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An observation from practice was devoted to the experience of an interdisciplinary approach in the diagnosis and surgical treatment of a patient with complicated course of Crohn’s disease against the background of the formation of a stricture of the terminal ileum, an enterovesical fistula, the penetration into the mesentery of the sigmoid colon.

Aim – to study the relationship between body composition and bone mineral density (BMD) in postmenopausal women with rheumatoid arthritis (RA).Material and methods. 68 postmenopausal women, median age 59 [54; 63] years, with RA were included in the study. Bone mineral density (BMD) and body composition were assessed with dual energy X-ray absorptiometry.Results. 33 (48.5%) women had osteopenia, and 17 (25.0%) – osteoporosis (OP). Low lean muscle mass was found in 10 (14.7%) patients. There were positive correlations between different areal BMD and body weight, trunk fat, trunk lean muscle mass and total lean muscle mass. In the multivariate linear regression analysis total lean muscle mass was associated with BMD of lumbar spine (β=0.638; p=0.001) and total hip (β=0.473; p=0.008), and appendicular lean muscle mass, estimated using the appendicular muscle index, with femoral neck BMD (β=0.360; p=0.014).Conclusion. 73.5% of patients with RA had a reduced BMD, and 14.7% women – low muscle mass. The revealed significant association between the lean muscle mass and BMD of lumbar spine and proximal femur indicates the importance of detecting and correcting low lean muscle mass, as well as preventing its decline in order to prevent loss of BMD and osteoporotic fractures.

Aim of the study was to clarify the body composition in patients with early rheumatoid arthritis before starting therapy with synthetic basic anti-inflammatory drugs, genetically engineered biological drugs and glucocorticoids using dual-energy X-ray absorptiometry and to assess the effect of inflammation and metabolic syndrome on body composition.Material and methods. The study included 37 patients (31 women and 6 men) with early rheumatoid arthritis. The control group consisted of 19 healthy donors without rheumatic diseases. Patients with rheumatoid arthritis and the control group were measured by waist size, height and weight, and body mass index was calculated. Body composition was determined by means of dual-energy X-ray absorptiometry using the “Whole Body” program on the HOLOGIC device (USA). The presence of metabolic syndrome was assessed according to the criteria of the International Diabetes Federation (IDF).Results. Patients with early rheumatoid arthritis had less lean tissue mass, which was negatively correlated with inflammatory markers (ESR and C-reactive protein levels). Overweight and obesity were diagnosed in 24% and 27% of patients with early rheumatoid arthritis, respectively. Patients with rheumatoid arthritis and metabolic syndrome had a higher body weight, body mass index, waist size, and adipose tissue mass than patients without metabolic syndrome. With the help of instrumental methods, it is shown that in rheumatoid arthritis there is a redistribution of fat mass in the body, its predominant accumulation in the trunk area and a parallel decrease in the volume of muscle tissue.Conclusion. Rheumatoid inflammation and metabolic syndrome affect body composition of patients with early rheumatoid arthritis before the start of antirheumatic therapy.

A new laser-plasma deposition method has been developed for the plasma chemical deposition of hard silicon carbonitride coatings on stainless steel substrates from the hexamethyldisilazane (HMDS) Si2NH(CH3)6 vapor in a high-speed Ar and Ar + 10 vol.% He gas stream at the HMDS gas flow activation after the laser beam focus. The method allows depositing silicon carbonitride coatings at the rate of 0.4 - 1.2 μm·min-1, i.e. ~2 times higher than that at introducing HMDS in the laser beam focus zone. The properties of the prepared coatings have been studied by the methods of IR and Raman spectroscopy, atomic force microscopy, nanoindentation and X-ray diffraction (XRD) analysis. Studying the film structure with the use of XRD showed that the prepared silicon carbonitride coatings are X-ray amorphous. It has been found that the coating deposition rate and the structure of coatings depend on the process parameters: HMDS flow rate and plasma-generating gas (argon or (Ar + He). The method allows depositing SiCN films at a high speed and a hardness of 20 - 22 GPa.

In this work, the correlations between the parameters of a DC glow discharge and dust particles in a lowtemperatureplasma is studied. The formation of voids inside the dust cloud was studied, depending on thecharacteristics of the discharge (discharge pressure, type of gas and discharge current) and dust particles(quantity and size). We have demonstrated that the ion drag force could lead to the formation of voids inthe center of the cloud of dust grains, which levitate in the field of a stratified positive column. It has alsobeen demonstrated that the accumulation of dust particles affects the discharge plasma in a non-local way,i.e., the density distribution of dust grains and the charge of each individual particle depend on the plasmaparameters outside the dust cloud. The presented qualitative estimates are important for understanding theprocesses occurring in complex plasma of a glow discharge.

