[Vertebral pain syndrome and quality of life in senior women with vertebral fractures depending on their quantity and localization.]

The features of vertebral pain (VP) and quality of life in postmenopausal women were analyzed depending on the number and location of vertebral fractures (VF). It was found that the intensity of pain in thoracic and lumbar spines, according to McGill pain index, was significantly higher in patients with two or more VF compared to women without any fractures, and absence of differences in subjects with a single VF. Most indices of 11-component Numerical Rating Scale at the thoracic spine were significantly higher only in females with two or more VF. In patients with thoracic spine fractures most parameters of VP measured at this level were significantly higher compared to control values, whereas in patients with lumbar spine fractures most indices did not differ from the corresponding parameters in subjects without fractures. There were no established significant differences of quality of life indices according to the EuroQol-5D questionnaire in senior women depending on the number and location of VF, while disturbances of daily activity parameters according to the Roland-Morris questionnaire were found in patients with 2 or more VF.

Epidemiology of Hip Fractures in Two Regions of Ukraine.

Worldwide, the number of hip fractures, the most important osteoporotic complication in the elderly, continues to increase in line with the ageing of the population. In some countries, however, including the Ukraine, data on the incidence of hip fracture are limited. This article describes the first analysis to characterize the incidence of hip fracture in the Ukrainian population from the age of 40 years. It is based on data from two regional studies, namely, the Vinnitsa city study and the STOP study, which were performed during 1997-2002 and 2011-2012 years, respectively. Hip fracture incidence rates were demonstrated to increase with increasing age. The rates were higher among younger men than women, however, with a female preponderance from the age of 65 years upwards. The incidence of hip fractures in Ukraine is 255.5 per 100,000 for women aged 50 years and older and 197.8 per 100,000 for men of the corresponding age. Overall, the incidence of hip fracture was comparable with data from neighboring countries, such as Poland and Romania. Hip fractures constitute a serious healthcare problem in Ukraine, and changes in healthcare are required to improve the management and long-term care of osteoporosis and its complications.

Epidemiology of hip fracture and the development of FRAX in Ukraine.

A country-specific FRAX model has been developed for the Ukraine to replace the Austrian model hitherto used. Comparison of the Austrian and Ukrainian models indicated that the former markedly overestimated fracture probability whilst correctly stratifying risk. INTRODUCTION: FRAX has been used to estimate osteoporotic fracture risk since 2009. Rather than using a surrogate model, the Austrian version of FRAX was adopted for clinical practice. Since then, data have become available on hip fracture incidence in the Ukraine. METHODS: The incidence of hip fracture was computed from three regional estimates and used to construct a country-specific FRAX model for the Ukraine. The model characteristics were compared with those of the Austrian FRAX model, previously used in Ukraine by using all combinations of six risk factors and eight values of BMD (total number of combinations =512). RESULTS: The relationship between the probabilities of a major fracture derived from the two versions of FRAX indicated a close correlation between the two estimates (r > 0.95). The Ukrainian version, however, gave markedly lower probabilities than the Austrian model at all ages. For a major osteoporotic fracture, the median probability was lower by 25% at age 50 years and the difference increased with age. At the age of 60, 70 and 80 years, the median value was lower by 30, 53 and 65%, respectively. Similar findings were observed for men and for hip fracture. CONCLUSION: The Ukrainian FRAX model should enhance accuracy of determining fracture probability among the Ukrainian population and help to guide decisions about treatment. The study also indicates that the use of surrogate FRAX models or models from other countries, whilst correctly stratifying risk, may markedly over or underestimate the absolute fracture probability.

[Features of vertebral pain syndromes in older women depending on the duration of postmenopausal period and bone mineral density indices].

We have analyzed the vertebral pain syndrome (VPS) rate in 2 844 women aged 40-89 years, divided into groups according to the period of life (reproductive, perimenopausal and postmenopausal (PMP)) and evaluated the relationship between VPS frequency and indices of bone mineral density (BMD). It was found that the frequency of VPS during different physiological periods of woman life ranges from 84,1 to 94,4 %, with significant increase when the PMP period is more than 20 years compared with women in reproductive and early postmenopausal periods. The significant increase of the VPS frequency in thoracic and lumbar spines starts from 1-3 years of PMP and is retained at higher level for all subsequent periods of PMP. In postmenopausal women, a significant increase of the relative risk of VPS in the thoracic (in 1,3-1,4 times) and the lumbar (1,2-1,3 times) spines was found. In patients with osteoporosis with duration of PMP for 1-3 years, the frequency of VPS in thoracic spine was significantly higher than the indices in women with osteopenia, while patients with duration of PMP of 7-9 years had significantly higher frequency comparing to groups with osteopenia and norms. In patients without vertebral fractures and osteoporosis VPS frequency in the thoracic spine was significantly higher during periods of 4-6 and 7-9 years of PMP compared with women in reproductive period and compared with the women with normal BMD indices. The revealed features of the VPS should be considered while planning therapeutic interventions in women of older age groups.

[AGE AND SEX FEATURES OF BONE MINERAL DENSITY IN RATS].

In vivo assessment of bone mineral density (BMD) and bone mineral content (BMC) indices gives an objective description of the possible rates of bone loss during aging and various diseases, as well as response to treatment by various drugs, affecting bone metabolism. This study was conducted on 376 Wistar rats of both genders, divided into 12 age groups using the method of dual-energy X-ray absorptiometry. Studying the parameters of BMD and BMC depending on age and sex has found no bone mass opeak) in rats of both sexes. Bone mineral density indices were increased in both male and female rats during growing, more pronounced in males. These differences are noted in all age groups of animals. Moreover, we have established age and gender particularities of BMC indices in different parts of the skeleton. In female rats, a significant increase of BMD and BMC parameters have been detected in age from 1.5 to 2 months (33%), from 2 to 3 months - by 12.5%. In males, the increase of BMD indices was found to happen 1 month later and it was less pronounced (from 2 to 3 months - 27%, from 4 to 5 months - 5%). In other age periods, the dynamics of BMD indices had only an upward trend, but significant differences different groups were not established. Our results of BMD and BMC indices and their age and gender features can be used for further research in osteology as reference data for modeling of experimental osteoporosis in rats and study of response to the use of different antiosteoporotic drugs.

Bone mineral density in ukrainian women of different age.

We determined the bone mineral density (BMD) of normal Ukrainian female subjects and compared results with USA-European reference data. The research was conducted at the Ukrainian Scientific-Medical Centre for the Problems of Osteoporosis and included 353 women aged 20-79 years. Conventional BMD measurements of the spine (L1-L4 in the anterior-posterior position), proximal femur (neck, Ward's triangle, and trochanter regions), and radial shaft (33% site) were determined by dual-energy X-ray absorptiometry using a densitometer Prodigy. Age-related changes in BMD were similar in form to those of USA-European reference data. We found that the BMD values of spine for Ukrainian women of 50-59 years were lower than published values. Regression analyses showed that weight was a significant predictor of female spine and femur BMD for both the premenopausal and the postmenopausal decades. Age was a significant predictor of female spine BMD in the 50- to 79-year age group. The prevalence of osteoporosis and osteopenia for Ukrainian women was 11% at the femoral neck and 20% and 24% at the spine and radial shaft, respectively.