Abstract Alcoholic osteonecrosis of the femoral head (AIONFH) is caused by long-term heavy drinking, which leads to abnormal alcohol and lipid metabolism, resulting in femoral head tissue damage, and then pathological necrosis of femoral head tissue. If not treated in time in clinical practice, it will seriously affect the quality of life of patients and even require hip replacement to treat alcoholic femoral head necrosis. This study will confirm whether M2 macrophage exosome (M2-Exo) miR-122 mediates alcohol-induced BMSCs osteogenic differentiation, ultimately leading to the inhibition of femoral head necrosis. M2 macrophages were identified by flow cytometry, and the isolated exosomes were characterized by transmission electron microscopy (TEM) and Nanoparticle Tracking Analysis (NTA). Next, miR-122 was overexpressed by transfecting miR-122 mimic, and the expression of miR-122 in M2 macrophages and their exosomes was evaluated. Subsequently, the effect of exosomal miR-122 on the osteogenic differentiation ability of BMSCs was detected, including cell proliferation, expression of osteogenic-related genes (RUNX2, BMP2, OPN, ALP), and calcium nodule formation. Finally, the therapeutic effect of M2-Exo was analyzed in a rat model of AIONFH, and bone repair and pathological damage were evaluated by Micro-CT, RT-qPCR, HE, Masson staining, and immunohistochemistry (COL I). The results showed that M2 macrophages were successfully polarized, with an average M2-Exo particle size of 156.4 nm and a concentration of 3.2E + 12 particles/mL. The expression of miR-122 in M2 macrophages is significantly higher than that in M0 macrophages, and miR-122 mimic can increase the content of miR-122 in M2-Exo. miR-122 in M2-Exo can promote osteogenic differentiation of rat bone marrow BMSCs, enhance cell viability, and increase the expression of osteogenesis-related genes. After being applied to the AIONFH rat model, the injection of M2-exo and miR-122 mimics significantly improved the repair effect of articular cartilage, alleviated pathological changes, and promoted the regeneration of bone tissue. M2-macrophage-derived exosomal miR-122 induces osteogenic differentiation of bone mesenchymal stem cells in treating AIONFH.
Orthopedic surgery, Diseases of the musculoskeletal system
Jorge Roberto Mosqueira Sanchez, Julio Cesar Layseca Ortiz, Nancy Victoria Mogrovejo Olivera
Osteopoikilosis, or disseminated condensing osteopathy, is an osteosclerosing dysplasia that is a rare genetic disorder of autosomal-dominant genetic transmission, and recent research suggests that the possible cause of osteopoikilosis might be the loss of function of the LEM domain-containing gene 3 (LEMD3). We describe the case of a young man with arm pain associated with increased volume, functional limitation, and fever who presented to the emergency department. Radiographic and magnetic resonance images are provided, which reveal bilateral periarticular osteosclerotic lesions in the pelvis, humeral head, and scapular region, showing no signs of malignancy.
Nicholas B. Sajjadi, Ryan Ottwell, Samuel Shepard
et al.
