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Connective tissue dysplasia: a risk factor for osteopenia in children and adolescents

https://doi.org/10.21518/2079-701X-2020-1-30-40

Abstract

Introduction:  in addition  to genetic  predisposition,  a significant  exogenous  factor in the  formation  of Undifferentiated connective tissue dysplasia (UDCTD) is the deficiency of osteotropic micronutrients such as vitamins (D, A, C, E, K); macroelements (calcium, phosphorus, magnesium), trace elements (copper, manganese, zinc, boron, selenium, silicon), so essential for the connective tissue matrix and, above all, for bone tissue. A small number of studies of osteotropic micronutrients and the state  of bone tissue in adolescents with UDCTD served as the basis for this comprehensive study.

Materials: a randomized  study of 130 adolescents aged 10–16  years in the 1–2  health  groups. The first group (primary) was 90 subjects with detected UDCTD. The second group (comparative) was 40 people  with no signs of dysplasia.

Methods: included the definition of: vitamin D – 25(ON)D: trace elements; calcium ductation: spinal column densitometry at LII–LIV level; physical development and psycho-emotional stress levels.

Availability disorders of 25(OH)D, low calcium consumption, magnesium  deficiency, and shifts in micronutrient content  correlated with densitometric data showing a 75% decrease  BMD in Group 1 adolescents, while in Group 2 only 27.5%.

The results  of a comprehensive study showed  that  osteotropic micronutrient deficiency is a serious  exogenous  trigger  for the development and progression  of UDCTD with osteopenia/osteoporosis formation. Osteopenia/osteoporosis, low physical development, disorders in the psycho-emotional sphere  indicate the seriousness of the prognosis of UDCTD in adolescents.

About the Authors

I. N. Zakharova
Russian Medical Academy of Continuing Professional Education; Z.A. Bashlyaeva City Children’s Clinical Hospital
Russian Federation

Irina N. Zakharova - Dr. of Sci. (Med), Professor, Honored Doctor of Russia, Head of the Department of Pediatrics  with the course  of polyclinic pediatrics  named  after G.N. Speransky, Federal  State Budgetary Educational  Institution  of Additional Professional  Education “Russian Medical Academy of Continuing Professional  Education“ of the Ministry of Health of the Russian Federation; State Budgetary Institution  of Healthcare of Moscow “Z.A. Bashlyaeva City Children’s Clinical Hospital of the Department of Healthcare of Moscow“.

b. 1, 2/1, Barrikadnaya St., Moscow, 125993; 28, Heroev Panfilovtsev  St., Moscow, 125373.



T. M. Tvorogova
Russian Medical Academy of Continuing Professional Education; Z.A. Bashlyaeva City Children’s Clinical Hospital
Russian Federation

Tat’yana M. Tvorogova - Cand. of Sci. (Med), Associate Professor of the Department of Pediatrics named after Academician G.N. Speransky, Federal State Budgetary Educational Institution  of Additional Professional  Education “Russian Medical Academy of Continuous Professional  Education“ of the  Ministry of Health  of the  Russian  Federation; State  Budgetary  Institution   of Healthcare of Moscow “Z.A. Bashlyaeva City Children’s Clinical Hospital of the Department of Healthcare of Moscow“

b. 1, 2/1, Barrikadnaya  St., Moscow, 125993; 28, Heroev Panfilovtsev St., Moscow, 125373.



E. А. Solov’yeva
Russian Medical Academy of Continuing Professional Education
Russian Federation

Ekaterina A. Solov’yeva - Postgraduate student  at  the  Department of  Pediatrics  named  after  academician G.N. Speransky,  Federal  State Budgetary Educational  Institution  of Additional Professional  Education “Russian Medical Academy of Continuous  Professional  Education“ of the Ministry of Healthcare of the Russian Federation.

b. 1, 2/1, Barrikadnaya St., Moscow, 125993.



L. L. Stepurina
Russian Medical Academy of Continuing Professional Education
Russian Federation

Larisa L. Stepurina - part-time postgraduate student at the  Department of Pediatrics  named  after  academician G.N. Speransky, Federal  State Budgetary Educational  Institution  of Further Professional  Education “Russian Medical Academy of Continuous  Professional  Education“ of the Ministry of Healthcare of the Russian Federation.

b. 1, 2/1, Barrikadnaya St., Moscow, 125993.



