Grygoryeva N. Locomotor system aging and age pathology (systemic osteoporosis, large joints osteoarthritis) onset during peri- and postmenopausal periods: diagnosis, prevention and treatment.

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0507U000043

Applicant for

Specialization

  • 14.01.21 - Травматологія та ортопедія

06-12-2006

Specialized Academic Board

Д64.607.01

Essay

Object of research - structural-functional state of bone of central and peripheral skeleton and cartilage's tissue of big joints, integral biological age and biological age of bone system, climacteric, vertebral and knee pain's syndromes and their dynamics after treatment. The purpose is to work out the methods of diagnostics, prophylaxis and treatment the age-depended pathology of locomotor's system (systemic osteoporosis, osteoarthritis of big joints) in women of peri- and postmenopausal periods on the basis of study the particularities of aging, mechanism and factors of development of pathology. Research methods: Experimental research: osteometrу, histomorphometry, biomechanical, chemical methods, X-ray-analysis. Clinical research: general clinical, neuroorthopedic and anthropometric inspection, questionnaire, ultrasound densitometry, X-ray morphometry of vertebral column, metacarpal bones and knee joint, study the integral biological age and biological age of bone system, study the factual feeding, immunofermentative (determination of the level FSG, LG, testosterone, interleukin-6 and TNF? in serum) and radioimmune (determination of the estradiol's level in serum) methods, statistical methods. Scientific novelty: First time, models of musculoskeletal system's pathologies were approbated and investigated experimentally (postcastrative osteoporosis and knee joint osteoarthritis). First time, the complex assessment of locomotor system's status and prevalence of age-specific pathology (systemic osteoporosis and big joints osteoarthritis) at the peri- or postmenopausal periods of life of women, was performed. It was determined that prevalence of combined musculoskeletal system's pathology increases with age and duration of postmenopausal period; and, prevalence of osteoporotic fractures and big joints osteoarthritis are dependent on age, climacteric period and duration of postmenopause. Most intensive bone tissue loss rates are observable in early years of postmenopause and constitute 23.9 % for 25 years of postmenopausal period of life. With increasing of postmenopausal period the value of women with osteoporotic fractures, in particular with Collis and vertebral fractures, is also increased. And there is the clear dependence on the ages of menopause and existence of fractures. With age and duration of postmenopausal period, the prevalence of big joints osteoarthritis is increased. The role of different factors (particularities of menstrual function, real diet and constitution) in development of systemic osteoporosis and big joints osteoarthritis for women of older age groups was founded. For the first time, the functional state of hypothalamo-hypophysial-ovarian system and the role of local cytokines in generation and behavior of main female locomotor system's pathology at the peri- and postmenopausal periods of life of the women were investigated, subject to the types, age of menopause and duration of postmenopause. The models of biological ages of bone tissue and differentiated approach to treatment of patients with accelerated bone tissue aging were developed, approbated and offered for practical use in healthcare. In experimental and clinical conditions the effectiveness of drugs from different drug groups (calcium drugs, HRT, phytoestrogens, STEARs, calcitonin, SYSADOA) in prophylaxis and treatment bone and joint system's pathology of women of older age groups was investigated. Results of conducted researches are applied during clinical practice in the Institute of gerontology of AMS of Ukraine, Institute of traumatology and orthopedics of AMS of Ukraine, the Ukrainian scientific and medical centers of problems of osteoporosis, Kharkiv medical Academy of post-graduating education, Lugansk State medical university, Donetsk hospital restore treatment, Krivij Rig clinical hospital №9, Chernigiv clinical hospital №2.

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