Abstract Context Osteopathic medicine in the United States continues to produce a substantial number of physicians and medical educators. However, recently popularized misconceptions about osteopathic medical practice, education, and manual therapy suggest an unsettling prevalence of inaccurate beliefs held by the public. The public often searches the internet to find out information about osteopathic medicine, but the content of questions and the transparency of the resulting information is unknown. Objectives We sought to explore frequently asked questions (FAQs) generated by Google to assess commonly searched questions about the osteopathic profession and to determine the level of information transparency associated with resulting sources. Methods On June 16, 2021, we searched Google for three terms: “osteopathic medicine,” “doctor of osteopathic medicine,” and “DO,” until a minimum of 100 FAQs and their answer links were extracted from each search. After excluding irrelevant FAQs, we used Rothwell’s Classification of Questions to categorize the FAQs. We then used the Journal of the American Medical Association’s Benchmark Criteria to assess information transparency for each corresponding answer source provided by Google. The answer sources were screened for the inappropriate use of “osteopathy” in place of “osteopathic medicine” and for “osteopath” in place of “DO,” “Doctor of Osteopathic Medicine,” or “Osteopathic Physician.” We performed statistical tests to ascertain the differences in information transparency between osteopathic and nonosteopathic information sources. Results Our Google search revealed 110 unique FAQs about osteopathic medicine. The majority of FAQs were classified as fact-based (82/110; 74.55%), nearly half of which (45.12%) were related to the medical practicing privileges of DOs. The FAQs were most commonly answered by academic institutions (44/110, 40.0%). Nearly half (49.09%) of the linked answer sources were deemed inadequate by JAMA benchmark criteria. Of the 110 linked answer sources, 19 (17.27%) misused either osteopathy, osteopath, or both to describe osteopathic physicians. Only 30 sources were linked to US-based osteopathic organizations. Osteopathic organizations were statistically less likely to meet high-transparency criteria than nonosteopathic organizations (p=0.002). Conclusions Our study shows that the US public may be unsure about the physician status of DOs, which may prevent securing the professional identity of osteopathic physicians in the eyes of the public. Osteopathic organizations should tailor awareness campaigns toward addressing the common misconceptions revealed by our study. Osteopathic organizations should use transparency criteria as a rubric when publishing information to enhance transparency.
Abstract Context The United States Medical Licensing Examination (USMLE) is not required for osteopathic students to match into postgraduate programs; however, it is unknown if taking the test improves their chances of matching. Objectives Our objective was to determine the association between taking the USMLE Step 1 and matching into the applicant’s preferred specialty for senior osteopathic students applying to the 10 specialties to which students applied most in 2020. Methods We performed a secondary analysis of the free and publicly available 2020 National Residency Match Program (NRMP) published match report for senior osteopathic students. First, we determined the number of senior osteopathic students that matched into their preferred specialty vs those that did not and stratified them by reported completion of the USMLE Step 1 within each specialty. Next, we calculated odds ratios (ORs) within each specialty for senior osteopathic students matching into their preferred specialty with and without the USMLE Step 1 utilizing the Fisher’s exact test. Finally, we repeated the analysis with only senior osteopathic students who had reported USMLE Step 1 scores in ranges including or below the mean for those who matched in their specialty. Results For senior osteopathic students, reported completion of the USMLE Step 1 was associated with matching for those who applied to Internal Medicine (OR 3.3 [95% confidence interval 2.07 to 5.48]), Emergency Medicine (2.1 [1.35 to 3.17]), Pediatrics (4.4 [1.38 to 18.63]), Psychiatry (2.5 [1.34 to 4.98]), Anesthesiology (3.4 [1.57 to 7.32]), and General Surgery (3.1 [1.56 to 6.14]). After repeating the analysis with only senior osteopathic students who reported low USMLE Step 1 scores, the association remained significant for those who applied to Internal Medicine (2.5 [1.49 to 4.28]), Anesthesiology (2.6 [1.17 to 5.54]), and General Surgery (2.5 [1.24 to 5.04]). Conclusions In 2020, reported completion of the USMLE Step 1 by senior osteopathic students was associated with matching for those who applied to Internal Medicine, Emergency Medicine, Pediatrics, Psychiatry, Anesthesiology, and General Surgery. In addition, reported completion of the USMLE Step 1 with a low score was associated with matching for those who applied to Internal Medicine, Anesthesiology, and General Surgery.
Stéphane Kremer, Frederic Blanc, Sabrina Kepka
et al.
