The latest data support the correlation of atherosclerosis and osteoporosis, indicating the parallel progression of two tissue destruction processes with increased fatal and non-fatal coronary events, as well as higher fracture risk. Vitamin D inadequacy associated with low bone mineral density increases fall and fracture risk, leads to secondary hyperparathyroidism, calcifies coronary arteries and significantly increases cardiovascular disease. Randomized clinical trial evidence related to extraskeletal vitamin D outcomes was limited and generally uninformative. A recent recommendation on vitamin D dietary requirements for bone health is 600 IU/d for ages 1-70 years and 800 IU/d for 71 years and older, corresponding to a serum 25-hydroxyvitamin D level of at least 20 ng/ml (50 nmol/l). Further large randomized controlled trials are needed to reassess laboratory ranges for 25-hydroxyvitamin D in both diseases, in order to avoid under- and over-treatment problems, and completely clarify the relationship between atherosclerosis and osteoporosis.

The study confirmed that the reduction of BMD depends on age and choice of measurement site. The best correlation was obtained in the women with osteopenia at all measurement sites. The discovery of vertebral fractures by lateral thoracic and lumbar spine radiography improves prompt treatment. Reference values of BMD do not exclude vertebral fractures. Of vertebral fractures, 72.5% were asymptomatic and thus spine radiographies are obligatory. Currently discussed is the position of DXA for measuring BMD as a method of detection for patients at risk of fracture.

Our results showed a high prevalence of vitamin D insufficiency (88.4%) among postmenopausal women. The levels of 25(OH)D and PTH changed significantly according to the season.

Kratak sadr`aj: Uticaj sepse na mozak nije u potpunosti ra z ja{njen. U ovom radu, ispitivali smo vrednosti proteina S100b, kao biomarkera o{te}enja mozga, kod te{ke sepse. Cilj rada bio je da se utvrdi da li su vrednosti proteina S100b povi{ene na samom po~etku bolesti i da li se na osnovu njih mo`e predvideti ishod. Ispitano je 30 pacijenata sa te{kom sepsom, koji su bili podeljeni na pre`ivele (n=8) i umrle (n=22). Za analizu, uzimana je krv u prvih 24h od pojave simptoma. Koncentracija proteina S100b merena je pomo}u imunolo{kog testa meto dom elektrohemiluminiscencije (Elecsys 2010, Roche Dia g no stics). Tako|e, meren je i nivo C-reaktivnog proteina (CRP) imuno ne felometrijskim testom. Od 30 ispitanih pacijenata, 74,4% imalo je povi{ene vrednosti proteina S100b, dok je 25,6% imalo vrednosti u okviru referentnog opsega. Povi{ene vrednosti CRP imalo je svih 30 pacijenata. Izme|u pre `ivelih i umrlih nije bilo statisti~ki zna~ajne razlike u srednjoj vrednosti proteina S100b i CRP (0,390±0,515 vs. 0,415±0,508 mg/L; 98,76±69,94 vs. 161,68±118,38 mg/L). Korelacija izme|u proteina S100b i ishoda nije na|ena. Povi{ene vrednosti S100b ukazuju na verovatna difuzna okultna o{te}enja mozga, koja mogu biti i reverzibilna. Osim toga, protein S100b nije dovoljno pouzdan marker za rano predvi|anje ishoda kod pacijenata obolelih od te{ke sepse.Klju~ne re~i: o{te}enje mozga, C-reaktivni protein, sepsa, S100bSummary: The effects of sepsis on the brain are not fully elucidated. This study investigated the serum levels of S100b protein in severe sepsis, as a biomarker of brain damage. The aim was to determine whether the levels of S100b are increased early, at the onset of sepsis, and if this protein is a good early predictor of outcome. We studied 30 patients with severe sepsis, divided into the survivors (n=8) and norsurvivors (n=22). Blood was sampled within the first 24h after the onset of symptoms. The concentrations of S100b were measu red using an electrochemiluminiscence immu noassay (Elec sys 2010, Roche Diagno stics). Also, we measured the levels of C-reactive protein (CRP) using the immunonephelometric assay. Out of 30 patients, 74.4% had increased levels of S100b, while 25.6% had values within the reference range. A total of 30 patients had increased levels of CRP. The mean values of S100b and CRP did not differ significantly between the survi vors and nonsurvivors (0.390±0.515 vs. 0.415± 0.508 mg/L; 98.76±69.94 vs. 161.68±118.38 mg/L). Corre lation bet ween S100b and outcome was not found. The increased le vels of S100b indicate possible occult diffu se brain injury, that can be reversible. Moreover, the study sho wed S100b protein not to be a good early predictor of outcome in severe sepsis.