Hard silicon carbonitride coatings are prepared using Ar and Ar (10 vol.% He) laser plasma from hexamethyldisilazane (HMDS) [(CH3)3Si]2NH and HMDS+benzene vapors. The coatings are characterized by infrared (IR), Raman, and X-ray photoelectron spectroscopies, transmission electron microscopy, and atomic force microscopy. The obtained coatings are amorphous and uniform in composition and over the film thickness. The microhardness of coatings synthesized on steel from a HMDS+ benzene mixture increases from 12 GPa to 18 GPa provided that other parameters remain constant.

To evaluate the frequency of sarcopenia (SP) according to EWGSOP2 criteria and factors associated with low lean mass in women with rheumatoid arthritis (RA).79 women (aged 4075 years) with RA were enrolled in the study. We analyzed clinical data: age, body mass index (BMI), disease duration, methotrexate use, glucocorticoid use, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate, bone mineral density (BMD) of the lumbar spine, femur neck, total hip and body composition by Dual energy X-ray absorptiometry. Also, muscle strength and functional tests were performed. We analyzed the correlation between disease parameters and low lean mass with the Spearman method.73 (92%) patients had low muscle strength, 20 (25%) patients had low muscle strength and low lean mass, among them 9 (11%) also had functional disability. There was no correlation between the age of patients and the presence of SP, while the duration of RA in women with SP was significantly greater (p=0.006). There were significant correlations between lean mass and body mass index, glucocorticoids used, methotrexate doses, creatinine and urea acid serum concentration, bone mineral density and falls number.According EWGSOP2 confirmed sarcopenia was found in 25% RA patients, among them 11% women had severe sarcopenia. Lean mass correlated with the factors related to the disease itself and some general clinical parameters, which requires further study.Цель. Определить частоту саркопении (СП) в соответствии с критериями EWGSOP2 и выявить факторы, ассоциированные с низкой мышечной массой, у женщин с ревматоидным артритом (РА). Материалы и методы. В исследование включены 79 женщин в возрасте 4075 лет с достоверным РА. Проанализированы клинико-анамнестические и лабораторные данные. Обследование включало двуэнергетическую рентгеновскую абсорбциометрию поясничного отдела позвоночника, проксимального отдела бедра и всего тела. Всем пациенткам проведены тесты для оценки мышечной силы и физической формы. Ассоциации между снижением массы мышц и различными факторами оценены на основании корреляционного анализа по Спирмену. Результаты. Снижение мышечной силы обнаружено у 73 (92%) пациенток, а мышечной массы у 20 (25%), из них у 9 (11%) обследованных также зафиксировано нарушение функции мышц. Не выявлено корреляции между возрастом больных и наличием СП, в то же время длительность РА у женщин с СП была значимо больше (р=0,006). Выявлены статистически значимые корреляции между мышечной массой и индексом массы тела, приемом глюкокортикоидов, дозой метотрексата, индексом коморбидности, уровнем креатинина и мочевой кислоты в сыворотке крови, минеральной плотностью кости и количеством падений. Заключение. Достоверную СП по критериям EWGSOP2 имели 25% больных РА, в том числе у 11% обследованных выявлена тяжелая СП. Нами обнаружены корреляции между мышечной массой и факторами, связанными как c самим заболеванием, так и с некоторыми общеклиническими параметрами, что требует дальнейшего изучения.

Introduction. The purpose of the presented work was to determine the cause of complaints of passengers dissatisfied with the thermal comfort in electric trains equipped with modern air conditioning systems. In order, this work to be done both practical and theoretical research was carried out in two stages. This work includes the estimation of microclimate parameters in cars and passengers thermal comfort parameters. Material and methods. At the first stage, direct measurements of microclimate on passenger seats were conducted while the train was in operation. Subsequent analysis of the obtained figures indicates the average values of the studied parameters to correspond to their normative values. At the second stage, Fanger calculation method of determining passenger comfort or discomfort was used to analyze passengers’ assessment of various microclimatic situations in electric trains, both in local areas and in the salons of cars as a whole. Using the Fanger method, based on the results of theoretical calculations, a diagram was constructed. It contains curves showing the warmth index of passengers under different combinations of air temperature and velocity. Results. PMV indices were calculated by using the first stage measurements. Afterward, passengers heating comfort area was drawn on the diagram. It was made for each car and the passengers’ complaints were taken into consideration. Conclusion. The diagram analysis of passengers heating comfort area location relatively to zero point shows the percentage of dissatisfied passengers and it helps to explain the reason it occurs.