A. S. Vorob’yeva
Z.A. Bashlyaeva City Children’s Clinical Hospital
Russian Federation

Aleksandra S. Vorob’yeva - Cand. of Sci. (Med), Pediatrician, State Budgetary Institution  of Healthcare of Moscow “Z.A. Bashlyaeva City Children’s Clinical Hospital of the Department of Healthcare of Moscow“.

28, HeroevPanfilovtsev  St., Moscow, 125373.



References

1. Martynov A.I., Nechaeva G.I. Guidelines of the russian scientific medical society of internal medicine on the diagnosis, treatment and rehabilitation of patients with the connective tissue dysplasia (first edition). Meditsinskiy vestnik Severnogo Kavkaza = Medical news of North Caucasus. 2018;13(1.2):1-73. (In Russ.) Available at: https://cyberleninka.ru/article/n/klinicheskie-rekomendatsii-rossiyskogo-nauchnogo-meditsinskogo-obschestva-terapevtov-po-diagnostike-lecheniyu-i-reabilitatsii/viewer

2. Kadurina T.I., Abbakumova L.N. Elemental status and flow characteristics of connective tissue dysplasia in children. In the book: Gnusayev S.F., Kadurina T.I., Semyachkina A.N. (edited). Pediatric Aspects of Connective Tissue Dysplasia. Achievements and perspectives: Russian collection of scientific works. Issue 2. Moscow, Tver, S.-Pb: PRE 100; 2011, pp. 39-46. (In Russ.) Available at: https://cyberleninka.ru/article/n/displaziya-soedinitelnoy-tkani-put-k-diagnozu

3. Styazhkina S.N., Knyazev A.D., Minakhanov I.I. Connective tissue dysplasia in modern clinical practice. Sovremennyye innovatsii = Modern innovations. 2016;(5):57-62. (In Russ.) Available at: https://elibrary.ru/item.asp?id=26111030.

4. Gromova O.A., Torshin I.Yu., Egorova E.Yu. Mechanisms of magnesium and pyridoxine influence on the structure and properties of connective tissue as the basis for magnesial therapy of connective tissue dysplasia. Lechashchiy vrach = The attending physician. 2010;(8):71. (In Russ.) Available at: https://www.lvrach.ru/2010/08/15434259/.

5. Benevolenskaya L.I. (ed.) Guide to Osteoporosis. Moscow: BINOM. Laboratory of Knowledge; 2003. 523 с. (In Russ.)

6. Semicheva T.V., Bakanova T.D. Peculiarities of bone tissue formation during puberty. Osteoporos i osteopatii = Osteoporosis and Bone Diseases. 2002;(1):2-5. (In Russ.) Available at: https://cyberleninka.ru/article/n/osobennosti-formirovaniya-kostnoy-tkani-v-period-pubertata.

7. Rylova N.V., Troegubova N.A., Zholinsky A.V., Sereda A.P, Hovhannisyan M.G. Assessment of mineral status in young athletes. Rossiyskiy Vestnik Perinatologii i Pediatrii = Russian Bulletin of Perinatology and Pediatrics. 2017;62(5):175-183. (In Russ.) doi: 10.21508/1027-4065-2017-62-5-175-183.

8. Gromova O.A. Osteotropic minerals: role in bone repair and damage. RMZH = RMJ. 2015;(25):1496-1498. (In Russ.) Available at: https://www.rmj.ru/articles/revmatologiya/Osteotropnye_mineraly_roly_v_vosstanovleniii_podderghanii_kostnoy_tkaniIntervyyu_s_OA_Gromovoy/

9. Gromova O.A., Torshin I.Yu. Vitamin D - paradigm shift. Moscow: GEOTAR-Media; 2017. pp. 197-253. (In Russ.) Available at: https://www.rosmedlib.ru/doc/ISBN9785970440582-0000/000.html.

10. Bird T.A., Levene C.I. The effect of a vitamin B-6 antagonist, 4-deoxypyridoxine, on the cross-linking of collagen in the developing chick embryo. Biochem J. 1983;210(3):633-638. doi: 10.1042/bj2100633.

