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Paediatric osteoporosis: features of skeletal mineralization in children, prevention, and treatment
- Source :
- Медицинский совет, Vol 0, Iss 10, Pp 164-171 (2020)
- Publication Year :
- 2020
- Publisher :
- Remedium Group LLC, 2020.
-
Abstract
- The prevention and treatment of osteoporosis in children is an urgent problem of pediatrics and pediatric endocrinology. This is due to the need for preventive measures for the formation of adequate bone mass and bone strength, the duration of rehabilitation during the development of the disease and the occurrence of fractures, as well as the requirements for optimizing the treatment of this pathology in childhood.Bone tissue is a dynamic and constantly updated system. The main regulators of osteogenesis include trace elements (calcium, phosphorus, zinc, fluorine, etc.), vitamin D, hormones (parathyroid hormone, calcitonin, growth hormone, corticosteroids, etc.), growth factors (IRF-1, IRF-2, ERF, FRF, etc.), local bone-resorbing factors (IL-1, IL-6, TNF, PGE, etc.) and mechanical stress. Remodeling processes continue throughout life, but are most intense until 18 years of age.The most important risk factors for developing osteoporosis are a history of prematurity and / or IUGR, rickets, low intake of protein, calcium and vitamin D, weight deficiency, periods of active growth, low physical activity, endocrine diseases (diabetes mellitus, growth hormone deficiency, hypogonadism, etc.), somatic pathology (chronic diseases of the kidneys, liver, malabsorption), taking certain medications (GCS, anticonvulsants, cytostatics, etc.). Clinical manifestations of osteoporosis in children include signs of tissue calcium deficiency (trophic changes in the nails, hair and tooth enamel, paresthesia, pain in the calf muscles) and a decrease in bone mineralization (impaired posture, slowed growth, pain in the spine and large joints, pathological low-energy fractures) Measures to prevent osteoporosis in childhood include regular physical activity, a balanced diet, adequate insolation, and the identification and treatment of somatic pathology. Additional pharmacological correction is carried out in risk groups – the recommended course use of preparations containing vitamin D, calcium and other osteotropic minerals.The treatment of osteoporosis in children and adolescents is actively debated. A mandatory component of therapy are calcium salts in combination with vitamin D. The possibility of using bisphosphonates is being examined, the effect of monoclonal antibodies (denosumab), somatropin and anabolic steroids on bone metabolism is being studied. In addition, non-pharmacological methods are prescribed - orthopedic correction for fractures, exercise therapy, gymnastics, therapeutic swimming and massage.
- Subjects :
- Pediatric endocrinology
Osteoporosis
Physiology
Parathyroid hormone
prevention and treatment of osteoporosis
Rickets
Bone remodeling
Growth hormone deficiency
03 medical and health sciences
critical periods of osteoporosis
0302 clinical medicine
children
risk factors of osteoporosis
030225 pediatrics
Vitamin D and neurology
medicine
030212 general & internal medicine
adolescents
business.industry
General Medicine
medicine.disease
osteoporos
Denosumab
bone mineralization
Medicine
business
medicine.drug
Subjects
Details
- Language :
- Russian
- ISSN :
- 26585790
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Медицинский совет
- Accession number :
- edsair.doi.dedup.....9c649513af826deaa2d4d84e2eadad5e