ObjectivesTo evaluate the prevalence of sarcopenia (SP) and associated factors in patients with rheumatoid arthritis (RA).Methods159 women (mean age 58.7±8.8) with confirmed RA according to ACR/EULAR criteria (2010) were enrolled. Hand grip strength was measured using mechanical dynamometry. Dual-energy X-ray absorptiometry (DXA) was performed to assess the body composition and bone mineral density (BMD) of the lumbar spine, femoral neck and total hip. SP was defined as muscle strength < 16 kg and appendicular lean mass index (ALMI) 2 or appendicular lean mass (ALM) ResultsSP was diagnosed in 33 (20.8%) women with RA. Patients with SP did not differ in age from those without it (59,0±8,9 and 58,7±8,8 years, respectively, p>0,05). 75.8% patients with SP and only 27.8% women without SP had normal BMI (p2[OR 6.75, 95%CI (2.45-18.56), p ConclusionAmong patients with RA, 1/5 of them had SP, which was positively associated with BMI and the presence of osteoporosis, but not with the age, activity and duration of the disease.Disclosure of InterestsNone declared

BackgroundThere are more evidence that diabetes mellitus (DM) aggravates the course of osteoarthritis (OA).ObjectivesAt multicenter study to evaluate impact of DM as part of metabolic syndrome on course of knee OA.MethodsThe enrolled patients had knee OA based on ACR criteria with x-ray confirmation with stage I-III (Kellgren and Lawrence (K&L). Mean disease duration was 5 (2-10) years. Patients were evaluated by report form, using the anthropometric parameters, questionnaires, disease history and comorbidity, clinical examination data, assessment of knee joints pain, standard X-ray, ultrasound signs of OA, DXA three sites the L1-L4 lumbar spine, femoral neck, and total hip. All participants were signed an informed consent form.ResultsAt prospective study were enrolled 253 women with mean age 58.3 ± 9.5 years (40-75) years, with knee OA. Compensated DM type 2 was diagnosed in 26 (10.3%) patients with knee OA. All patients with knee OA were divided into two groups:1st group was with DM and 2nd group without DM (Table 1). Patients with DM were older, had higher weight and BMI. In patients with DM was harder course of OA based on clinical and instrumental data: higher pain by WOMAC score; at X-ray were more frequent confirmed III stage (K&L) (ОR=3.1, 95%CI 1.1-8.7, р= 0.01). At X-ray investigation narrow of medial joint space and at ultrasound thickness of the cartilage were also smaller at 1st group (рTable 1.Comparative characteristics of patients with OA with or without DM.Parameters1 group (n=26)2 group (n=227)pAge, years, Me65.5 (60- 68)59 (52- 65)0.002BMI, кg/m2, Me33.5 (29.4- 35.8)28.7 (25.6- 32.3)0.0006OA duration, years, Ме11 (7- 18)4 (2-10)0.0032Generalized ОА, %5024.50.009WOMAC pain, mm, Ме199 (158- 230)120 (45- 190)0.005X-ray stage (K&L), %I8.732.50.04II65.257.3III26.110.2Medial knee joint space, mm, Ме2 (0.6- 3.1)3.4 (2.2- 4.5)0.03Cartilage thickness in posterior-lateralis area of knee joint, mm, Ме1.5 (1.4-1.7)1.7 (1.6- 1.9)0.05HbA1c, %; Ме7.2 (5.4-7.7)5.4 (5-5.7)0.01Glucosae, mmol/l, Ме6.6 (5.1-6,9)5.3 (4.9- 5.7)0.003Hypertension, %84.660.80.01Metabolic syndrome, %92.354.20.0002Medial knee joint space, mm, Ме2 (0.6- 3.1)3.4 (2.2- 4.5)0.03Cartilage thickness in posterior-lateralis area of knee joint, mm, Ме1.5 (1.4-1.7)1.7 (1.6- 1.9)0.05BMD total hip, g/cm2, Ме0.966 (0.955-1.054)0.878 (0.801-0.944)0,04Number of components of MS, %0021.10.0009I10.532.8II47.436.7III and more41.29.4Nonalcoholic steatohepatitis, %18.80.80.003In the Spearman correlation analysis are confirmed positive associations between DM and more difficult and prolonged course of OA. We found out that higher WOMAC pain subscale (r=0.18), total hip BMD at DXA (r=0.25), smaller size of medial joint space (r=-0.24) and thickness of the cartilage at ultrasound (r= -0.13) are associated with DM (рConclusionThe patients with OA are high frequent comorbidity with DM (10.3%). Association OA and DM lead to severe OA and higher comorbidity.ReferencesNoneDisclosure of InterestsNone declared

