Titova I. Osteoporosis in patients with type 2 diabetes mellitus with nonalcoholic fatty liver disease: optimization of diagnosis and justification of treatment

The strategy of diagnosis and treatment of osteoporosis in patients with type 2 diabetes mellitus with non-alcoholic fatty liver disease is substantiated and detailed by establishing the features of the structural and functional state of bone tissue, the content of 25-hydroxycolecalciferol and magnesium. A method for predicting the risk of developing osteoporotic changes in the above category of patients has been developed. Object of research: osteoporotic changes in patients with type 2 diabetes mellitus with non-alcoholic fatty liver disease. The aim of the study is to improve the algorithm of early diagnosis and justify the complex treatment of osteoporosis in patients with type 2 diabetes mellitus with non-alcoholic fatty liver disease. Methods: anthropometric; biochemical; instrumental; statistical. Ultrasound-medical ultrasound diagnostic scanner ALOKA-SSD-3500, working in real time and equipped with sensors with a working frequency of 3.5 MHz (for abdominal organs). The densitometric study was performed using x-ray double absorbometry using the Explorer QDR W (Hologic) apparatus of the lumbar spine (L1-L4) and the proximal part of both thighs. The work deepens the level of scientific knowledge about the features of the state of bone tissue, the content of vitamin D and trace elements in patients with type 2 diabetes mellitus with non-alcoholic fatty liver disease. For the first time, mathematical models were created to calculate the prognosis of the risk of developing osteoporosis in this category of patients. The expediency and effectiveness of complex administration of Mg, vitamin D and CA in daily doses, depending on the degree of detected violations and deviations of laboratory parameters in patients with type 2 diabetes mellitus with non-alcoholic fatty liver disease and osteoporosis to improve the condition of bone tissue, has been demonstrated. The feasibility of determining the content of vitamin D, Mg and the structural and functional state of bone tissue in patients with type 2 diabetes mellitus with and without non-alcoholic fatty liver disease has been proved. For the first time, a questionnaire was developed for the above-mentioned category of patients, which allows detecting early signs of osteoporosis. A method for predicting the risk of developing osteoporosis in patients with type 2 diabetes and non-alcoholic fatty liver disease has been developed. The results of the study are implemented in the work of research institutions and educational institutions, as well as in the practical activities of endocrinologists in Kharkiv and other regions of Ukraine.