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16УДК: 616.71-007.234 ANALYSIS OF THE EFFECTIVENESS OF HORMONE THERAPY IN PATIENTS WITH POST-CASTRATION SYNDROME
AKHMATOVA DILNOZA FURKATZHONOVNA
Master of the Department of Obstetrics and Gynecology, Bukhara State Medical Institute named after Abu Ali Ibn Sino, city of Bukhara, Republic of Uzbekistan. ORCID ID 0000-0003-4037-4333 KHAMDAMOVA MUKHAYYOKHON TUKHTASINOVNA DSc, associate professor of obstetrics and gynecology, Bukhara State Medical Institute named after Abu Ali Ibn Sino, city of Bukhara, Republic of Uzbekistan. ORCID ID 0000-0003-3128-6120
ABSTRACT
This article presents the results of many authors on the primary prevention of post-castration syndrome, such as osteoporosis, causes and consequences of hormonal imbalance, and methods of correction. The relationship of the reduction of steroid hormones with the mineral components of bones.
Key words: calcium deficiency circumstance, osteoporosis, hormone replacement therapy.
АНАЛИЗ ЭФФЕКТИВНОСТИ ГОРМОНАЛЬНОЙ ТЕРАПИИ У ПАЦИЕНТОК С ПОСТКАСТРАЦИОННЫМ СИНДРОМОМ
АХМАТОВА ДИЛНОЗА ФУРКАТЖОНОВНА
Магистр кафедры акушерство и гинекологии, Бухарский Государственный медицинский институт имени Абу Али Ибн
Сино, город Бухара Республика Узбекистан.
ORCID ID 0000-0003-4037-4333 ХАМДАМОВА МУХАЙЁХОН ТУХТАСИНОВНА DSc, доцент кафедры акушерство и гинекологии, Бухарский Государственный медицинский институт имени Абу Али Ибн
Сино, город Бухара Республика Узбекистан.
ОИСЮ Ю 0000-0003-3128-6120 АННОТАЦИЯ
В настоящей статье даны результаты многих авторов по первичной профилактике посткастрационного синдрома, такие как остеопороз, причины и следствия гормонального дисбаланса и методы коррекции. Взаимосвязь уменьшения стероидных гормонов с минеральными компонентами костей.
Ключевые слова: Кальций дефицитное состояние, остеопороз, остеопения, заместительная гормональная терапия.
ПОСТКАСТРАЦИОН СИНДРОМИ БУЛГАН БЕМОРЛАРДА ГОРМОН ТЕРАПИЯСИНИНГ САМАРАДОРЛИГИНИ ТА^ЛИЛ
КИЛИШ
АХМАТОВА ДИЛНОЗА ФУРКАТЖОНОВНА
акушерлик ва гинекология кафедраси магистри, Бухоро давлат тиббиёт институти, Бухоро, Узбекистон
ОИСЮ Ю 0000-0003-4037-4333 ХАМДАМОВА МУХАЙЁХОН ТУХТАСИНОВНА DSc, акушерлик ва гинекология кафедраси доценти, Бухоро давлат тиббиёт институти, Бухоро, Узбекистон
ОИСЮ Ю 0000-0003-3128-6120 АННОТАЦИЯ
Ушбу маколада посткастрацион синдромга алоцадор булган остеопорозни бирламчи бартараф этишга царатилган чора-тадбирлар муцокама цилинган. Гормонал мувозанат холатининг бузилиши сабаб ва оцибатларини урганиб, уни тугрилаш усуллари курсатилиб, утилади. Стероид гормонлари мицдорининг камайи-шининг суяк минерал компонентларининг камайиши билан узаро богликлиги цацида маълумот берилган.
Калит сузлар: кальций етишмовчилиги холати, остеопороз, остеопения урин босувчи гормонал терапия.
Osteoporosis is a systemic, metabolic disease of the skeleton, characterized by a decrease in bone mass and a violation of the microarchitectonics of the bone, often occurring in postmenopausal women. A decrease in bone mass and a rearrangement of its microstructure lead to an increase in bone fragility. As a result, a mechanical failure of the bone is formed, which is clinically manifested by fractures. The three most common locations of osteoporotic fractures are the femoral neck, spine, and distal radius. Hip fractures, which are the most fatal, are widespread among older women, and the WHO predicts that their absolute number will double over the next 25 years, reaching 6 million by 2050 - [2; 6].
The medical and social significance of osteoporosis is determined by several aspects. Treatment of osteoporosis and osteoporotic fractures requires large material costs both on the part of society and on the part of patients. The danger of the disease for patients and their relatives is a high risk of mortality - with a hip fracture, 22% of patients die within 6-12 months, and another 25% of patients become disabled. Only about half of those who lived independently and independently before the fracture can do without assistance after a hip fracture. Based on this, not treatment, but prevention of osteoporosis is an urgent task, the solution of which can significantly improve the indicators of life expectancy and quality of life -[10].
Osteoporosis develops as a result of the action of preventable and unavoidable factors, including low body weight, heredity, smoking, the use of glucocorticoids, low physical activity, etc. More than 60% of the causes of osteoporosis are somehow associated with hereditary factors responsible for the functioning of the bone and other organ systems, and
are unavoidable. However, about 40% of the risk is provided by lifestyle and transient, preventable factors that can and should be overcome - [1]. Genetic factors of osteoporosis itself play an important role in the realization of its risk, although specific genes have not yet been identified. But, for example, it is known that the presence of different alleles of the VDR gene (the vitamin D receptor gene) determines individual quantitative differences in the absorption of calcium in the intestine, as well as reactions that affect the level of bone mineral density (BMD), when using calcium salts and drugs - [9].
