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\nV.I. Strukov, D.G. Elistratov, A.I. Kislov, N.V. Erjomina, O.A. Ismailova, Yu.G. Shtscherbakova, T.A. Kuptsova<\/em><\/p>\n
State educative establishment of supplementary professional education \u00abPenza institute of physicians\u2019 advanced training\u00bb of Health Ministry of Russia (rector \u2013 Medicine Dr., Prof. Kislov A.I.), Osteoporosis research center, Russia, Penza city. <\/sup>Parapharm Ltd.Co, Russia, Penza city.<\/em><\/p>\n<\/blockquote>\n
Osteoporosis is reported to be one of the most serious diseases, that affects mostly the elderly men and women, sometimes with lethal effect [1]. The mechanism of development of osteoporosis among the elderly as a result of sex hormones deficiency effect on the osseous tissue is extremely complicated and not fully researched. The blood serum of the healthy menstruating women contains estrogens as well as androgens. But when the important physiological significance of androgens in a man\u2019s organism reproductive development is clear, the precise role of the same androgens in a woman\u2019s organism is less investigated. Despite the fact, that the level of androgens in a woman\u2019s organism 10-20 times lower, than in a man\u2019s one, these hormones play significant role in woman\u2019s organism [2,3]. Androgens have such necessary functions, as synthesis of estrogens, development of follicles, regulates the normal functioning of ovaries, osseous metabolism and sexual behavior [4,5,6]. Androgenic deficiency among women may have a negative effect on all their organs and systems. In a woman organism, androgens as well estrogens regulate the skeleton homeostasis, although relative role of each hormone is not precisely revealed. For the time present was reported, that the low level of androgens was linked to the low density of osseous tissue and increased risk of fractures [7,8].<\/p>\n
Initially, the deficiency of estrogens, which, as was reported, might initiate processes of accelerated loss of the bone mass, independently of the causes of ovaries function insufficiency, was believed the main cause of the development of postmenopausal osteoporosis. In view of all this, the hormone replacement therapy with using estrogens is extensively used for preventing of the loss of bone tissue mass among women after menopause. It decreases substantially the risk of wrist and spine fractures [9].<\/p>\n
[\/vc_column_text][vc_row_inner][vc_column_inner width=”1\/2″][vc_column_text]The role of estrogens in the mineralization of osseous tissue is clearly shown in many researches. What concerns the role of androgens for woman\u2019s health, it is much less investigated. None the less, many authors report that importance of androgens in metabolic processes is much higher, than it was believed. This suggestion may be confirmed by the fact, that androgenic (as well as estrogenic) sex steroid receptors are present almost in all organs and tissues of female organism: osseous tissue, central nervous system, skin, blood vessels, adipose tissue, smooth muscle tissue and skeletal striated muscles. Thus, the deficiency of androgens in female organism may lead to various diseases, including osteoporosis [10,11,12,13].[\/vc_column_text][\/vc_column_inner][vc_column_inner width=”1\/2″][vc_single_image image=”83″ img_size=”large”][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner][vc_column_text]It was determined, that such hormone as testosterone stimulates the general growth of the bone matrix and contributes to the retention of calcium in organism. The bone matrix growth is correlated with the anabolic activity of testosterone, and the formation of calcium deposits is a secondary effect, caused by the growth of bone matrix. The metabolic activity of testosterone is intermediated by the androgenic receptor in the cell cytoplasm. Within the cell cytoplasm the testosterone is binding to cell\u2019s receptor (protein). After the complex was formed, the testosterone becomes activated and then is transported to the cell nucleus. The binding of the complex to chromosomal proteins starts the formation process of messenger ribonucleic acid (mRNA), necessary for synthesis of proteins, which are responsible for testosterone activity. Receptor can interact with testosterone and some other androgens. Within osseous tissue cells and skeletal muscle fibers, testosterone possesses the higher sensibility to the receptor than other androgens. Within other cells the highest sensibility to the receptor showed 5a-dihydrotestosterone. In this case, after testosterone was within the cell, it is to be transformed into 5a-dihydrotestosterone. In the skeletal muscles and osseous tissue this transformation of testosterone into 5a-dihydrotestosterone is impossible. The genetic information, contained in mRNA, is transferred within the process of cell\u2019s proteins synthesis in ribosome.<\/p>\n
