Aim. The study aims to develop a practical model for screening bone turnover state in patients with diabetes and evaluate its clinical usefulness to identify diabetic osteopathy. Materials. The study was conducted in 2015–2017 in the Endocrinology Department of the Therapeutic Clinic of AM University. A total of 235 patients were assessed in the study (98 with T1DM and 137 with T2DM). 89 nondiabetic subjects served as controls. Bone mineral density (BMD) [by dual energy X-ray absorptiometry (DXA)] and serum markers of bone remodeling [aminoterminal propeptide of procollagen type I (P1NP) and c-terminal telopeptide of type I collagen (CTX)], parathyrin, and 25(OH)D were measured in all 235 patients. Results. Our results show that patients with T2DM have lower b-CTx values and relatively higher levels of P1NP, reflecting less pronounced changes in bone metabolism compared to patients with T1DM, regardless of age or duration of the disease. Osteoporosis was detected in 50% of patients with T1DM, compared to 13% of patients with T2DM. Conclusion. In some cases, bone remodeling markers are useful for improving the assessment of the state of bone tissue in early stages of diabetes, while alterations in bone microarchitecture may not always be captured by bone mineral density measurements.

Background: The purpose of the study was to assess the effect of changes in male and female's body with type 1 diabetes mellitus (T1DM) on the state of the bone mineral density and the metabolic rate, and to determinate the direction of changes in serum markers of bone remodeling and bone mineral density in both sexes due to this disease.

Objective. To evaluate the effectiveness of the use of L-arginine in the treatment of placental insufficiency (PI) in pregnant women. Materials and methods. We examined 49 pregnant women with PI at 22-34 weeks of gestation. The women were divided into two groups. The 1st group included 27 patients who, as part of the standard complex treatment, were injected intravenously with L-arginine (Tivortin®, “Yuria-Pharm”, Ukraine) 4.2 % solution for infusion at a dose of 100 ml a day for 5 days. The 2nd group included 22 women in which standard basic therapy was used for PI treatment. To study the state of the fetoplacental complex in the blood serum of pregnant women, the level of human placental lactogen (hPL) and free estriol (E3) was determined by direct competitive enzyme immunoassay (ELISA). Results and discussion. All patients included in the study were comparable in somatic and obstetric status. The age of pregnant women in both groups ranged from 22 to 39 years, averaging 26±3.2 years in the 1st and 31±2.4 years in the 2nd group. The level of hPL before therapy was reduced in 10 (37.03 %) patients in the 1st group and in 8 (29.62 %) patients in the 2nd group. The concentration of free E3 was reduced in 12 (44.44 %) patients of the 1st group and in 9 (40.9 %) patients of the 2nd group. In the main group, the average concentration of free E3 was 18.8±13.3 ng/ml, and the hPL was 7.1±2.6 mg/L. In the comparison group, the level of free E3 averaged 19.1±10.2 ng/ml and hPL was 6.9±3.9 mg/L. After adjustment of PI in all patients of the 1st group, and in 19 (86.36 %) of the 2nd group, the concentration of hPL and free E3 corresponded to the norm. Thus, in the main group, the average concentration of free E3 was 22.7±14.1 ng/ml, and the hPL was 8.1±2.9 mg/L. In the comparison group, the level of free E3 averaged 22.1±14.6 ng/ml and hPL – 8.3±3.9 mg/L. Only in 3 (13.63 %) patients of the comparison group, the level of hormones was still reduced. Conclusions. The inclusion of L-arginine (Tivortin) in therapeutic regimens in order to correct placental dysfunction leads to a regression of fetoplacental circulatory disorders and reduces the risk of unfavorable perinatal outcomes.

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