Early Diagnostics and Prevention of Osteoporosis in Women in Pre- and Postmenopausal Period

Purpose. To improve the early diagnosis and prevention of osteoporosis and its complications in women pre - and postmenopausal women using the most informative biochemical, radiological, clinical and anamnestic tests. Materials and Method.49 women at the age of 4565 years are examined within the bounds of a routine inspection. The examination was carried out by the method of dual-energy X-ray absorptiometry in three points of the skeleton (the lumbar part of backbone L1L4, the proximal part of the femur and the distal part of forearm) by means of device QDR-4500 Elite of firm Hologic, USA. The marker of bone resorbtion (B-CrossLaps), the marker of bone formation (osteocalcin) and parathyroid hormone in blood serum of each woman were measured on the Humolazer automated analyzer (German). The most expressed disorders of bone density in women of pre-and postmenopausal ages were accompanied by increase of levels B-CrossLaps, osteocalcin and parathyroid hormone in blood serum. Results. Using standard indicators, from 0, 162 to 0, 436 ng/ml for osteocalcin 11 to 32 ng/ml, of all examined women were divided into three groups. The first group included 15 patients with normal markers of bone metabolism, the second 16 women with normal levels of osteocalcin and increased numbers B-CrossLaps, and the third included 18 women with elevated levels of both indicators. B-CrossLaps is the most sensitive biochemical marker of a decrease in bone density, this marker precedes increase of osteocalcin level and occurrence of densimetric signs of osteoporosis. On the basis of biochemical markers of bone turn over (B-CrossLaps and osteocalcin) and estimation of clinical-anamnestic risk factors, as well as being based on results of densitometry, the algorithm of early diagnostics and prevention of osteoporosis in the women of pre- and postmenopausal ages is developed. Conclusion. The most pronounced disorders of bone density in women pre - and postmenopausal age is accompanied by increased levels of B-CrossLaps, osteocalcin and parathyroid hormone in the serum. B-CrossLaps is the most sensitive biochemical marker of lower bone density prior to the increase in the content of osteocalcin and the appearance of densitometric evidence of osteoporosis.