ObjectivesTo determine the need for anti-osteoporotic therapy in postmenopausal women and men over 50 years of age with systemic sclerosis (SSc).MethodsThe study included 150 patients with SSc who met the ACR/EULAR 2013 criteria: 124 (82,7%) postmenopausal women and 26 (17.3%) men over 50 years of age. Median age was 59,0 [54,0; 64,0] years. The duration of the disease was 8,0 [5,0; 14,5] years. A history of fragility fractures was collected. FRAX was calculated in patients without prior fractures to identify patients at high risk of low-energy fractures. Dual-energy X-ray densitometry (DXA) was performed in persons at moderate risk of fractures, and 10-year probability of major osteoporotic fractures was recalculated with the inclusion of a hip neck T-score. DXA was also performed on all patients from the low-risk group who had 2 or more risk factors of OP.Results36 (24%) patients had a history of fragility fractures: 21 (16.9%) women and 6 (4.3%) men - vertebrae fracture, 8 (6.5%) women - peripheral fractures, 1 (3.8%) man – hip fracture.The calculation of the 10-year probability of fractures by FRAX showed that 21 (16,9%) women had a high risk, and another 60 women and 3 men had moderate risk of fractures. After the FRAX recalculation with the inclusion of the femoral neck T-score, only 26 (21,0%) women moved from the moderate-risk group to the high-risk group. All men and 48 women had a low risk of osteoporotic fractures according to FRAX, among them 12 (8,0%) people (4 men and 8 women) had osteoporosis by DXA.Thus, among SSc patients 84 (67.7%) women and 11 (42,3%) men needed anti-osteoporotic treatment.ConclusionAs a result of a comprehensive assessment of the risk of fractures and OP, it was found that 63.3% of patients with SSc needed anti-osteoporotic treatment.Disclosure of InterestsNone declared

ObjectivesTo assess body composition and bone mineral density (BMD) in rheumatoid arthritis (RA) women compared to patients with osteoarthritis (OA).Methods133 women with RA and 45 women with OA aged 50 and over were enrolled in the study. Body composition (fat mass (FM), lean mass and bone mineral component (BMC)) and BMD of the lumbar spine, femoral neck and total hip were measured using dual-energy X-ray absorptiometry (DXA). Appendicular muscle mass (AMM) and appendicular mass index (AMI) were calculated. Muscle strength was assessed in all patients. The criteria of the European Working group on Sarcopenia in Older people 2 (EWGSOP2) were used for low muscle mass and sarcopenia. Osteoporosis was determined in accordance with WHO criteria.ResultsMean age of RA patients and women with OA was 61.3±7.1 and 61.9±6.2 years, respectively (p>0.05). BMC and AMM were lower in RA patients than in women with OA: BMC - 1948.6±425.7g and 2167.1±398.1g, respectively (p=0.004); AMM - 17.5±2.9 kg and 20.1±2.7 kg, respectively (p2 and 7.5±0.9 kg/m2 in RA and OA patients, respectively (p0.05). Overfat was discovered in 99 (77.4%) and 38 (84.4%) in women with RA and OA, respectively (p>0.05). All women with low AMM/AMI had low muscle strength and were diagnosed with confirmed sarcopenia.In RA patients BMD at any region was less than in women with OA: in the lumbar spine – 1.026±0.174 g/сm2 and 1.114±0.177 g/сm2, respectively (p=0.009); in the femoral neck – 0.844±0.151 g/сm2 and 0.914±0.137 g/сm2, respectively (p=0.005) and in the total hip 0.878±0.148 g/сm2 and 0.986±0.117 g/сm2, respectively (pConclusionRA patients had lower BMC, AMM/AMI, total FM and BMD compared to women with OA, and they were significantly more likely to have sarcopenia and osteoporosis.Disclosure of InterestsNone declared

