Object: vitamin D deficiency and insufficiency. The aim: develop set of measures for hypovitaminosis D correction and prevention based upon verification of incidence of vitamin D deficiency and insufficiency, their impact on parameters of bone mineral density as well as on the clinical course of primary system osteoporosis and knee osteoarthritis in elderly subjects. Methods: clinical, laboratory, dual energy absorbtiometry, statistical. The incidence of vitamin D deficiency and insufficiency was established in elderly patients (50-89 years old) with primary system osteoporosis and knee osteoarthritis. The influence of gender, age, and anthropometric parameters on vitamin D status in these subjects has been established. It was found out that in elderly patients with primary system osteoporosis and knee osteoarthritis the lowest serum 25(OH)D levels are registered in March and February. We also established that vitamin D status has an impact on the clinical course of primary system osteoporosis and knee osteoarthritis in elderly patients. In particular, the vertebral pain intensity, as well as knee pain intensity, were higher in these subjects, while their quality of life was poorer than in patients without hypovitaminosis D. For the first time in Ukraine in cooperation with the National institute for food technology fortified bread was developed. Regular intake of this bread allows for stable daily supply of vitamin D by most physiological means without the need for continuous monitoring. Vitamin D deficiency and insufficiency risk factors have been identified in elderly patients with primary system osteoporosis and knee osteoarthritis (these factors being age, female gender, winter/spring season, obesity). This will allow practicing doctors to facilitate the diagnosis and correction of hypovitaminosis D in such subjects. The latter will have a positive influence on mineral bone density parameters, pain syndrome intensity as well as the quality of life in these patients. Implementation of suggested individual targeted therapy of vitamin D deficiency and insufficiency in elderly people with primary system osteoporosis and knee osteoarthritis will allow for selection of optimal treatment approach for every individual subject. Implementation of this approach into the daily medical practice will also allow the possibility of vitamin D deficiency mitigation in such subjects as well as reach the quickest and longest correction of vitamin D status. Usage of fortified bread in risk group patients facilitates the possibility of reaching optimal vitamin D status by most physiological means and with maintenance of satisfactory safety profile. The suggested algorithm of vitamin D deficiency monitoring and correction in elderly patients with bone and muscle diseases will facilitate implementation of the approach into the clinical practice. The recommendations can be used in the daily practice of orthopedic doctors, traumatologists, rheumatologists, family doctors, geriatrists, as the guidelines improve timeliness of vitamin D deficiency diagnosis in such subjects. Implementation of a robust vitamin D deficiency diagnosis and correction scheme will minimize the need to systematically check serum 25(OH)D levels, thereby reducing the frequency of visits to the clinic. The main results of the research have been applied in clinical practice of State Enterprise "Institute of Gerontology named after Chebotariov of National Academy of Sciences", department of therapy №2 of Ternopil communal city hospital, rheumatology department of Lviv Regional clinical hospital, department of traumatology and orthopedics at Scientific and Exploratory Institute of rehabilitation of Vinnitsa national medical university named after Pyrogov, department of traumatology and orthopedics of Zakarpattia regional clinical hospital. Traumatology and Orthopedics.