Introduction Soccer is the most popular sport in the world. This contact sport carries the risk of exposure to repeated head impacts in the form of subconcussions, defined as minimal brain injuries following head impact, with no symptom of concussion. While it has been suggested that exposure to repetitive subconcussive events can result in long-term neurophysiological modifications, and the later development of chronic traumatic encephalopathy, the consequences of these repeated impacts remain controversial and largely unexplored in the context of soccer players.Methods and analysis This is a prospective, single-centre, exposure/non-exposure, transverse study assessing the MRI and neuropsychological abnormalities in professional retired soccer players exposed to subconcussive impacts, compared with high-level athletes not exposed to head impacts. The primary outcome corresponds to the results of MRI by advanced MRI techniques (diffusion tensor, cerebral perfusion, functional MRI, cerebral volumetry and cortical thickness, spectroscopy, susceptibility imaging). Secondary outcomes are the results of the neuropsychological tests: number of errors and time to complete tests. We hypothesise that repeated subconcussive impacts could lead to morphological lesions and impact on soccer players’ cognitive skills in the long term.Ethics and dissemination Ethics approval has been obtained and the study was approved by the Comité de Protection des Personnes (CPP) No 2021-A01169-32. Study findings will be disseminated by publication in a high-impact international journal. Results will be presented at national and international imaging meetings.Trial registration number NCT04903015.
<h4>Background</h4>This study describes osteopathic practise activity, scope of practice and the osteopathic patient profile in order to understand the role osteopathy plays within the United Kingdom's (UK) health system a decade after our previous survey.<h4>Method</h4>We used a retrospective questionnaire survey design to ask about osteopathic practice and audit patient case notes. All UK registered osteopaths were invited to participate in the survey. The survey was conducted using a web-based system. Each participating osteopath was asked about themselves, their practice and asked to randomly select and extract data from up to 8 random new patient health records during 2018. All patient related data were anonymised.<h4>Results</h4>The survey response rate was 500 osteopaths (9.4% of the profession) who provided information about 395 patients and 2,215 consultations. Most osteopaths were self-employed (81.1%; 344/424 responses) working alone either exclusively or often (63.9%; 237/371) and were able to offer 48.6% of patients an appointment within 3 days (184/379). Patient ages ranged from 1 month to 96 years (mean 44.7 years, Std Dev. 21.5), of these 58.4% (227/389) were female. Infants <1 years old represented 4.8% (18/379) of patients. The majority of patients presented with musculoskeletal complaints (81.0%; 306/378). Persistent complaints (present for more than 12 weeks before appointment) were the most common (67.9%; 256/377) and 41.7% (156/374) of patients had co-existing medical conditions. The most common treatment approaches used at the first appointment were soft-tissue techniques (73.9%; 292/395), articulatory techniques (69.4%; 274/395) and high velocity low amplitude thrust (34.4%; 136/395). The mean number of treatments per patient was 7 (mode 4).<h4>Conclusion</h4>Osteopaths predominantly provide care of musculoskeletal conditions, typically in private practice. To better understand the role of osteopathy in UK health service delivery, the profession needs to do more research with patients in order to understand their needs and their expected outcomes of care, and for this to inform osteopathic practice and education.
The osteopathic community has long hypothesized that the autonomic nervous system (ANS) represents one of the putative substrates through which osteopathic manipulative treatment (OMT) can improve body functions that have been altered by musculoskeletal alterations. Heart rate variability (HRV) is an important physiological measure of cardiac ANS activity. Emerging evidence suggests that OMT is associated with HRV changes that (i) are indicative of a larger cardiac vagal modulation, (ii) are independent from the part of the body needing treatment, (iii) occur even in the absence of musculoskeletal alterations. Yet, many questions remain unanswered, the duration of these effects and the specificity of HRV responses to different OMT techniques being perhaps the most critical. Therefore, this paper discusses prospects for future applications of HRV for the study of the influence of OMT on ANS function. Moreover, based on existing studies and preliminary data on the effects of OMT on HRV in specific pathological (hypertension) and physiological (stress exposure and recovery from sport competition) conditions that are commonly associated with increased sympathetic and/or decreased vagal activity, we propose that HRV analysis could be exploited to evaluate the effectiveness of OMT as a preventive or complementary strategy in clinical and non-clinical conditions characterized by ANS imbalance.