At the same time, the difference in VDR alleles may reflect the influence of people's diet and lifestyle, which increases with age - [3]. Age is the main risk factor for osteoporosis: after the age of 80, the risk of a fracture in European women increases by 3% annually, the average age for a spinal fracture is 65 years. In individuals with spinal fractures, the further risk of osteoporotic fractures increases significantly - [7].
Osteoporosis mainly affects postmenopausal women. Regardless of age, in women of this period of life, the risk of fractures is three times higher than in older men and is about 15% in women of European race. The frequency of fractures of the wrist and other bones of the peripheral skeleton (in addition to the hip), according to many studies, increases 10fold within 15 years after ovariectomy - [5; 7].
It is not surprising that the development of osteoporosis is associated with menopause - the metabolism of bone tissue throughout life depends on the level of sex hormones. Bone is a form of connective tissue consisting of a collagen matrix that is mineralized by inclusions of calcium phosphate crystals. This composition of the fabric gives the skeleton strength and strength, while maintaining the properties of elasticity. There are two morphological types of bone: cortical, or compact, and spongy. Bones perform a number of important functions in the body: protection from traumatic injuries, movement, and the creation of a calcium
depot. In turn, calcium plays a role not only in the structural integration of the skeleton. The stability of the concentration of Ca ions in the extracellular fluid and cytosol is one of the physiological constants of the body - [4].
Blood plasma contains three fractions of calcium: ionized (50%), bound to proteins (about 40%), combined with phosphoric ions or citrates (about 10%). The most important is ionized calcium, which is involved in the processes of blood clotting, neuromuscular excitability, regulating the permeability of cell membranes, etc. The calcium content in the blood is a hard constant, with a decrease in the intake of calcium or an increase in its consumption/loss, calcium begins to be extracted from its main depots, the bones - [2].
Bone is a living tissue. It is constantly being renewed, resorbed, and re-formed, and this process is called remodeling. Bone remodeling occurs throughout life and is provided by osteoblasts and osteoclasts. Osteoblasts are responsible for the formation of bone, and osteoclasts specialize in its resorption. During the growth period of the body, bone formation prevails over resorption. In the age period from thirty to fifty years, the processes of bone formation and bone resorption take place with approximately the same intensity - [8].
After the removal of the ovaries in women and fifty years of age in men, bone resorption begins to prevail over bone formation. The bone mass available in an elderly person is the difference between the amount of bone accumulated by maturity (the so-called peak bone mass) and the bone mass lost with age. There is a significant variation in individual indicators of peak bone mass. Body size is essential, and hereditary factors are very important. The degree of physical activity and the amount of calcium consumed also affect the formation of bone mass. Pathogenetic factors that contribute to the formation of osteoporosis either disrupt the
formation of bone tissue during growth, or contribute to the acceleration of bone resorption after the removal of the ovaries - [9].
Thus, summing up all of the above, we can say that women taking hormone replacement therapy should be consulted at least once a year for the purpose of objective examination, clarification of medical and family history, conducting appropriate laboratory and instrumental studies, discussing lifestyle and approaches to the prevention and correction of chronic diseases.
References:
1. Mohammadi Z., Fayyazbakhsh F., Ebrahimi M., Amoli M.M., Khashayar P., Dini M., Zadeh R.N., Keshtkar A., Barikani H.R. Association between vitamin D receptor gene polymorphisms (Fok1 and Bsm1) and osteoporosis: a systematic review. //J. Diabetes Metab. Disord. - 2014, Oct 17, 13(1), 98. doi: 10.1186/s40200-014-0098-x.
2. Bolland M.J., Grey A., Avenell A., Gamble G.D., Reid I.R. Calcium supplements withor without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health Initiative limited access dataset and meta-analysis // BMJ. 2011; 342 (apr19): d2040.
3. Bolland M.J., Avenell A., Baron J. A., Grey A., MacLennan G.S., Gamble G.D., Reid I.R Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. // BMJ. 2010; 341: c. 3691.
4. Liu Y.J., Zhang L., Papasian C.J., Deng H.W. Genome-wide Association Studies for Osteoporosis: A 2013 Update. // J. Bone Metab. -2014. - May; 21(2): 99-116.
5. De Villiers T.J., Gass M.L.S., Haines C.J., Hall J.E., Lobo R.A. et al. Global consensus statement on menopausal hormone therapy. // Climacteric. - 2013; 16: 203-204.
6. Stevenson J.C., Panay N., Pexman-Fieth C. Oral estradiol and dydrogesterone combination therapy in postmenopausal women: Review of efficacy and safety. // Maturitas. - 2013. - 76; 10- 21.
7. Khamdamova M.T. Age echographic characteristics of the uterus and ovaries in women of the first and second period of middle age // Биология и интегративная медицина 2020. №2 March- April(42).-P.75-86.
8. Teshaev Sh.J., Khamdamova M.T. Features of anthropometric parameters in women of the first and second period of middle age with different constitutional types // Новый день в медицине 2020, №1 (29).-Р.91-93.
9. Хамдамова М.Т., Ахматова Д.Ф. Остеопороз у молодых женщин репродуктивного возраста, факторы риска - // Биология и интегративная медицина 2021. №1, 146-159.
10. Zaripova D. and Sharipova R. Comparative evaluation of the use of aleandronic acid in menopausal women complicated by osteoporosis // European journal of biomedical and pharmaceutical sciences. - 2020. - №7. - P. 145-147
