,
.
.
,
, ,
2-10 .
[19, 49].

3/200?

, , , .
. , , , [15,34].
Colon-Emeric et al. (2002) [13]
65 29% 77% ( BMD).
,
BMD, . , ,
, , ,
BMD, , [47].
, , . , 2 [15],
BMD 1,9.
, BMD . , ,
BMD [17, 18]. , , BMD, . - . BMD. SOF
1,9 , BMD 1,3
[40]. , , ,
.


[2, 28, 37] [28]. -
, .
, [8], 65 , 65 -
.
: ,
,

[29]. , [30, 35, 38]. -

, , [44], .
,
: SCORE
[35], SOFSURE [5], ORAI [10], [4], OST [31], OSTA
[1,22,41] . .
SCORE,
6 (, ,
, , , ), 91%
40% BMD
(- < 2) [35]. , , BMD , .
Reginster et al. [42],
: , ,
- 85%,
38,9%.
ORAI,
, ,
: 97% 41% [7]. , , ,
, . ,
,
[4].
,
(OSTA), , , (ORAI) [31]. OSTA
BMD :
() (), 0,2. ( < 2,5) 61%
OSTA, 15% -
3% - . , OSTA . , ,
,
, [41],
[1,22].
, (OST). , OST
,
. OST
: - OST - 3 ; OST -3 1; - OST > 1 [22].

, BMD,
, -

3/2002

OSTEORISK -
: , , , , ,
, , .
, , , ( 91%, 47%). (, , OST),
(92%
45% ) [43, 45]. OST,
OSTEORISK 65,6% , - 26,7%, 8% [43, 45].
65 (- = - 1,7) SCORE BMD ( 71%, 75%) [12]. ,
[3,25]. [8]

(
!) . , ,
, DXA.
,
OSTA BMD
[33, 39] (
81% 65%, OSTA - 84% 54% ),
BMD [39]. , OSTA, .
,


. , Hawker G.A.
et al. (2002) [27] ,
,
.
90%- ,
BMD / QUS .

BMD. Mc.Grother et al. (2002) [37]
70 , . , , , , ..
84%, - 68%. -

, , .
(EPIDOS [i6], MOF [14],
[9]), ,
,
( ) , ,
BMD (BUA).
, ,
, [13, 16].
,
Mc.Grother et al. (2002) [37]
BMD

3 ( 84% 68%).
.
, ,
( ).
,
10 (, , , -), Colon-Emeric et al. (2002) [13].
,

2,5
. , -
[8].

,
. OST,
. ,
. ,
. BMD .

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3/2002

4. Ben Serdine W., Broerst P., Devogelaer J.-P., Depresseux


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3/2002


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SUMMARY
The authors present modem concepts on the pathogenetic
mechanism ofosteopenic syndrome in women during lactating.
The data of the published information indicates on appointed
intercommunication between length of lactation and condition
of bone tissue. It is emphasized that the hyper'prolactinemia
may have negative influence on mineral bone density (BMD).
The question ofpathogenesis ofosteopenia of lactation women,
especially the role of rate ofestrogen and progesterone in the
blood serum is described in the special section. We conclude
that cytokines play the important role in disruption of bone
remodeling. Metabolism of bone tissue during lactating,
diagnosis of osteopenia, principals of bone densitometry are
described. BMD measurements of mostly trabecular skeleton
sites are recommended in women with physiological
hyperprolactinemia, because the bone loss process proceeded
most actively in skeletal sites in which concellous bone prevailed
Special attention is paid to necessity of prevention of bone loss
during lactating.

3/2002

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10. .., .., .. -
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- // / . . .. . :
-, 1999. . 423-484.
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. 1997. . 3, 1. . 19-32.
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//
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// . 2000. 6.
. 24-29.
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// . 1988.
. 33. 8. . 60-62.
19. .., .., .. //
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20. O.K., .., .. // . 1994.
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3/2002



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1. Management of postmenopausal osteoporosis:

position statement of the North American Menopause
,
Society. Menopause 2002, 9: 84-101.
. 2. Gennary Analgesic effect of calcitonin in
osteoporosis. Bone 2002. 30: 67S-70S.
, 3. Body J. Calcitonin for the long-term prevention
.
and treatment of postmenopausal osteoporosis. Bone
, 2002, 30: 75S-79S.