Background The transition from American Osteopathic Association (AOA) and Accreditation Council for Graduate Medical Education (ACGME) residency matches to a single graduate medical education accreditation system culminated in a single match in 2020. Without AOA-accredited residency programs, which were open only to osteopathic medical (DO) graduates, it is not clear how desirable DO candidates will be in the unified match. To avoid increased costs and inefficiencies from overapplying to programs, DO applicants could benefit from knowing which specialties and ACGME-accredited programs have historically trained DO graduates. Objective This study explores the characteristics of residency programs that report accepting DO students. Methods Data from the American Medical Association's Fellowship and Residency Electronic Interactive Database Access were analyzed for percentage of DO residents in each program. Descriptive statistics and a logit link generalized linear model for a gamma distribution were performed. Results Characteristics associated with graduate medical education programs that reported a lower percentage of DO graduates as residents were surgical subspecialties, longer training, and higher US Medical Licensing Examination Step 1 scores of their residents compared with specialty average. Characteristics associated with a higher percentage of DO graduates included interviewing more candidates for first-year positions and reporting a higher percentage of female residents. Conclusions Wide variation exists in the percentage of DO graduates accepted as residents among specialties and programs. This study provides valuable information about the single Match for DO graduates and their advisers and outlines education opportunities for the osteopathic profession among the specialties with low percentages of DO students as residents.
Andréia Vielmo, Ronaldo Michel Bianchi, Letícia Franciele Gomes Kinappe
et al.
ABSTRACT: Prostatic carcinomas in are aggressive neoplasms and bone metastases may occur; however, hypertrophic osteopathy associated with that condition is poorly documented. A ten-year-old, neutered male, mixed breed dog had a history of lameness and volume increase in the left pelvic limb. On radiographic examination, a lytic bone mass was observed in the left metatarsus, as well as a diffuse proliferative periosteal reaction in several bones of the appendicular skeleton, in addition to radiopaque nodular structures in all lung lobes. A presumptive diagnosis of primary bone neoplasia with pulmonary metastases and hypertrophic osteopathy was established and chemotherapy treatment was started. However, there was no satisfactory clinical response, and euthanasia was ellected. At necropsy, there was moderate enlargement of the prostate gland. The gland was firm and whitish, with a multilobulated aspect. Several similar masses were observed in the right kidney, lungs, mediastinal lymph nodes, and multiple bones of the appendicular skeleton. These bones also presented evident diffuse periosteal reaction. Histological examination revealed a metastatic prostatic carcinoma with bone involvement and hypertrophic osteopathy. This report is an unusual case of metastatic prostatic carcinoma in association with hypertrophic osteopathy and concomitant bone metastases.
Julie A. Swartzendruber Ryan W. Incrocci Samantha A. Wolf Ariee Jung Katherine L. Knight College of Graduate Studies, Midwestern University, Downers Grove, Illinois Department of Microbiology and Immunology, Midwestern University, Downers Grove, Illinois Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Illinois College of Dental Medicine – Illinois, Midwestern University, Downers Grove, Illinois Microbiology and Immunology, Loyola University Chicago, Maywood, Illinois
Background: Musculoskeletal (MSK) disorders are one of the most common causes of disability and emergency department and physician visits in the United States. However, there is very little consistency in how physicians in training are prepared to treat MSK disorders. On the basis of published reports, medical school graduates have a relative lack of cognitive mastery in MSK medicine, even with the recent increase in instruction. This study sought to compare MSK education at an allopathic medical school with that at an osteopathic medical school. Methods: An anonymous survey of students in medical school graduate years 2, 3, and 4 at Michigan State University College of Human Medicine (allopathic) and College of Osteopathic Medicine (osteopathic) was conducted. Questions were structured into three main categories: demographic information, content of the current MSK curriculum, and opinions regarding importance, instruction, and assessment of MSK education. Results: As of 2010, 83% of medical schools require MSK courses because of the United States Bone and Joint Initiative to incorporate such coursework into core curriculum. Yet only 54% of surveyed students thought that their MSK education was adequate. A greater portion of osteopathic students (57.1%) compared with allopathic students (26.8%) thought that their