Kartashova K. Mechanisms of secondary osteoporosis in patients with chronic noncalculous cholecystitis and obesity.

Thesis is devoted to optimization of diagnosis and treatment of chronic noncalculous cholecystitis (CNC), which runs in conjunction with obesity, based on detection of risk factors for osteoporosis, assessment of violations of calcium homeostasis and bone remodelling. It was found that the course of CNC and obesity is accompanied by changes in parameters of calcium metabolism: there is a reduction of total and ionized calcium ratio, which reflects changes in cell and extracellular content of this macroelement. It was determined that secondary osteoporosis is formed in patients with CNC and obesity. Osteopenic syndrome in this group of patients is the result of imbalance of bone remodelling process, dominated the processes of bone resorption. It was shown that increased body mass in patients with CNC leads to changes in lipid metabolism, characterized by the formation of the combined type of hyperlipidemia (type II b or II a by Friederikson). That is an unfavorable factor of metabolic syndrome. The correlation between indices of calcium homeostasis, bone remodelling and mineralization of bone was determined. It can be used for screening osteopenic state in patients with CNC. It was proposed to include to the individual treatment regimen the combined medication of calcium citrate, vitamin D3 with microelements and officinal herbal hypolipidemic preparation in patients with distinct shifts in lipid and calcium metabolism.