[THE EFFICIENCY OF THERAPY WITH VITAMIN D METABOLITES OF STRUCTURAL AND FUNCTIONAL CHANGES IN THE BONE TISSUE IN...

The aim of work was to evaluate the efficacy of combination therapy with vitamin D metabolites on mineral bone density and markers of bone remodeling in postmenopausal women with arterial hypertension, obesity and vitamin D deficiency working in adverse environmental conditions. We examined 95 women aged from 48 to 60 years, 79 people (main group) had arterial hypertension, obesity and deficiency vitamin D and worked in adverse conditions of production, 16 were healthy women. The main group depending on the conducted treatment were divided into 3 groups: А group - received standard antihypertensive therapy, Cholecalciferol and Alfacalcidol; group B - standard antihypertensive therapy and Cholecalciferol; group C - standard antihypertensive therapy. The examination included anthropometric measurements (body weight, height, calculation of body mass index, waist circumference, hip circumference, calculation of index waist circumference / hip circumference), measurement of blood pressure, laboratory tests - determination of the 25-hydroxyvitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, osteoprotegerin, instrumental study of mineral density of bone tissue (the definition of T-criterion). The dynamics of the level of 25-hydroxyvitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, osteoprotegerin and mineral density of bone tissue after 6 and 12 months. The results showed a positive effect of Cholecalciferol and Alfacalcidol on the level of 25-hydroxyvitamin D, markers of bone formation in serum and parameters of mineral bone density in women. However, combination therapy with vitamin D metabolites showed a more pronounced effect on the processes of bone formation and mineral density of bone tissue (p<0.05). Found that the lack of correction of deficiency and insufficiency of vitamin D contributes to the progressive decrease in mineral density of bone tissue and disruption of the processes of bone formation. Combination therapy with vitamin D metabolites is effective (p<0.05) and pathogenetically justified in the treatment of vitamin D deficiency and structural and functional changes of bone tissue in postmenopausal women with arterial hypertension and obesity, working in adverse environmental conditions.