MSK curriculum is adequate, and as a consequence, 36.6% of allopathic students thought that they were inadequately prepared for the MSK content of US medical licensing examinations compared with 8.1% of osteopathic students. Further curriculum development and improvement is needed to advance physicians' abilities to address and treat MSK disorders. Medical students surveyed feel that this goal can be accomplished by emphasizing MSK education in third and fourth years of medical school. Conclusion: These findings highlight differences in MSK education between an allopathic and osteopathic medical school. Further standardization of the curriculum in medical schools may help improve the quality of teaching student comfort levels of new physicians. Level of Evidence: Level III
Pierre-Yves Rodondi,1,2 Anne-Sylvie Bill,1 Nadia Danon,3 Julie Dubois,1,2 Jérôme Pasquier,1 Florence Matthey-de-l’Endroit,1 Lilli Herzig,1 Bernard Burnand11Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland; 2Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland; 3Pain Center and Center for integrative and complementary medicine, Department of Anesthesiology, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, SwitzerlandPurpose: To investigate among primary care patients and their physicians in western Switzerland the prevalence of use, perceived usefulness, and communication about common treatments for chronic or recurrent low back pain (crLBP) including complementary medicine (CM).Patients and methods: A cross-sectional cluster observational study involving 499 crLBP patients visiting 45 primary care physicians (PCPs) was conducted from November 1, 2015, to May 31, 2016. Patients and primary care physicians completed questionnaires about lifetime use and usefulness of 30 crLBP therapies. We conducted multivariate analyses of factors associated with therapy use, including sociodemographic variables, pain duration, insurance coverage, and primary care physicians’ characteristics.Results: The five most frequent modalities used at least once by patients were physiotherapy (81.8%), osteopathic treatment (63.4%), exercise therapy (53.4%), opioids (52.5%), and therapeutic massage (50.8%). For their PCPs, the five most useful therapies were physiotherapy, osteopathic treatment, yoga, meditation, and manual therapy. In multivariate analysis, the use of physiotherapy was significantly associated with longer pain duration; osteopathic treatment was associated with age under 75 years, female gender, higher education, and CM insurance coverage. Exercise therapy was associated with non-smoking and longer pain duration. Smokers were more likely and patients of PCPs with CM training were less likely to have used opioids. During their lifetime, 86.6% of the participants had used at least one CM therapy to manage their crLBP, with a mean of 3.3 (SD=2.9) therapies used per participant; 46.1% of participants reported that their PCP did not enquire about CM use. Among CM users, 64.7% informed their PCP about it.Conclusion: Patients with crLBP use a variety of treatments, including self-prescribed and unreimbursed therapies, most frequently physiotherapy and osteopathy. The results suggest that PCPs should systematically discuss with their patients the treatments they tried to manage crLBP, including CM.Keywords: chronic low back pain, lifetime use, treatments
Abstract Introduction The aim of this study was to evaluate the implementation of a 'third wave' cognitive behavioural therapy and osteopathic treatment programme (OsteoMAP) and explore its effect on patients with chronic musculoskeletal pain. Method This evaluation included a non-randomised before-and-after patient reported outcomes study with an embedded fidelity evaluation. Patients were seen for 1 h per week for six weeks. They received a questionnaire prior to receiving treatment and six months later. A purposive sample of patients were interviewed and clinical sessions were observed to evaluate competence and adherence to the intervention manual. Results 208 patients were enrolled and 86% attended 3 or more OsteoMAP sessions. 82 students were trained to deliver the intervention under supervision. They were >90% adherent to the manual in 8 of the 12 domains measured. At baseline (n = 147), 69% of patients were female, 64% white and 77% reported pain for more than one year. At 6 months (matched pairs n = 63), there were clinically important changes of 58% in a composite score for pain, function, mood and coping (Bournemouth Questionnaire) and significantly higher psychological flexibility scores (difference in means 6.98 (95% CI 4.2,9.8)) (Acceptance and Action Questionnaire). No statistically significant change was seen in mindfulness (Freiburg Mindfulness Inventory), 30% of patients reported temporary symptom increases during the course but 95% were satisfied or very satisfied with their overall experience and outcomes. Conclusions OsteoMAP was feasible, well received with some beneficial effects. Integrating psychological and osteopathic care shows promise and further research is warranted to assess effectiveness.
