Object: Children and adolescents aged 10-19 years, adults ages 20-89 years old, living in different parts of the Donetsk region. Aim: develop a system of the provision of medical and diagnostic care for patients with osteoporosis based on the study of structural and functional status and bone mineral density, risk factors, prevalence of this disease and its complications in children and adults in the Donetsk region. Methods: clinical and orthopedic examination, anthropometric study questionnaire, questionnaire design (assessment of the severity of vertebral pain syndrome (visual analogue scale), the level of activity and life activity which related to back pain by questionnaires ECOS-16, Roland-Morris, the quality of life by questionnaire EroQol-5D), ultrasound densitometry of the calcaneus ("Sahara", Hologic), X-ray absorptiometry (Dual Energy X-ray densitometer Discovery QPR, Bedford, USA, serial number 83678 and "Prodigy" (GE Medical systems, model 8743, 2005), electrochemiluminescence method for studying the level of 25(ОН)D and іPTG (analyzer Elecsys 2010), study of the actual nutritional using the questionnaire-gravimetric method according to the procedure the three-day examination. Statistical analysis was performed using programs "Statistika 6.0" and "Microsoft Excel". For the first time reference base of indices of bone mineral density depending on the age and sex for the residents of Donetsk region were created. First the effects of age, sex and region of residence on bone mineral density (according to the DEXA) and structural-functional state of bone (according to ultrasound densitometry) in the population of Donetsk region were studied. The role of age, gender, anthropometric characteristics in the formation of peak bone mass and its loss in the population of Donetsk region was determined. For the first time age features of frequency of osteoporotic fractures of the distal forearm in children, adolescents and adults in the Donetsk region were revealed. For the first time nutrition features and their effect on the bone mineral density Впервые изучены особенности питания и их влияние на минеральную плотность костной ткани in the population of the Donetsk region were studied. The frequency of vitamin D deficiency was identified and proposed methods for prevention deficits. The role of active metabolites of vitamin D was studied; on the clinical condition influence of active metabolites alphacalcidol on the structural and functional state of the musculoskeletal system was assessed. System of medical-diagnostic care to the population of Donetsk region for the diagnosis, prevention and treatment of osteoporosis and its complications was developed, tested and implemented. The proposed reference database can be used for comparative assessment of bone mineral density (studied by dual energy X-ray absorptiometry) and indicators of structural-functional state of bone (measured by ultrasound densitometry) in the population of Donetsk region. Data of reference database of bone mineral density and anthropometrical characteristics will serve as a control for comparative evaluation of the features of formation of peak bone mass in children and adolescents in Donetsk region. These database can be used to estimate the rate of physical development and the formation of peak bone mass in military recruits in professional selection and for predicting the occurrence of traumatic injuries. The experimental and clinical results have proved the effectiveness of the use of active vitamin D metabolites in postmenopausal osteoporosis treatment in the population of Donetsk region. Recommended methods of diagnosis and prevention will promote the physiological formation of peak bone mass, and will allow to prevent bone loss during ontogenesis. Created and introduced in practice the system of diagnosis, prevention and treatment of osteoporosis and its complications in the Donetsk region allows to provide appropriate assistance to the population. Study results were introduced into Результаты исследования in the work of Department age-related changes of the musculoskeletal system SI "Institute if Gerontology named D.F.Chebotarev NAMS of Ukraine", Scientific Research Institute of Traumatology and Orthopedics of M. Gorky Donetsk National Medical University, therapy department number 2 Ternopil City Community Hospital, department of rheumatology of the Lviv Regional Hospital, department of traumatology and orthopedics Transcarpathian regional Hospital, department of rheumatology Luhansk Regional Hospital. Traumatology and orthopaedics