The state of the cell\u2019s receptors is regulated by increase or decrease of binding locations and binding sensibility changes. Thus, the testosterone effect on metabolic processes depends from its source, as well as from stimulation or inhibition of specific cell\u2019s receptor function; hence, the increasing of metabolic hormonal influence may be conditioned not only by high concentration of hormone in the intercellular fluid, but also by as a result of increase of binding locations and\/or increased receptor\u2019s sensibility to hormone. When receptor\u2019s function is reduced, even the high hormone level will be incapable to influence effectively on the metabolism. Therefore it is incorrect to equal the concentration of hormone in blood and the degree of its effect on metabolism.<\/p>\n
Effect of testosterone among women may be increased dependent of estrogens output (Danhaive, Rousseau, cit. [20]). The increased sensibility to testosterone is believed to be due to the stimulation of the function of androgenic receptors.<\/p>\n
Basing on these facts, the authors suppose:<\/strong><\/p>\n
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- Testosterone has an effect on the bone matrix growth;<\/strong><\/li>\n
- Keeping of appropriate testosterone level is important for woman\u2019s organism;<\/strong><\/li>\n
- Testosterone effect on woman\u2019s organism may be strengthened by estrogens [2,3].<\/strong><\/li>\n<\/ol>\n
The main androgens in the blood serum of women with normal menstrual cycle are testosterone and dihydrotestosterone. Dihydroepiandrosterone sulfate (DHAE-sulfate), dihydroepiandrosterone (DHAE), and androstenedione are estimated as prohormones since their androgenic properties become effective only after their conversion into testosterone. Organism of an average healthy woman of reproductive age secretes ca. 300 \u03bcg of testosterone per day (i.e. 5% from the average per day testosterone output among men). With ageing the amount of androgens in female organism is being significantly reduced. Thus, the average levels of bioavailable and free testosterone, androstendione and dihydroepiandrosterone (DHAE) among the 45 years old women amount 50%, among 60 years old \u2013 ca. 30%, among 70 years old \u2013 10% in comparison with the average level for 20 years old women (100%) [12]. As was reported in some researches, the endogenous androgens showed the favorable effect on the bone mineral density among the women after menopause [10]. On the base of abovementioned facts, S.Kalinchenko et al. (2008) supposed, that investigation of the role of androgens in bone metabolism is completely reasonable and necessary for further treatment of osteoporosis and osteopenia, especially among women.<\/p>\n
At present the world practice has a great experience of hormone replacement therapy (HRT) based on administration of estrogens. However there are more an more data, which confirm, that the effective treatment of osteoporosis is often impossible without correcting the age-dependent androgenic deficiency (hypogonadism). Furthermore, the wide use of hormone (estrogen) replacement therapy, especially among aged women, may be limited because of series of contraindications, such as various diseases of liver, risk of thrombus developing, thrombophlebitis, risk of endometrial hyperplasia and hyperplasia of the breast. During prolonged (10-15 years) administration of estrogens the risk of cancer increases in 30-50% [10].<\/p>\n
Considering all above mentioned, it may be concluded that the exploring of further new methods of effective treatment of senile osteoporosis is extremely actual. As since administration of natural hormones (estrogens and androgens) has several disadvantages, it was recommended to use herbal hormones. So, in USA was developed a substrate (Citracal plus Vitamin D plus Genistein), intended for synthesis of organism\u2019s own hormones, containing calcium citrate and genistein (isoflavone, extracted from soybeans). We (Parapharm Ltd.Co. and Penza institute of physicians\u2019 advanced training) have developed new technologies in treatment for osteoporosis with addition of such bee keeping articles as drone brood as donator of sex hormones (Patent \u21162412616) [14,15,16,17].