Approximately 95% of skeletal size, bone, and muscle mass is achieved by the age of 18, with a rapid acceleration in bone mineral accumulation and muscle growth during the adolescent growth spurt. Bone mineral status in children and adolescents in Kazakhstan is a relevant subject for both clinical and fundamental research. The aim of this study was to investigate the prevalence of low bone mineral density (BMD) and the factors associated with it in children and adolescents living in the Abay region of Kazakhstan. The target group consisted of children and adolescents aged 5 to 17 years (n = 509) who had been residing in the Abay region of Kazakhstan since birth. Based on physiological age, participants were divided into two groups: 5–10 years (preschool and early school age) and 11–17 years (adolescence). All participants completed a questionnaire and underwent bone mineral density assessment using dual-energy X-ray absorptiometry (DXA). Comparisons were made between two age groups (5–10 and 11–17 years) and based on the presence or absence of reduced bone mineralization. Regression analysis identified four factors independently associated with reduced bone mineralization: ionized calcium (AOR 2099.9; p = 0.007), age (AOR 1.21; p = 0.013), body weight (AOR 0.97; p = 0.047), and green vegetables (AOR 0.46; p = 0.017). Conclusions: Our study demonstrated that 50.5% of children aged 5–10 years and 57.4% of adolescents aged 11–17 years had BMD below the age-specific norm. The study identified several risk factors that are associated with a decrease in BMD. These include blood ionized calcium, age, inadequate consumption of fruits and vegetables and dairy products, low physical activity, and insufficient sun exposure. These findings highlight the importance of early prevention of osteopenic conditions beginning in childhood and adolescence.

Osteoporosis is considered a serious public health problem that particularly affects the postmenopausal period. In 2018, in the Republic of Kazakhstan, the prevalence of osteoporosis was 10.0, and the incidence was 3.7 new cases, per 100,000 adults, respectively. The objective of this study was to assess the prevalence of osteoporosis and indicate the main factors affecting low bone mineral density by screening the adult population of the Abay region, Kazakhstan. The target group comprised 641 respondents aged between 18 and 65 years old, from a Kazakh population, who had been living in the Abay region since birth. All participants filled out a questionnaire and were subjected to a bone mineral density measurement by means of dual-energy X-ray absorptiometry (DXA) between 15 July 2023 and 29 February 2024. Logistic regression analysis was conducted to assess the association between low bone mineral density and key demographic characteristics, such as lifestyle factors and nutritional habits. We identified the prevalence of low bone mass (osteopenia) and osteoporosis to be 34.1%, with the highest prevalence of 48.3% being found in the older population group (50+ years). The regression analysis revealed a number of indicators associated with the likelihood of bone sparing. However, only four of these showed significance in the final multivariate model (R² = 22.4%). These were age (adjusted odds ratio (AOR) 1.05) and fracture history (AOR 1.64) directly associated with the likelihood of low bone density. Meanwhile, the body mass index (AOR 0.92) and the consumption of nuts and dried fruits (AOR 0.48) reduced the chance of bone tissue demineralization. Additional studies examining the prevalence and any emerging risk factors for osteoporosis are needed to advance clinical epidemiological knowledge and implement public health programs.

Osteoporosis is considered a serious public health problem, particularly affecting the postmenopausal period. In 2018, in the Republic of Kazakhstan the total and primary incidence was 10 and 3.7 cases per 100,000 adults, respectively. The objective is to study osteoporosis prevalence and indicate main factors affecting low bone mineral density by screening adult population of Abay region, Kazakhstan. The target group were 641 respondents aged between 18 and 65 years old, Kazakh population living in Abay region since birth. All participants filled out questionnaire and had a bone mineral density measurement by dual energy X-ray absorptiometry (DXA) between July 15, 2023 and February 29, 2024. Logistic regression analysis was conducted to assess the association between low bone mineral density and key demographic characteristics, aforementioned lifestyle factors and nutrition habits. We identified the prevalence of low bone density and osteoporosis at the level of 34.1% with the highest prevalence in the older population group (50+ years) - 48.3%. Regression analysis revealed a number of indicators associated with the likelihood of bone sparing. However, only 4 of these showed significance in the final multivariate model (R2=22.4%). These included age (AOR 1.05), body mass index (AOR 0.92), fracture history (AOR 1.64), consumption of nuts and dried fruits were associated with lower prevalence of osteoporosis (AOR 0.48). Our study was the first in Kazakhstan that investigates the association of key demographic, behavior and anamnestic factors with low mineral density.

