The dissertation is devoted to the improvement of methods of prediction, early diagnosis, and increase of efficiency of treatment of structural and functional disorders of bone tissue in postmenopause in women with arterial hypertension and obesity, who work in harmful conditions of manufacturing.
The material is based on a comprehensive examination of 170 postmenopausal women aged 48 to 60 years (postmenopausal duration - (7.4 ± 2.4) years), of whom 140 had hypertension and obesity: Group I - 80 women who worked in conditions of action of harmful factors of manufacturing, II group - 60 workers, whose work is not related to the action of harmful factors of manufacturing. The control group (III) - 30 practically healthy women.
Arterial hypertension, obesity, and harmful conditions of manufacturing have been shown to be independent risk factors for decreased bone mineral density. Decreased osteoprotegerin levels have been shown to be a predictor of bone loss, bone remodeling disorders, lipid, and carbohydrate metabolism.
For prediction, early detection, and prevention of structural and functional disorders of bone tissue in postmenopausal women with hypertension and obesity, working under the influence of harmful factors of manufacturing, mathematical models for predicting the most informative indicators are osteoprotegerin and T-test.
Based on the analysis of clinical risk factors for osteoporosis, a mathematical model for assessing the severity of osteoporosis (φ severity) has been developed, which allows taking into account additional risk factors to diagnose low bone mineral density and monitor the effectiveness of treatment and prevention.
Combination therapy with vitamin D metabolites with additional inclusion in the standard antihypertensive therapy of cholecalciferol and alfacalcidol has been proposed and tested. Combination therapy with vitamin D metabolites for 12 months had a positive effect on the parameters of the clinical course, the state of lipid and carbohydrate metabolism in postmenopausal women with hypertension and obesity, working under the influence of harmful factors of production.
An algorithm for the diagnosis and treatment of structural and functional disorders of bone tissue in postmenopausal women with hypertension and obesity, who work in conditions of harmful manufacturing.
Keywords: arterial hypertension, obesity, postmenopause, harmful factors of manufacturing, osteoporosis, osteopenia, osteoprotegerin, vitamin D.
