Bone tissue was studied in 56 postmenopausal women (mean age 62.30 ± 2.74 years), of which 46 patients who worked in unfavorable working conditions had a decreased bone mineral density (BMD) (osteoporosis (OP) — in 31 women, osteomalacia (OM) — in 13); 10 women had no metabolic changes in bone tissue (BT). A BT scan fragment was obtained during surgery for a fracture of the femoral neck. Non-decalcified QD sections were prepared, the functional activity of the QD cell nuclei was determined using the method of differential staining of nuclei with different functional activity. Morphological changes in OP and OM have both common features and differences. The common is the thinning of the bone rods, the expansion of the canals of osteons, the presence of cell-free areas, and cell-free lacunae. In contrast to OP, OM presents with the thickness and area of the osteoid increase, a less pronounced decrease in oxyphyllin matrix, a higher functional activity of BT cells. A decrease in BMD and the occurrence of low-energy fractures may result not only from OP but also OM. When prescribing treatment, it is necessary to carry out diffe-rential diagnostic measures that determine the cause of the decrease in bone mass.

The prevalence of osteoporosis and vitamin D deficiency in postmenopausal women working under harmful labour conditions has been examined. Reduced bone mineral density was revealed in 85% of the persons under observation, the incidence of OP was 35%, sarcopenia (SP) - 35%. Vitamin D deficiency was found in 91.3% of the workers, at the same time severe VD deficiency was observed in 32.9%, VD deficiency - in 7.5%, and the optimal level of vitamin D was observed in 1.2% of cases. 79 PM women with OP aged 50 - 60 y. o. (mean age - (55.7 ± 0.9) years), working at harmful  conditions of the working environment with an average length of service 26.14 ± 0.91 years have been examined. Clinical group A (n = 30) received cholecalciferol at a dose of 2000 IU (4 drops) per day and alfacalcidol 1 μg (1 capsule) once a day for a year. This resulted in a positive effect on the level of 25(OH)D. The complex appointment of cholecalciferol and alfacalcidol reduced the level of PTH and confirmed the role of VD deficiency in the progress of secondary hyperparathyroidism. The data obtained revealed a slowing of the effect of VD on osteoclastogenesis. Decrease of bone resorption marker CTx in the women under examination confirmed the latter.

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