Биология ва тиббиёт муаммолари 2026, №1 (167)

Subject of the article

ANTIRESORPTIVE THERAPY FOR PREGNANCY- AND LACTATION-ASSOCIATED OSTEOPOROSIS (28-32)

Authors

Alikhanova Nodira Mirshovkatovna, Abboskhuzhaeva Lola Saidiganikhodjaevna

Institution

1 - Institute of Health and Strategic Development, Republic of Uzbekistan, Tashkent; 2 - Republican Specialized Scientific and Practical Medical Center of Endocrinology named after Academi-cian Y.Kh. Turakulov, Republic of Uzbekistan, Tashkent

Abstract

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare but serious condition characterized by multiple low-trauma fractures, primarily of the vertebral bodies, occurring in the third trimester of pregnancy or early postpartum. The main risk factors for PLO include vitamin D deficiency, low body mass index (BMI), inadequate calcium intake, low physical activity, smoking, and other adverse factors. Diagnosis is challenging due to re-strictions on the use of imaging techniques during pregnancy and lactation. The aim of this study was to evaluate the effectiveness of treatment for pregnancy- and lactation-associated osteoporosis. The study included 27 women aged 18 to 40 years with a diagnosis of PLO. All patients underwent laboratory and instrumental studies, including determination of calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), bone remodeling mark-ers (β-CrossLaps), and bone mineral density (BMD) assessment using dual-energy X-ray absorptiometry (DEXA). During therapy, a significant decrease in alkaline phosphatase activity, β-CrossLaps, and osteocalcin levels was noted. Vitamin D concentrations reached adequate levels (≥30 ng/ml) in 45.2% of patients. A 13.6% increase in spinal BMD was observed, with the increase being clinically significant in 54.8% of patients. Bone mineral density in the femoral neck increased slightly by 4.5% (left neck: before treatment 0.795±0.13 g/cm²; after treatment 0.804±0.13 g/cm²; p=0.41), with positive dynamics noted in 29.0% of patients. BMD of the right and left femurs in-creased by 4.6% and 3.5%, respectively, with an increase in indicators recorded in 29.0% and 41.9% of the exam-ined patients. In the right femoral neck, an increase in BMD by 5.3% was detected in 19.4% of patients. Thus, anti-resorptive therapy in combination with calcium and vitamin D preparations, as well as cessation of breastfeeding, help to reduce the severity of back pain, significantly increase bone mineral density and reduce the risk of further vertebral fractures.

Key words

pregnancy- and lactation-associated osteoporosis, antiresorptive therapy, calcium-phosphorus metabolism, bone mineral density.

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