Registration Number
0212U001595,
0109U001721
, R & D reports
Title
Vitamin D deficiency and diseases of the musculoskeletal system (osteoporosis, osteoarthritis) in people of all ages
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Head
Povoroznjuk Vladislav V., Butenko Genady M., Доктор медичних наук
Registration Date
14-02-2012
Organization
State Institution "Institute of Gerontology AMS Ukraine"
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The purpose of the study - to examine the role of vitamin D deficiency in the development of the musculoskeletal system diseases (osteoporosis, osteoarthritis) in people of all ages. Methods: the orthopedic examination, questionnaires (Scale VAS, EuroQol-5D, Roland-Morris, Ecos-16, 1-min. test IOF, fractures form); anthropometric studies, dual-energy X-ray absorptiometry (spine, forearm, femur, total body, body composition), X-ray of thoracic and lumbar spine, followed by X-ray morphometry, ultrasound densitometry; X-ray of hand, bone turnover markers in blood serum. Methods: the orthopedic examination, questionnaires (Scale VAS, ECOS-16, EuroQool-5D, Roland-Morris, Leken index, a questionnaire on risk factors of osteoporosis and fractures), anthropometric studies, dual-energy X-ray absorptiometry (spine, forearm, femur, total body, body composition), X-ray of thoracic and lumbar spine, followed by X-ray morphometry, ultrasound densitometry, biochemical blood analysis (calcium, lipid profile), bone turnover markers in blood serum, 25 (OH) vitamin D, parathyroid hormone . Results: In the epidemiological part of the work it was determined the frequency of deficiency and insufficiency and vitamin D among adults and children. Only 4.6% of Ukrainians have a 25 (OH) vitamin D in the normal range, the 13.6% observed have insufficiency, and in 81.8% deficiency of vitamin D. There is a negative association between 25 (OH) vitamin D and PTH (r =- 0,16 P <0,00001). Secondary hyperparathyroidism was diagnosed in 11.9% of cases. Significantly higher level of 25 (OH) vitamin D among residents of the southern regions of Ukraine and during summer. The frequency of vitamin D deficiency among children is 92.2%, of vitamin D - 6,1%. Secondary hyperparathyroidism is recorded in 0.9% of cases. In children of pubertal age and with vitamin D deficiency it was found the negative significant association between levels of parathyroid hormone and ultrasound densitometry data, such as strength index (r =- 0,19, p <0,05), the extrapolated bone mineral density (r = - 0,19, p <0,05) and broadband ultrasound attenuation (r =- 0,23, p <0,01). In clinical part of research it was determined the association between bone mineral density (BMD) and the level of 25 (OH) vitamin D. According to the results of correlation analysis, no significant relationship between 25 (OH) vitamin D and DXA, but in people younger than 60 years with vitamin D deficiency it was found significant negative association between PTH and DMD: the lumbar spine (r = - 0,14, p = 0,03), femoral neck (r =- 0,18, p <0,003), proximal femur (r =- 0,16, p <0,009), upper extremities (r = - 0,18, p <0,003), lower extremity (r =- 0,20, p <0,001), forearm 33% (r =- 0,20, p <0,001). In patients with vitamin D deficiency observed weak correlation between the 25 (OH) vitamin D and osteocalcin (r = 0,17, p = 0,03) and 25 (OH) vitamin D and ?-Tx (r = 0,16, p = 0,04), which were absent in patients with normal levels of vitamin D. Among patients with osteoarthritis, vitamin D deficiency was detected in 79.5% of patients, insufficiency in 16.9% of examined patients. Normal level of 25 (OH) vitamin D was registered only in 3.6% of patients. Averages 25 (OH) vitamin D does not depend on the degree of osteoarthritis (p> 0,05). Intensity of pain syndrome by VAS score was higher in patients with severe and moderate vitamin D deficiency compared with whom 25 (OH) vitamin D was above 50 nmol/l ((39,2 ± 6,6) and ( 57,8 ± 11,8) vs. (22,4 ± 8,1) points, respectively (P <0.05)). Quality of life and EuroQoL-5D indexes in patients with a level of 25 (OH) vitamin D above 50 nmol/l were significantly lower than in patients with vitamin D deficiency ((3,17 ± 0,91) against (5,05 ± 0,39) and (5,69 ± 0,54) scores (p <0.05)). In patients with osteoporosis, vitamin D deficiency is recorded in 80.7% of patients. Vitamin D deficiency - 11.5%, 7.9% of patients has normal 25 (OH) D level. The frequency of secondary hyperparathyroidism is 13.9%. 225 patients had osteoporotic fractures in history of life. 82.2% of them had vitamin D deficiency. 16.4% patients have vertebral fractures. Vertebral fractures mostly occurred in patients with deficiency of vitamin D (86,5%). The intensity of pain in the lumbar spine was significantly higher in patients with severe and moderate vitamin D deficiency and was (43,1 ± 3,51) and (45,4 ± 3,63) points against the (14,0 ± 14) points patients with a level of 25 (OH) vitamin D in the normal range (p <0.05). Quality of life and EuroQoL-5D indexes were significantly lower in patients with a level of 25 (OH) vitamin D in the normal range compared to groups with severe and moderate vitamin D deficiency and were (2,0 ± 1,53) points against the (4 6 ± 0,30) and (5,0 ± 0,34) points, respectively (p <0.05).
Product Description
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Балацька Наталія Іванівна
Бистрицька Марина Анатоліївна
Гибало Надія Михайловна
Григор'єва Наталія Вікторівна
Дзерович Наталія Іванівна
Дубецька Галина Сергіївна
Карасевська Тетяна Анатоліївна
Креслов Євгеній Олександрович
Крочак Святослава Петрівна
Орлик Тетяна Василівна
Пішель Ірина Миколаївна
Парахіна Тетяна Володимирівна
Поворознюк Василь Валерійович
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2020-04-02
