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POVOROZNYUK V.V., NISHKUMAY O.I., NEKRASOVA N.B. Institute of Gerontology named after D.F. Chebotarev AMS Ukraine, Ukrainian Scientific-Medical Centre for the Problems of Osteoporosis, Kyiv, Ukraine
Pain Syndrome n Postmenopausal Women with Osteoarthritis, Combined with Essential Hypertension
The aim of the research is to conduct a comparative assessment of pain in women with osteoarthritis in combination with hypertension.
Materials and methods. 31 postmenopausal women (average age 61.1 ± 1.2 years, menopause duration 5.4 ± ± 2.2 years) were examined. All respondents were divided into two groups: group I comprised 13 patients diagnosed with osteoarthritis (gonarthritis) Roentgen phase II according to classification of Kellgren & Lawrence (1957), group II comprised 18 patients with gonarthritis of stage II in combination with hypertension of the second degree. Pain syndrome was assessed with the usage of verbal analogue scale (VAS) and the scale of WOMAC. All patients were taken Ultrasound densitometry (BUA, SOS, stiffness index, T-score) with the Lunar Achilles device (Lunar Corporation, Madison, Wisc., USA). Laboratory data included total serum calcium, PTH, vitamin D.
Results. All women surveyed revealed osteopenia, the severity of which is not dependent on the degree of hy-
pertension. Pain intensity on VAS was significantly higher in patients with osteoarthritis, combined with hypertension compared to patients with osteoarthritis (60.1 ± ± 2.3 mm and 51.2 ± 1.2 mm respectively, p < 0.05). Evaluation of functional impairment score WOMAC revealed significantly greater stiffness in patients with co morbidity compared with osteoarthritis (70.3 ± 3.2 and 52.5 ± 2.1 respectively, p < 0.05). Also the greatest severity of functional impairment observed in group II compared with the first group (60.5 ± 1.2 and 52.5 ± 2.1 respectively, p < 0.05). Patients of group II were identified to have secondary hyperparathyroidism and vitamin D deficiency (21.99 ± 1.20 nmol/l) probably caused by the D-hormone-deficiency taking into consideration the increases in serum creatinine and decreased creatinine clearance in this group.
Conclusion. Thus, the more intense the pain and functional impairment in patients of group II were seen against the background of the identified secondary hyperparathy-roidism and vitamin D deficiency probably caused by the D-hormone-deficiency taking into consideration the increase in serum creatinine and decreased creatinine clearance in this group. Secondary hyperparathyroidism enhances bone resorption and exacerbates pain due to the development of osteomalacia. It indicates the necessity to use the active metabolite of vitamin D (alfacalcidol) to correct the violations.
SHYMON V.M., STOYKA V.V., SHEREGIYA.A., SHYMONM.V., SLYVKA R.M.
Uzhgorod National University, Uzhgorod, Ukraine
The Indicators Bone Metabolism in Fractures of Trochanteric Areas of Femur in Patients with Type 2 Diabetes
Introduction. Fractures of the trochanteric area of the femur is an actual problem. There are the peculiarities regeneration of fractures of the trochanteric area of the femur in patients with type 2 diabetes. This is due to the peculiarities of osteoreparation background of type 2 diabetes. In recent decades was conducted a large number of studies to determine changes in bone in patients with type 2 diabetes. The available data are very different. Thus, according to different authors an increase in bone mineral density (BMD), normal density and decrease in BMD compared with controls can be observed. In a me-ta-analysis of the observed experiments-LMa and co-authors (2012) noted that these differences may be related to differences in the design of experiments methodology for determining BMD, samples of patients and the presence of complications. We believe that individual indicator BMD may not fully reflect the osteoreparative processes. Comparison of data ultrasound mineral densi-tometry and hormonal balance will help to understand the changes in bone metabolism in patients with type 2 diabetes and help to find ways to prevent complications in the treatment of fractures.
Aim. To study changes in bone metabolism in fractures of trochanteric area of the femur in patients with type 2 diabetes.
Materials and methods. In the period since 2012 to 2015 were examined 42 patients who were hospitalized in the clinic at the department of general surgery UzhNU about fractures of the trochanteric area of the femur. There were 34 injured women, men — 8. Age composition ranged from 48 to 79 years, average age — 67 years. Before trauma patients had active lifestyle.
The main group consisted of 19 patients with type 2 diabetes. Body mass index (BMI) was 29.4 (25.7-34.2) kg/m2, level of glycosylated hemoglobin (HbA1c) — 9.6 (7.711.3) %. Part of patients (n = 13) took sulfonylurea drugs 10.5 (7-10.5) mg/day, metformin — 1.5 (1-1.5) g/day, and other (n = 5) received combined treatment with insulin. The average duration of the disease diabetes was 8 years old. Newly diagnosed diabetes was 1 case, in 4 patients disease duration was less than 5 years, 7 patients — from 5 to 10 years, 7 patients — more than 10 years. Among the complications of diabetes was more frequent diabetic micro and macro angiopathy limbs — 9 people, diabetic retinop-athy — 5 people, diabetic neuropathy — 4 people. Cardiovascular diseases were observed in 13 people.
The control group consisted of 23 patients with fractures of the trochanteric area of the femur in which rates of sugar of blood serum and glycated hemoglobin does not exceed the norm. BMI was 28.9 (25.3-33.9) kg/m2. Both groups were comparable in age, sex, severity of the
№ 2 (18), 2015
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