11. Torshin I.Yu., Gromova O.A. Magnesium and pyridoxine: fundamental studies and clinical practice. New York: Nova Science Publishers, Inc.; 2009. 196 p. Available at: https://www.ncbi.nlm.nih.gov/nlmcatalog/101503279.

12. Baranov A.A., Namazova-Baranova L.S., Borovik T.E., Ladodo K.S., Zakharova I.N., Kon' I.Ya. et al. National Programme for optimizing the supply of vitamins and minerals to Russian children (and the use of vitamin and vitamin-mineral complexes and enriched products in pediatric practice). Union of Pediatricians of Russia. Moscow: Pediatrician Association; 2017. 152 p. (In Russ.) Available at: https://elibrary.ru/item.asp?id=29014438.

13. Mark M., Ghyselinck N.B., Chambon P. Function of retinoic acid receptors during embryonic development. Nucl Recept Signal. 2009;7:e002. doi: 10.1621/nrs.07002.

14. Gromova O.A., Torshin I.Yu. Vitamins and miner¬als: between Scylla and Charybdis: about misconception and other monsters. Moscow: MZNMO; 2013. 764 с. (In Russ.) Available at: https://search.rsl.ru/ru/record/01006596407.

15. Pogozheva A.V. The value of food macro and micronutrients in optimizing bone mineral density. Consilium Medicum. 2015;17(2):61-65. (In Russ.) Available at: https://elibrary.ru/item.asp?id=23554894.

16. Dydykina I.S., Dydykina P.S., Alekseyeva O.G. Trace elements (copper, manganese, zinc, boron) and healthy bone: prevention and treatment of osteopenia and osteoporosis. Ehffektivnaya farmakoterapiya. Ehndokrinologiya. 2013;(38):42-49. (In Russ.) Available at: https://umedp.ru/articles/vklad_mikroelementov_2006;(1):79-84. Режим доступа: https://elibrary.ru/item.asp?id=19082835.

17. De Francisco A.L., Rodriguez M. Magnesium - its role in CKD. Nefrologia. 2013;33(3):389-399. doi: 10.3265/Nefrologia.pre2013.Feb.11840.

18. Ueshima K., Shibata M., Suzuki T., Endo S., Hiramori K. Extracellular matrix disturbances in acute myocardial infarction: relation between disease severity and matrix metalloproteinase-1, and effects of magnesium pretreatment on reperfusion injury. Magnes Res. 2003;16(2):120-126. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12892382.

19. Torshin I.Yu., Gromova O.A. Connective tissue displasia, cell biology and molecular mechanisms of magnesium exposure. RMZH = RMJ. 2008;(4):230. (In Russ.) Available at: https://www.rmj.ru/articles/fundamentalnaya_meditsina/Displaziya_soedinitelynoy_tkani_kletochnaya_biologiya_i_molekulyarnye_mehanizmy_vozdeystviya_magniya/#ixzz6CJwVTzR5.

20. Gromova O.A. Magnesium and pyridoxine: basic knowledge. Moscow: ProtoTip; 2006. 176 p. (In Russ.)

21. Yu X.D., Yаn С.H., Yu X.G., Gao Y., Xu J., Shen X.M. Еffесt оf zinс dеfiсiеnсy оn thе рrоtеin еxрrеssiоn оf vitаmin D rесерtоr аnd саlсium binding рrоtеin in grоwth stаgе rаts duоdеnаl muсоsа. Zhonghua Er Ke Za Zhi. 2006;44(1):11–14. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16623997.

22. Craig T.A., Benson L.M., Naylor S., Kumar R. Modulation effects of zinc on the formation of vitamin D receptor and retinoid X receptor alpha-DNA transcription complexes: analysis by microelectrospray mass spectrometry. Rapid Commun Mass Spectrom. 2001;15(12):1011-1016. doi: 10.1002/rcm.332.

23. Potocnik F.C., van Rensburg SJ., Hon D., Emsley R.A., Moodie I.M., Erasmus R.T. Oral zinc augmentation with vitamins A and D increases plasma zinc concentration: implications for burden of disease. Mеtаb Brnin Dis. 2006;21(2-3): 139-147. doi: 10.1007/s11011-006-9023-4.