ObjectivesTo identify the frequency and risk factors of osteoporosis (OP) in men with systemic scleroderma (SSc).Methods37 men with SSс were enrolled in the study: 19 (51,4%) with limited and 18 (48,6%) with diffuse cutaneous subtype. Patients with overlap rheumatic syndromes were not included. The median age was 56,0 [46,0; 61,0] years, the median duration of the disease was 6,0 [3,0; 9,0] years. 31 (83,8%) patients were treated with glucocorticoids (GC) > 3 months, the median duration of GC use was 3,7 [2,0; 7,0] years. Dual energy X–ray absorptiometry (DXA) of the lumbar spine (LS), the femoral neck (FN) and the total hip (TH) was performed. Osteoporosis (OP) was diagnosed with a T-score < -2.5 SD and osteopenia – with a T-score from -1SD to -2.5 SD at any region of interest. Z-score < -2 SD was used for diagnosis of OP in men < 50 years old. Spearman correlation between BMD and different factors was performed. Traditional and specific risk factors for OP were analyzed using univariate logistic regression analysis.ResultsThe median LS BMD was 1,13 [1,03; 1,26] g/cm2, the FN BMD 0,95 [0,84; 0,99] г g/cm2 and the TH BMD - 0,99 [0,93; 1,06] g/cm2. Low BMD at least in one region of interest was detected in 19 (51,4%) patients: OP – in 8 (21,6%) (6 persons 50 years and older and 2 men < 50 years); osteopenia – in 11 (29,7%) men, without significant difference between the subtypes of the disease (p>0,05). 9 (24,3%) men had a history of low-trauma fracture, among them 2 (22,2%) patients had OP, 3 (33,3%) - osteopenia and 4 (44,4%) persons - normal BMD. 5 (27,8%) men with diffuse form and 3 (15,8%) - with limited cutaneous subtype had OP (p>0,05).BMD in the LS correlated with uric acid (UA) (Rs = 0,59, pConclusionOP was found in 21.6% of men with SSc. There was no statistically significant difference in the frequency of OP depending on the subtype of the disease. Among analyzed factors, only the FVC was positive associated with OP. Further research is needed.Disclosure of InterestsNone declared

ObjectivesTo compare the effect of rituximab (RIT) treatment on bone mineral density (BMD) in women with rheumatoid arthritis (RA) and those with RA without biological therapy.Methods78 women over 40 years with confirmed RA according to ACR/EULAR criteria (2010) were enrolled in the study: 48 patients treated with RIT and methotrexate (RIT+) and 30 women received only methotrexate (RIT-). The patients did not differ in the glucocorticoid therapy duration and cumulative dose. BMD was determined in the lumbar spine, femur neck and total hip using dual energy x-ray absorptiometry (DXA, Hologic 4500A) at baseline and after 1 year. RA activity was evaluated by disease activity score using 28 joint counts and erythrocyte sedimentation rate (DAS28 ESR). Nonparametric statistic tests were performed.ResultsThere were no differences between patients RIT+ and RIT- in age (median - 58 [53; 63] years and 52 [50; 69] years, p>0.05), RA duration (median – 15 [4; 21] year and 9 [3; 11] year, p>0.05) and DAS28 ESR (median – 5.18 [4.35; 6.25] and 5.71 [4.66; 5.94]). The percentage BMD changes from baseline in lumbar spine, femoral neck and total hip were 0.2% [-3.9%; 4.0%], -1.8% [-6.2%; 2.4%] and -0.3% [-3.5%; 4.5%], respectively, in patients RIT+ and -1.0% [-4.9%; 3.3%], -2.5% [-5.8%; -0.4%], -1.7% [-4.3%; 4.2%], respectively, in persons RIT-. There were no differences in BMD changes in the pair matching test both patients RIT+ and RIT-. No correlations between BMD changes with age, RA duration and DAS28 ESR were found.ConclusionRIT had no effect on BMD in women with RA after 1 year therapy. BMD changes were not associated with age, RA duration and disease activity.Disclosure of InterestsNone declared

