Objectives. Osteoporosis, in addition to its consequent fracture burden, is a common and costly condition. FRAX® is a well-established, validated, web-based tool which calculates the 10-year probability of fragility fractures. A FRAX model for Ukraine has been available since 2016 but its output has not yet been translated into intervention thresholds for the treatment of osteoporosis in Ukraine; we aimed to address this unmet need in this analysis. Methods. In a referral population sample of 3790 Ukrainian women, 10-year probabilities of major osteoporotic fracture (MOF) and hip fracture separately were calculated using the Ukrainian FRAX model, with and without femoral neck bone mineral density (BMD). We used a similar approach to that first proposed by the UK National Osteoporosis Guideline Group, whereby treatment is indicated if the probability equals or exceeds that of a woman of the same age with a prior fracture. Results. The MOF intervention threshold in females (the age-specific 10-year fracture probability) increased with age from 5.5% at the age of 40 years to 11% at the age of 75 years where it plateaued and then decreased slightly at age 90 (10%). Lower and upper thresholds were also defined to determine the need for BMD, if not already measured; the approach targets BMD measurements to those at or near the intervention threshold. The proportion of the referral populations eligible for treatment, based on prior fracture or similar or greater probability, ranged from 44% to 69% depending on age. The prevalence of the previous fracture rose with age, as did the proportion eligible for treatment. In contrast, the requirement for BMD testing decreased with age. Conclusions. The present study describes the development and application of FRAX-based assessment guidelines in Ukraine. The thresholds can be used in the presence or absence of access to BMD and optimize the use of BMD where access is restricted.

The aim of the study was to investigate the relationship between bone mineral density (BMD) of lumbar spine, femoral neck, trabecular bone score (TBS) and body mass index (BMI), in postmenopausal women with knee osteoarthritis (OA). Materials and methods: The study group comprised 359 postmenopausal women aged 50-89 years. They were divided into 2 groups: I group – 117 postmenopausal women with symptomatic knee OA and II group –242 women with a normal functional activity of knee joints. Analysis of data was performed taking into account their BMD of lumbar spine (L1-L4) and femoral neck, measured by the Dual-energy X-ray absorptiometry (DXA) Hologic (Discovery WI, USA, 2016). TBS of L1-L4 was detected by TBS insight® software (MedImaps, Pessac, France), and BMI classified by World Health Organization (WHO). Results: In postmenopausal women with obesity prevalence of symptomatic knee OA was detected in 41.1% of cases. However, in women with normal BMI knee OA was revealed in 29.0% of women. The highest level of knee OA in obese women aged 70-79 years – 45.8%. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2=5.05, p=0.02). Conclusion: Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of knee. Significant negative correlation were detected between TBS and BMI, and significant positive correlations between lumbar spine BMD and BMI.

Background. The purpose of the study is to determine the serum level of N-terminal propeptide of type I procollagen (PINP) in healthy men and women of various ages. Materials and methods. The study included 1,568 individuals (1,422 females and 146 males, aged 20-89 years (mean age 60.36 ± 13.68 yrs). All patients were divided into 7 groups, by decades and according to the gerontological age classification: young age-20-44 yrs, middle age 45-59 yrs, elderly 60-74 yrs, and old 75-89 yrs. During the study, we examined the effect of such demographic characteristics, as age and gender, on serum PINP level, using the electrochemiluminescence immunoassay ECLIA on the cobas e 411 analyzer. Results. We have detected no significant effect of age on the serum variability of PINP in females (F = 1.453, p = 0.19). However, we observed a significant decrease of PINP level in the female age groups of 40-49 yrs (47.74 ± 21.31, p = 0.02), 60-69 yrs (49.76 ± 25.75, p = 0.03), 70-79 yrs (50.49 ± 26.71, p = 0.04), compared with the age group of 20-29 yrs (58.67 ± 27.46). The regression analysis revealed a significant decrease of PINP level with age in young women and men (20-44 years). When comparing serum PINP level in the oldest age group (80-89 years), we detected its increase in women (55.20 ± 28.38 ng/ml), compared with the 70-79 years group (50.49 ± 26.71 ng/ml), and its decrease in men (54.87 ± 28.24 and 39.16 ± 12.46 ng/ml, respectively). In men, we revealed significant effect of age on the serum variability of PINP (F = 3,077, p = 0.007). Conclusions. The regression analysis showed a significant decrease in PINP level with age in men and women of 20-44 years. In men, we detected a significant effect of age on the variability of serum PINP level. A comparison of serum PINP levels in the oldest age group of 80-89 revealed its increase in women, compared to the 70-79 age group, and decrease in men. The obtained results may be used as reference values for PINP level in serum among representatives of the Ukrainian population of various ages and sexes.

Introduction. Despite the recent ASBMR, AACE, Endocrine Society, ECTS&NOF guidelines for osteoporosis management in the era of COVID-19 the impact of antiosteoporotic drugs on disease risk and severity is insufficiently studied. The purpose of this study was to assess the COVID-19 risk for the patients receiving the parenteral bisphosphonate or Denosumab treatment, and the severity of its course in patients with systemic osteoporosis. Materials and methods. We performed the phone survey and studied the results of 195 patients (92 % women; mean age – 62.7 ± 10.8 years) with systemic osteoporosis depending on the current use of parenteral antiresorptive drugs (Zoledronic, Ibandronic acids, or Denosumab, n = 125) and compared the results with data of the patients with osteoporosis who did not use any anti-osteoporotic drugs previously (n = 70). Results. The group of patients with COVID-19 included 32.9 % of patients who did not receive previously any anti-osteoporotic treatment and 33.3 % of osteoporotic patients treated with parenteral antiresorptive drugs. The share of the patients taking the Zoledronic acid who fell ill with COVID-19 was 29.2 %, the share of those ta­king the Ibandronic acid was 34.4 %, and the share of those taking Denosumab was 42.9 %. We did not reveal any significant differences in the COVID-19 frequency and severity depending on the presence and type of parenteral anti-osteoporotic therapy. Additionally, there were no differences depen­ding on the patients' age, gender, obesity, and other osteoporosis risk factors. The risk of COVID-19 in the patients with systemic osteoporosis did not differ depending on antiresorptive drug use, amounting (odds ratio (OR) 95 % CI) 1.1 (0.6-2.0), or on the use of the definite anti-osteoporotic drug (for the Zoledronic acid – 0.9 (0.4-2.0), the Ibandronic acid – 1.1 (0.5-2.3), and for the Denosumab – 1.6 (0.5-5.2). Conclusions. Parenteral anti-osteoporo­tic drugs (Zoledronic acid, Ibandronic acid, or Denosumab) do not have any influence on COVID-19 frequency and severity and can be recommended for the continuation of the treatment of patients with osteoporosis.

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