Введение. Распространённость и тяжесть язвенного колита определяют его актуальность в современном мире. Судя по современным данным, заболевание имеет сложный патогенез, в состав которого входит реакция многих функциональных систем организма. К числу последних может относиться и сосудистый эндотелий, взаимосвязь состояния которого с наличием и течением НЯК, а также роль в процессе лечения малоизучены. Цель. Определить особенности функции сосудистого эндотелия в соотношении с клиническим течением неспецифического язвенного колита в динамике лечения. Материалы и методы: Обследованы 68 пациентов с НЯК, распределённые по активности процесса и проводимому лечению, и 80 клинически здоровых лиц контрольной группы. Изучен ряд параметров состояния сосудистого эндотелия: число циркулирующих эндотелиоцитов (ЦЭ), содержание метаболитов NO и эндотелина-1 в крови, степень эндотелий зависимой вазодилятации. Определены частота и сроки развития рецидивов при проспективном наблюдении продолжительностью 1 год. Результаты. Выявлены значимые различия показателей функции эндотелия между основной и контрольной группами (превышение активности эндотелина-1 на 119,5%; p<0,01; содержания ЦЭ – на 88,4%, p<0,001). При сравнении между подгруппами больных, выделенными по активности процесса, определены значимые различия между всеми подгруппами по содержанию ЦЭ, но не по остальным параметрам, связанным с эндотелиальной функцией. Однако отмечались особенности в отношении контрольной группы, различий с которой при минимальной степени активности практически не определялось. В процессе лечения также были определены различия между клиническими группами лишь по содержанию ЦЭ – на 18,8% (р=0,043). У пациентов с умеренной активностью процесса частота ремиссии была существенно выше при воздействии на эндотелий, а сроки ее развития сокращались. Различия в пользу группы 1 по первому параметру составили 50,8% (t=0,032, р<0,05), а по второму - 46,3% (р=0,013). Выводы: 1. Течение НЯК сопровождается наличием эндотелиальной дисфункции, определяемого нарушением баланса вазодилятирующих и вазоконстрикторных факторов, снижением вазодилятации, а также повреждением эндотелиального слоя сосудистой стенки. 2. Имеется связь активности процесса и уровня нарушений эндотелиальной функции с увеличением таковых при более высоких степенях активности, что является свидетельством патогенетической роли дисфункции эндотелия при НЯК. 3. Посредством медикаментозного лечения возможно уменьшение степени эндотелиальной дисфункции, сохраняющееся в течение длительного времени. Introduction.The prevalence and severity of ulcerative colitis (UC) make it a relevant issue in the modern world. According to current data, the disease has a complex pathogenesis involving reactions from various functional systems of the body. One such system is the vascular endothelium, whose condition and relationship with UC progression and treatment outcomes remain poorly studied. Aim: To determine the characteristics of vascular endothelial function in relation to the clinical course of ulcerative colitis during treatment. Materials and methods: A total of 68 patients with UC, categorized based on disease activity and treatment regimen, and 80 clinically healthy individuals in the control group were examined. Several endothelial function parameters were analyzed: the number of circulating endothelial cells (CECs), levels of nitric oxide (NO) metabolites and endothelin-1 in the blood, and the degree of endothelium-dependent vasodilation. The frequency and timing of relapses were assessed over a one-year prospective observation period. Results: Significant differences in endothelial function indicators were observed between the main and control groups (endothelin-1 activity increased by 119.5%, p<0.01; CEC levels increased by 88.4%, p<0.001). Among subgroups of patients categorized by disease activity,...

ОЦЕНКА РАСПРОСТРАНЕННОСТИ НЕАЛКОГОЛЬНОЙ ЖИРОВОЙ БОЛЕЗНИ ПЕЧЕНИ В ВИДЕ ФИБРОЗА ПЕЧЕНИ У ПАЦИЕНТОВ С ХРОНИЧЕСКИМ ПАНКРЕАТИТОМ С ПОМОЩЬЮ ИНДЕКСА NAFLD FIBROSIS SCORE

Гепато-ренальный синдром является одним из грозных осложнений цирроза печени, который может привести к летальному исходу. Описанный клинический случай демонстрирует цирроз печени, который усугубился почечной недостаточностью и печеночной комой, вследствие развития гепато-ренального синдрома. В данной статье описывается течение и тяжесть заболевания, динамика нарастания симптомов. За последние годы распространённость цирроза печени разной этиологии растет. Данные, приведенные в статье будут полезны терапевтам, врачам общей практики, гастроэнтерологам и нефрологам. Hepato-renal syndrome is one of the formidable complications of liver cirrhosis, which can be fatal. The described clinical case demonstrates a case of liver cirrhosis, which was aggravated by renal failure and hepatic coma due to the development of hepato-renal syndrome. This article shows the severity of the disease, the dynamics of increasing symptoms, and the course of the clinical picture. In recent years, the prevalence of liver cirrhosis of different etiologies is increasing. The data given in the article will be useful for general practitioners, gastroenterologists and nephrologists.