The dissertation research is devoted to improving the diagnosis of structural and functional disorders of bone tissue in children and adolescents through a comprehensive analysis of physical development indicators, bone mineral density, and bone quality, taking into account the level of vitamin D sufficiency. This approach makes it possible to increase the accuracy of detecting early changes in the skeletal system and to promote the timely implementation of preventive measures for musculoskeletal diseases and their appropriate treatment.
The purpose of the dissertation research is to improve the diagnosis of structural and functional disorders of bone tissue in children and adolescents by studying indicators of their physical development, bone mineral density, and bone quality, depending on the level of vitamin D sufficiency.
In the course of the study, 142 children aged 8 to 17 years, permanently residing in Kyiv, were examined. All participants underwent a comprehensive set of anthropometric measurements, including determination of height, body weight, and calculation of body mass index. To assess vitamin D status, the concentration of 25-hydroxyvitamin D (25(OH)D) in serum was measured.
Bone mineral density and its structural characteristics were assessed using dual-energy X-ray absorptiometry. Examinations were performed in three anatomical regions: the lumbar spine (L1–L4), the whole body (excluding the head), and the proximal femur. The evaluation of children’s actual nutrition was carried out using the software package 'Rational Nutrition Test' (TRH-analysis).
The study established that 84% of the examined children residing in Kyiv had impaired vitamin D sufficiency (40.8% – deficiency, 43.1% – insufficiency), which depended on the stage of pubertal development. Statistically significantly higher vitamin D levels were recorded at stage I of maturation, followed by a gradual decrease at stages II and III, where critically low levels of vitamin D were observed, indicating an increased risk of deficiency precisely during the period of active hormonal restructuring. The concentration of 25(OH)D was significantly lower in children with reduced bone mineral density, confirming the important role of vitamin D in maintaining bone health during childhood and adolescence.
A reduction in bone mass indices was identified in 6.3% of the examined children, which indicates a potential risk of osteopenia development during adolescence. The assessment of the actual dietary intake of children and adolescents revealed that 61.5% of schoolchildren residing in Kyiv consume a daily diet that fails to meet their physiological requirements due to an imbalanced ratio of proteins, fats, and carbohydrates.
Based on the obtained research results, an algorithm for the diagnosis of bone mineral density disorders in children has been developed, and a prognostic mathematical model has been created for the early detection of disturbances in bone mineralization.
The dissertation presents the results of a comprehensive study on vitamin D status and its impact on physical development as well as the structural and functional condition of bone tissue in school-aged children in Kyiv. For the first time, the prevalence of vitamin D insufficiency and deficiency among schoolchildren aged 8–17 years over the past five years has been established, and the indicators of physical development have been characterized in relation to the level of vitamin D sufficiency.
Bone mineral density and quality in children and adolescents were examined with consideration of age, sex, and vitamin D status. The actual dietary intake and its impact on vitamin D sufficiency were analyzed. Statistically significant risk factors for the development of structural and functional disorders of bone tissue were identified, and a prognostic mathematical model was constructed. An algorithm for the diagnosis of bone mineral density disorders was developed and implemented in the practice of healthcare institutions providing preventive and therapeutic services.
The practical significance of the obtained results lies in the establishment of contemporary normative indices of bone mineral density and quality in children and adolescents in Kyiv, the development of tools for predicting the risk of bone disorders, and the implementation of an effective diagnostic algorithm that contributes to the improvement of early detection and prevention of osteopenic conditions in pediatric practice.
Keywords: children, health, overweight, obesity, calcium, vitamin D, hypovitaminosis D, healthy lifestyle, bone mineral density and quality, densitometry, nutrients, nutrition.