Abstract Background This study investigated perceived preparedness to practice, one year after graduation across osteopathic education institutions (OEIs) and explored possible differences between countries where osteopathy is regulated (Reg) and countries where it is not (Unreg). Methods Two hundred forty-five graduates from 7 OEIs in 4 European countries, already assessed in a previous study, were contacted one year after their graduation to complete the survey. Survey tools included a questionnaire to assess perceived preparedness to practice: Association of American Medical Colleges (AAMC) questionnaire, and a questionnaire to collect socio-demographic information and practice characteristics. Results One hundred sixty-eight graduates (68.6%) completed the survey. The AAMC mean score one year after the graduation (23.19; confidence interval 22.81–23.58) was significantly higher than in the previous study (17.58; 16.90–18.26) (p < 0.001). A difference was also found between Reg (23.49; 23.03–23.95) and Unreg (22.34; 21.74–22.94) (p = 0.004). Osteopaths with a previous healthcare degree scored significantly higher on AAMC score (25.53; 24.88–26.19) than osteopaths without a previous healthcare degree (22.33; 21.97–22.69) (p < 0.001). Regulation and a previous degree were the only significant independent variables in the most predictive multivariate linear model. The model had an r2 = 0.33. Conclusions Graduates from OEIs where osteopathy is regulated felt significantly better prepared to practice than Unreg. Systematic information searches about graduates’ perception of preparedness to practice, may enable OEIs to strengthen their existing curricula to ensure their graduates are effectively prepared to practice.
Los fitoestrógenos representan una familia de componentes derivados de plantas. Tienen una estructura esteroidea y son capaces de actuar en el receptor estrogénico. Poseen propiedades tanto estrogénicas como antiestrogénicas, en función del tejido en el que actúen. Los mecanismos potenciales por los cuales los fitoestrógenos pueden afectar a las actividades celulares se han dividido en efectos genómicos y no genómicos. Los primeros actúan a través de receptores de estrógenos, y estos últimos están mediados por proteínas celulares.
El mecanismo de acción de las isoflavonas de soja en el hueso puede considerarse beneficioso, ya que actúan estimulando la actividad de los osteoblastos. Por otra parte, a través del sistema RANK-L/OPG inducen una disminución en la supervivencia y la actividad de los osteoclastos.
Este artículo revisa estudios in vitro, en animales y humanos, que involucran a las isoflavonas y la salud ósea con el fin de conocer el efecto que sobre ésta tendrán dichas sustancias en aquellas mujeres postmenopáusicas que las utilizan en el contexto del tratamiento o prevención del síndrome climatérico.
En general, la valoración global de los estudios en humanos muestra variabilidad en el diseño, en la variedad de fuentes de isoflavonas, en el tiempo del análisis y en la dosis. Además, es preciso considerar la variabilidad en la biodisponibilidad y el metabolismo de las isoflavonas entre los sujetos. Todo ello dificulta obtener conclusiones consistentes.
En conclusión, los resultados arrojan algunos resultados positivos, justificando la necesidad de investigaciones adicionales. Desde un punto de vista clínico, las isoflavonas son utilizadas en aquellas mujeres con síntomas climatéricos que no pueden o no desean realizar terapia hormonal. No estarían indicadas con el objetivo de tratar la osteoporosis, pero aquellas mujeres que las utilizan a las dosis y tiempo adecuados pueden esperar un beneficio en el sentido de mantenimiento de su masa ósea.