Objectivesto outline specific biochemical and imaging features of metabolic phenotype of knee osteoarthritis (OA) in a multicenter prospective study.Methods284 female patients with knee OA (according to the ACR criteria) aged 40-78 were included in this prospective multicenter study. OA radiologic stages in the study group varied from I to III (Kellgren & Lawrence) and all the patients signed an informed consent. Mean age was 58.5 ± 9.5 years, disease duration was 5 (2-10) years. BMI was 29.6 ± 5.6 kg/m2, with hip (HC) – 109.3 ± 10.4 cm and waist circumference (WC) – 92.5 ± 12.5 cm. Physicians filled out individual case report forms, which included anthropometric information, history and physical assessment data. All patients performed lab tests, ultrasonography and x-ray of the knee, as well as proximal femur and lumbar spine DEXA.ResultsMetabolic phenotype was diagnosed in 52.4% of patients. Participants were then divided in two groups. Patients with metabolic phenotype of osteoarthritis were older (61 (57-68) vs 52 (43-58), respectively, pTable 1.Comparison of patients depending on phenotypeIndexMetabolic phenotype(n=149)No metabolic phenotype(n=135)pK&L radiologic grade0.01I grade13.6%56.7%II grade62.7%36.7%III grade23.7%6.6%Posterior lateral tibial cartilage, mm, Me1.5 (1.4-1.8)1.7 [1.6;1.8]0.05Posterior medial tibial cartilage, mm, Me1.6 (1.3-1.8)1.7 [1.6;1.8]0.014Medial knee joint space, mm, Me2.6 (1-4.6)3.6 [3;4.3]0.023Osteophytes of the medial tibial condyle, mm, Me1 (1-2)0 [0;0]0.025Osteophytes of the lateral tibial condyle, mm, Me1 (1-2)0[0;1]0.042Synovium thickness, mm, Me3.1 (2.9-3.5)2.9 (2.6-3.1)0.02Total hip BMD, (g/cm2), mm, Me0.95 (0.87-1.02)0.87 (0.77-0.99)0.03CRP, mg/l, Me2.8 (1.4-5.1)1.1 (0.49-2.0)0.0001HbA1c, %, Me5.7 (5.4-5.9)5.2 (4.9-5.6)0.0001Uric acid, mcmol/l, Me312 (268-391)269.7 (233.9-324.5)0.0002Cholesterol, mmol/l, Me6.4 (5.33-6.85)5.4 (4.78-5.82)0.002LDL, mmol/l, Me4 (3.38-4.59)3.1 (2.6-3.89)0.0009Triglycerides, mmol/l, Me1.6 (1.19-2.44)1.1 (0.76-1.48)ALT/AST, units/l, Me21 (17.15-28.9)/ 20.6 (17.6-25)15.9 (11.4-19.8)/ 18.1(14.9-21.6)0.0006Glucose, mmol/l, Me5.6 (5.1-6,155)5.2 (4.97-5.53)0.001Leptin, ng/ml, Me35.6 (25.5-55.6)20 (14.7-31)COMP, ng/ml, Me1415 (1115-2100)712.2 (484.5-1015)IL-6, pg/ml, Me0.55 (0.25-0.8)0.03 (0.01-0.4)Spearman correlation analysis showed positive correlations (p ConclusionComprehensive examination of patients with the use of imaging and biochemical methods showed that metabolic phenotype of osteoarthritis is more severe (with correction for age taken into account). Patients with metabolic phenotype showed higher levels of hsCRP, leptin, IL-6, COMP, which possibly demonstrate a more active form of low-grade inflammation (the underlying mechanism of OA pathogenesis) and more significant cartilage damageDisclosure of InterestsNone declared

ObjectivesTo determine the frequency and risk factors of osteoporosis (OP) in fertile women with systemic scleroderma (SSс)Methods64 women (36,0 [31,5; 43,5] years old) with SSс were enrolled in the study: 35 (54,7%) with limited and 29 (45,3%) with diffuse cutaneous subtype without overlap rheumatic syndromes. The median disease duration was 5,0 [2,0; 9,0] years. Glucocorticoids (GC) were taken by 49 (76,6%) patients with the median duration of treatment 5,0 [2,0; 10,0] years. Dual energy X–ray absorptiometry (DXA) of the lumbar spine, the femoral neck and the total hip was performed. To estimate the value of the BMD the Z-score was used. Low BMD was considered at a Z-score < -2.0 SD. A univariate logistic regression analysis was performed to analyze the factors associated with OP.ResultsLow BMD was detected in 8 (12.5%) patients. 5 (7,8%) women had a history of low-trauma fracture, among them only 1 (1,6%) patient had low BMD and 4 (6,2%) persons - normal BMD.A univariate logistic regression was performed to identify OP risk factors. Among traditional risk factors, low body mass index (BMI) associated with OP (OR 1,39 [1.04; 1.88], p=0,03) and falls during the past year (OR 5,25 [1.04; 26.36], p=0,04). Among specific ones – duration of SSc (OR 1,19 [1.02; 1.39], p=0,02), duration of GC using (OR 1,11 [1.00; 1.23], p=0,04), hand joint contractures (OR 8,54 [1.41; 51.63], p=0,02). There was no effect of smoking, treatment with proton pump inhibitors, family history of osteoporosis, age, subtype SSc, modified Rodnan score, digital ulcer, cutaneous calcification, esophageal hypotension, interstitial lung disease, diffusing capacity of the lung for carbon monoxide, force vital capacity, CRP, erythrocyte sedimentation rate, creatinine, presence of antinuclear antibody, anticentromere antibody or antitopoisomerase I antibody on the development of OP in fertile women with SSс.ConclusionLow BMD was detected in 12.5% of fertile women with SSс. Low BMI, falls during the past year, duration of SSs and GC taking, hand joint contractures associated with OP.Disclosure of InterestsNone declared

