Masik N. Systemic disturbances of bone metabolism in patients of different age groups with chronic obstructive pulmonary disease and ways of their correction (clinical experimental study)

A comprehensive clinical examination and the study of structural and functional condition of the bone tissue and calcium-phosphorus homeostasis were performed in 696 COPD patients, the experimental study involved was conducted on 120 healthy Wistar with simulated COPD, we found new aspects of pathogenesis of osteoporosis in COPD patients in this dissertation based on complex investigation. A lumbar spine was found the most vulnerable area for osteoporosis in COPD patients, as evidenced by a significant decrease of bone mineral density in this area in patients with at least stage II of the disease. We determined the frequency of osteopenic syndrome, osteoporosis and osteoporotic fractures in COPD patients according to age, sex, severity and duration of illness. Risk factors of osteoporosis for patients with chronic obstructive pulmonary disease were also determined. The study established the relationship of bone metabolism with bad habits of patients, severity of COPD, age, systemic inflammation, and formation of negative adaptive responses. The efficacy of pharmacological correction of systemic disorders of bone metabolism with osteotropic medicines was proven with experimental and clinical laboratory methods. We developed an algorithm of COPD patients’ supervision that served as a basis for reducing a period of diagnostic process and definition of ultimate risk group in terms of development of systemic osteoporosis and its complications. We also designed and justified treatment programs and physical rehabilitation of these patients.