MODERN MARKERS OF OSTEODYSMETABOLIC SYNDROME

Abstract

Osteoporosis is a prevalent systemic osteodysmetabolic disease affecting bone tissue, characterized by a loss of bone mass, microstructure disturbances, and an increased susceptibility to low-traumatic fractures. Global statistical data from 2019 indicate that 32 million people worldwide were diagnosed with osteoporosis, with 25.5 million being women and 6.5 million men. Hypoestrogeny, considered one of the key mechanisms in the development of osteometabolic syndrome, disrupts the RANK/RANKL/OTG signalling system by activating nuclear factor-κB (NF-KB) or STAT-3. This activation triggers osteoclastogenesis and subsequently leads to the development of osteoporosis, which is a significant global health concern. The aim of this study is to investigate the specific features of osteometabolic changes in bone tissue and assess the 10-year risks of osteoporotic fractures and hip fractures. An examination was conducted on 130 individuals (116 women and 14 men) with an average age of 55.3±15.4 years. The participants were further divided into three groups: Group I (main group, n=85), Group II (control group, n=31), and Group III (comparative group, n=14). Anthropometric parameters were evaluated, revealing deviations in body mass index (BMI) from the norm. The average BMI values were as follows: Group I - 27.2±5.2 kg/m2, Group II - 23.4±4.3 kg/m2, and Group III - 25.8±3.5 kg/m2 (p = 0.0013). Estimating the 10-year probability of developing osteoporotic fractures using the FRAX model indicated a higher likelihood in the main group compared to the control group (7.4% [4.0–15.0%] vs. 2.7% [2.4–3.3%], p = 0.0001). When analyzing the 10-year risk of hip fracture, the results were as follows: Group I - 1.1% [0.2–5.1%], Group II - 0.1% [0–0.3%], and Group III - 0.15% [0.1–0.4%] (p = 0.0001). These findings suggest the activation of systemic inflammatory pathways as a consequence of hypoestrogenism in women from the main group. This study clearly demonstrates a higher likelihood of 10 different osteoporotic fractures and hip fractures, as indicated by the FRAX model, in the main group compared to Groups II and III. Therefore, utilizing ultrasound densitometry in conjunction with the FRAX model can help prevent the occurrence of osteoporotic fractures and hip fractures. Furthermore, when changes in tissue mineral density and markers of systemic inflammation are detected, it enables the development of gender-specific approaches for further diagnosis and treatment