ObjectivesTo evaluate quality of life and its relationship with muscle strength and physical performance in patients with rheumatoid arthritis (RA).Methods157 women with RA (median age was 58.6±8.8 years, median duration of RA was 8.0 [4,0; 14] years) were included in the study. Assessment of functional disability and quality of life was carried out using Health Assessment Questionnaire Disability Index (HAQ), EQ-5D (index and visual analog scale, VAS), Hospital Anxiety and Depression Scale (HADS, with two subscales for anxiety and depression, HADS-A and HADS-D), Rheumatoid Arthritis Impact of Disease (RAID). Also, all patients underwent tests to determine muscle strength by hand dynamometry and test “Chair stand” and physical performance by the Short Physical Performance Battery (SPPB). Dual-energy X-ray absorptiometry of the whole body, lumbar spine and proximal hip was done. Spearman’s correlation test was performed.Results88.5% of RA patients had low muscle strength, 61.1% of people had low physical performance. No correlation was found between physical performance and age, RA activity, body composition and BMD. In persons with reduced physical performance, HAQ, EQ-5D index, VAS and RAID were worse than in women with normal physical function (pConclusion88.5% of RA patients had low muscle strength and 61.1% - low physical performance. Quality of life negatively correlated with physical performance.Disclosure of InterestsNone declared

Carbon nitride coatings are synthesized in the new laser plasma of powerful optical pulsating discharge using acetonitrile as a precursor. A high-pressure and -temperature C3N4 cubic phase with a spinel structure type is obtained. The microhardness of coatings of this structure type is ~45 gPa. The chemical composition and structure of the coatings are characterized by a complex of spectroscopic (IR, Raman, EDS) techniques as well as microscopic (AFM and XRD) techniques.

Lytic polysaccharide monooxygenases (LPMOs) are recently discovered enzymes that catalyze the oxidative deconstruction of polysaccharides. However fast and reliable methods of determination of LPMO activity still need to be developed, especially those based on the initial reaction rates. A method based on the oxygen consumption rate (OCR) measurements, using a Seahorse XFp Analyzer with highly-sensitive fluorimetric sensors, was applied for monitoring the oxidation of amorphous cellulose by three fungal LPMOs: recombinant enzymes from Thielavia terrestris (GH61E), Trichoderma reesei (Cel61A), and a native LPMO9A from Myceliophthora thermophila. The turnover numbers for 4 μM enzymes acting on 4 mg mL−1 cellulose at 37 °C were 0.88, 1.26 and 0.93 min−1, respectively. A possibility of feeding the dissolved reagents into the reaction system during measurements with obtaining a simultaneous response in the OCR allowed in situ monitoring the LPMO inhibition and activation by EDTA and Cu2+ ions as well as studying other effects on the enzymatic reaction.

The article investigates the issue of equal educational opportunities and learning achievements for students belonging to different social classes, communities and confessions, and analyses various approaches to its solution. The authors of the article reflect on the concept of equal opportunities and the current state of its implementation in the world and in Russian education. The idea of equal educational opportunities for all is one of the key ideas in education policies and strategies of different countries in the information age. In the present situation of social inequality, many countries with developed economies focus on creating conditions for equal educational opportunities and learning achievements within the framework of their education policies for certain social groups (people of the third age, migrants and their children, people with special needs etc.—inclusive education). This innovative research is multidisciplinary in nature. It is accounted for by the clear eagerness of scientists and educators of different countries for international dialogue about systemic reforms and the most critical issues, in order to find the best solutions to the present-day obstacles. The study aims at developing methodological approaches to tackling the problem of equal opportunities for everyone in the contemporary society. The findings of the study should lead to establishing fundamental scientific notions on the current stage of the implementation of the concept of equal opportunities and learning achievements (expertise), at outlining teaching conditions and mechanisms that are necessary for its implementation.