24. Mukhina Yu.G., Klyuchnikov S.O., Netrebenko O.K., Shcheplyagina L.A (ed.) Clinical significance of zinc metabolism disorders: author’s lectures on pediatrics. М.; 2005. (In Russ.) Available at: http://medvuz.com/med1808/t3/22.php.

25. Biryukova Ye.V. A Contemporary View on a Role Played by Selenium in Physiology and Pathology of the Thyroid Gland. Ehffektivnaya farmakoterapiya = Effective Pharmacotherapy. 2017;(8):34-41. (In Russ.) Available at: https://elibrary.ru/item.asp?id=28831396.

26. Martin K.R. The chemistry of silica and its potential health benefits. J Nutr Health Aging. 2007;11(2):94-97. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17435951.

27. Skripnikova I.A., Gur'ev A.V. Microelements in the prevention of osteoporosis: focus on silicon. Osteoporos i osteopatii = Osteoporosis and Bone Diseases. 2014;(2):36-40. (In Russ.) Available at: https://elibrary.ru/item.asp?id=22704221.

28. Jugdaohsingh R. Silicon and bone health. J Nutr Health Aging. 2007;11(2):99-110. Available at: https://www.ncbi.nlm.nih.gov/pub-med/17435952.

29. Ivanova I., Gnusaev S.F., Apenchenko Y.S., Kapustina L.V., Gerasimov N.A., Soldatova I.A. The characteristic manifestations of digestive tract disorders in children with connective tissue dysplasia. Current Pediatrics. 2012;11(5):50-55. (In Russ.) doi: 10.15690/vsp.v11i5.428.

30. Kadurina T.I., Abbakumova L.N. The principles of rehabilitation for patients with connective tissue dysplasia. Lechashchiy vrach = The attend¬ing physician. 2010;(4):28-31. (In Russ.) Available at: https://www.lvrach.ru/2010/04/12839563/

31. Holick M.F., Binkley N.C., Bischoff-Ferrari H.A., Gordon C.M., Hanley D.A., Heaney R.P. et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930. doi: 10.1210/jc.2011-0385.

32. Pludowski R, Karczmarewicz E., Bayer M., Carter G., Chlebna-Sokol D., Czech-Kowalska J. et al. Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol. 2013;64(4):319-327. doi: 10.5603/ep.2013.0012.

33. Martinchik A.N., Korolev A.A., Trofimenko L.S. Physiology of nutrition, sanitation and hygiene. Moscow: Higher School; 2000. 192 c. (In Russ.)

34. Sheplyagina L.A., Moiseeva T.Y., Kruglova I.V. Clinical assessment of bone mass in children. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2006;(1):79-84. (In Russ.) Available at: https://elibrary.ru/item.asp?id=19082835.

35. Apanasenko L.G. Individual health: theory and practice. Valeologiya = Valaeology. 2006;(1):5-13. (In Russ.) Available at: http://journal.valeo.sfedu.ru/journal/200601.pdf.

36. Frolova T.V., Okhapkina O.V. Features of microelement balance in dysplastico-dependent pathology of undifferentiated dysplasia of connective tissue in children. In book: Pediatric aspects of connective tissue dysplasia. Achievements and perspectives: A collection of scientific works. Moscow-Tver-Saint Petersburg; 2010, pp. 86-91. (In Russ.)

37. Oberlis D., KHarland B., Skal'nyy A. Biological role of macro- and microelements in humans and animals. Saint Petersburg: Nauka; 2008, pp. 145-418. (In Russ.)

38. Nechaeva G.I., Drokina O.V., Martynov A.I., Loginova E.N., Druk I.V., Lyalyukova Е.А., Vershinina M.V. Fundamentals of treatment patients with connective tissue dysplasia in primary care. Therapy. 2015;(1):29-36. (In Russ.) Available at: https://therapy-journal.ru/ru/archive/article/31356.


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For citations:


Zakharova IN, Tvorogova TM, Solov’yeva EА, Stepurina LL, Vorob’yeva AS. Connective tissue dysplasia: a risk factor for osteopenia in children and adolescents. Meditsinskiy sovet = Medical Council. 2020;(1):30-40. https://doi.org/10.21518/2079-701X-2020-1-30-40

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