Lukianets Y. Screening of osteoporosis and osteopenia in women of different ages in association with risk factors for chronic noncommunicable diseases at the primary care

Українська версія

Thesis for the degree of Doctor of Philosophy (PhD)

State registration number


Applicant for


  • 222 - Медицина


Specialized Academic Board

ДФ 26.003.068

Bogomolets National Medical University


Osteoporosis refers to progressive degenerative-metabolic diseases of the skeleton, characterized by a decrease in bone mass due to an imbalance between bone formation and resorption, which leads to a violation of the microarchitecture of bone, an increase in its fragility and the occurrence of complications – osteoporotic fractures In the developed world, as life expectancy increases, osteoporosis becomes one of the main causes of health loss and death. In terms of significance, it is one of the main chronic noncommunicable diseases in the population, which is often identified in the family practice while providing primary health care. The dissertation is targeted at the study of the spread of osteoporosis and osteopenia among women from different regions of Ukraine, the analysis of methods for early detection of this disease in the family practice, the assessment of various algorithms for the risk of osteoporotic fractures (FRAX and Qfracture), the identification of factors that can affect the structural and functional state of bone tissue. The aim of this study was to evaluate bone mineral density, the risk of fractures in women of different ages with risk factors for chronic noncommunicable diseases, compare the prevalence of osteoporosis and osteopenia in different regions of the country, and investigate the possibilities of screening osteoporosis using ultrasound densitometry and using FRAX and Qfracture risk assessment algorithms in the family practice. The object of the research: bone tissue in women of different ages with risk factors for chronic noncommunicable diseases, risk factors for osteoporosis and its complications. The subject of the research: women aged 20 to 87 years with normal bone indicators and structural and functional changes (osteopenia and osteoporosis), with low-energy fractures and no life history of fractures, the 10-year probability to have osteoporotic fractures in postmenopausal women. Research methods: general clinical, instrumental, anamnestic, laboratory, anthropometric, questionnaires, use of QFracture algorithms and the Ukrainian FRAX algorithm model, statistical. Statistical processing of the obtained data was carried out by methods of parametric and nonparametric statistics using a package of statistical programs IBM SPSS Statistics Base v.22 for Windows and "MS Excel 2016". The normality of the distribution was determined by the Shapiro-Wilk test. The results are presented as averages and their standard deviation (M±SD), where M is the average value of the indicator, SD is the standard error and as median (Me) and 25 – 75 quartiles for parametric plus nonparametric distributions, respectively. The reliability of divergence between indicators was determined using the Student's t-test, the Pearson coefficient, Spearman's and Kendall rank correlation coefficients, and analysis of variance (ANOVA). Differences in sample distribution were evaluated using the chi-squared test (χ2 test). Correlation analysis was used to assess links between indicators. ROC analysis was used to assess sensitivity and specificity. In all statistical calculations, the threshold value of the significance level was determined at p<0.05.


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