Teona Albertovna Shvangiradze, Denis Igorevich Burchakov, Larisa K. Dzeranova
et al.
This paper presents a case of primary hyperparathyroidism with a broad spectrum of metabolic disturbances and concomitant sleep apnea syndrome. As shown a timely surgical treatment helps to improve the mineral parameters and alleviate the risk of possible cardiovascular complications in future.
The article is the RePrint from the original publication in Obesity and Metabolism (2014) 11(3); pp. 51-55. doi: 10.14341/omet2014351-55
С сахарным диабетом 2 типа связано увеличение риска переломов. Дефицит витамина Д и ответное повышение уровня паратгормона чаще встречаются у пациентов с сахарным диабетом 2 типа и являются факторами, повышающими риск переломов. Цель исследования - изучить распространенность повышения уровня паратгормона у пациенток с сахарным диабетом 2 типа в период постменопаузы. Материал и методы. В кросс - секционное исследование вошли 57 пациенток с сахарным диабетом 2 типа (СД2) периода постменопаузы, находившиеся на стационарном лечении в отделении эндокринологии ГБУЗ СО СОКБ № 1 с 01 января 2015 по 01 декабря 2015 года. В ходе исследования изучен уровень паратгормона, общего кальция, фосфора в крови. Для исследования уровня 25(ОН)D случайным образом отобраны 15 пациенток. В ходе двухэнергетической рентгеновской абсорбциометрии (ДХА) изучена минеральная плотность костной ткани (МПК) шейки бедра, поясничного отдела позвоночника, произведен расчет Т-критерия. Для оценки микроархитектоники костной ткани исследован костный трабекулярный индекс (trabecular bone score (TBS)). Корреляция уровня паратгормона с антропометрическими, анамнестическими данными, данными МПК, TBS рассчитана при помощи корреляции Пирсона. Результаты. Средний возраст пациенток составил 62,34±6,64 лет, длительность СД2 12,99±7,38 лет, длительность менопаузы 12,41±7,21 лет. Остеопороз, по данным Т- критерия (менее -2,5 стандартных отклонений (СО)), при ДХА выявлен у 2 (3,40%) пациенток, остеопения (Т критерий менее -1,0 СО) - у 22 (37,28%) пациенток. Уровень паратгормона в среднем составил 48,71±25,93 пг/мл. Повышение уровня паратгормона выше референсного значения (15-65 пг/мл) выявлено у 12 из 57 пациенток, что составило 21%. Выявлена положительная корреляция средней силы уровня паратгормона с длительностью менопаузы пациенток (r=-0.36), слабая корреляционная слабой силы с индексом массы тела (r=-0.21), отрицательная связь слабой силы с уровнем клубочковой фильтрации (CKD-EPI) и TBS (r= - 0.28, -0,21соответственно). Мы выявили отрицательную корреляцию умеренной силы между уровнем паратгоромо-на и фосфора венозной сыворотки (r= - 0,36), тогда как с уровнем общего кальция связи не обнаружено. Средний уровень 25(ОН)D составил 10,33±7,85 нг/мл. У 10 (66,67%) пациенток уровень 25(ОН)D соответствовал выраженному дефициту витамина Д (менее 10 нг/мл), у 3 (20%) умеренному дефициту (10-20 нг/мл), у 1 пациентки (6,67%) - в диапазоне 20-30 нг/мл, что соответствует недостатку витамина Д. Только у одной пациентки уровень 25(ОН)D был на достаточном уровне (более 30 нг/мл). Между уровнем паратгормона и 25(ОН)D выявлена отрицательная корреляция умеренной силы. Выводы. У пациенток с СД 2 в период постменопаузы выявлена высокая распространенность дефицита витамина Д и повышения уровня паратгормона. Своевременное выявление позволит назначить адекватные (насыщающие) дозы витамина Д, предотвратить формирование вторичного гиперпаратиреоза и, вероятно, снизить риск переломов.