Tsyhanyk L. Characteristics of calcium-phosphorus metabolism and bone mineral density in patients with systemic lupus erythematosus and lesions of the internal organs: diagnosis and principles of differentiated treatment

The dissertation presents a theoretical generalization and solution to the relevant scientific problem of improving the diagnosis and the effectiveness of treatment of patients with systemic lupus erythematosus (SLE) and co-occurring lesions of the internal organs. the prevalence of osteoporosis in premenopausal women with SLE was 18.70 %, the prevalence of osteopenia – 58.54 %. Disturbances of bone metabolism in patients with SLE were caused by increased calcium excretion, vitamin D deficiency, weakening of osteoblast function, and the acceleration of osteoclast function. There was no relationship between bone mineral density and SLEDAI scores. However, there were relationships between bone mineral density and SLICC Damage Index scores, disease duration, frequency and duration of exacerbations. According to the dissertation findings, the amount of calcium in the urine increases and the concentration of 25-hydroxyvitamin D in the blood decreases with the rise in disease activity. Statistically significant indirect relationships were found between osteoblast dysfunctions and the SLE activity by SLEDAI, the disease duration, the number and duration of exacerbations, the average and total course dose of glucocorticoids. Statistically significant direct relationships were found between the marker of osteoclast function and the disease activity by SLEDAI, the average and total dose of glucocorticoids. Prescribing complex differentiated treatment of patients with systemic lupus erythematosus should take into account the amount of vitamin D in the blood, as well as markers of osteoblast function (osteocalcin) and osteoclast function (β-crosslaps). These steps can improve the quality of the patients with SLE and significantly increase the effectiveness of treatment.