Background Systemic sclerosis (SSc) is a severe connective tissue disorder causing vascular, immune, and fibrotic changes in the skin and internal organs. Patients with SSc may have an increased risk of osteoporosis (OP) and fractures due to a chronic inflammatory state, latent malabsorption or malnutrition, immobilization, and use of corticosteroid therapy. Objectives: to determine the frequency of low mineral density, falls, low energy fractures and 10-year probability of new fracture in patients with SSc. Methods 191 patients with SSc were enrolled in the study: 160 women (mean age 51±13 yrs), among them 107 postmenopausal, and 31 men (mean age 53±14 yrs). Bone mineral density (BMD) was measured at lumbar spine (LS), femoral neck (FN) and total hip (TH) by dual energy X-ray absorptiometry (DXA, Hologic 4500A). BMD decreasing grade was determined in accordance to WHO criteria. All patients were interviewed on a special questionnaire and assessment of 10-year probability of new fracture by FRAX® was performed. Vitamin D level was measured in 104 patients. Results Low BMD was found in 68% women and 55% men: osteopenia in 30% and 32% and OP in 38% (21% in reproductive age and 50% in postmenopausal) and 23%, respectively. BMD in LS, FN and TH associated with body mass index (r=0,3, p=0,030; r=0,41, p=0,0027; r=0,49, p=0,0002, respectively) and duration of postmenopausal period in women (r=-0,56, p=0,023; r=-0,66, p=0,006; r=-0,63, p=0,009, respectively). BMD of LS and FN correlated with age (r=-0,22, p=0,045; r=-0,23, p=0,016, respectively), duration of SSc (r=-0,32, p=0,037; r=-0,31, p=0,046, respectively), glucocorticoid cumulative dose for LS only (r=-0,31, p=0,024). Mean 25(OH)D level was 19,83±11,06 ng/ml. Normal vitamin D level had 9% of SSc patients. No correlation between BMD and 25(OH)D level was found. 46 (24%) patients reported falls in the year prior to the interview, among them in 2 patients the fall led to fracture. A total of 48 (25%) patients had low energy fractures in the past, among them 8 (4%) of women had two or more fractures. Frequency of low energy fractures was 35%, 8% and 25% among postmenopausal women, women of reproductive age and men, respectively. The mean age at which the fracture occurred was 55±11 yrs. in postmenopausal women, 30±12 yrs. in young women and 60±12 yrs. in men. The most frequent were the fractures of distal forearm and vertebrae: 13 (7%) and 26 (14%) patients, respectively. Five patients each (3%) had ankle and humerus neck fractures and 7 – other localizations. Nobody reported the fracture of the proximal femur. Patients with abnormal BMD (OP or osteopenia) had a risk of falls and low energy fractures more than 2 times higher than patients with normal BMD (OR 2.93 [95% CI 1.11; 8.01], p=0,016 and OR 2.58 [95% CI 1.04; 6.6], p=0,025, respectively). 10-year probability of any major osteoporotic fracture was 18.4 ± 9.6% in women and 9.7 ± 8.6% in men and of hip fracture - 3.5 ± 3.7% and 1.5 ± 3.9%, respectively. Among all patients, 55% of women and 4% of men had a high risk of subsequent fractures using the FRAX® algorithm. Conclusion Low BMD was diagnosed in 68% of women and 55% of men with SSc. The correlations between BMD and age, body mass index, the duration of postmenopause were revealed. Additionally, we found associations with risk factors related to the disease itself: disease duration and glucocorticoid cumulative dose. Reduced BMD was associated with an increased risk of falls and fractures. 55% of women and 4% of men had a high risk of further fractures. Disclosure of Interests Olga Dobrovolskaya: None declared, Nikolay Demin: None declared, Oxana Desinova: None declared, Natalia Toroptsova Speakers bureau: Amgen, Lilly

Objectives To find the relationship between bone mineral density (BMD) and risk of knee OA progression in a 5-year prospective study. Methods 110 females with knee OA were examined twice with 5-year interval. Examination included filling questionnaires, VAS pain assessment, plain knee radiography and axial skeleton densitometry. I stage knee OA was established in 33 (30%) patients, II stage - in 46 (41,8%, III stage – in 26 (23,6%), and IV - in 5 (4,5%). Normal lumbar vertebrae densitometry BMD values were found in 45 patients (40,9%), osteopenia-corresponding BMD values – in 33 (30,0%), and osteoporosis – in 32 (29,1%). Normal femoral neck BMD values were identified in 60 (54,5%) patients, osteopenia-level BMD – in 48 (43,7%), osteoporosis – in 2 (1,8%). In all premenopausal patients (n = 15) axial skeleton BMD values were normal. Results In 5-year interval radiographic progression was established in 40 patients (Group 2), while in 70 (Group 1) patients no progression occurred. Both groups were comparable in terms of age and disease duration, although, more patients from Group 2 tended to have normal baseline densitometry BMD values - both in lumbar vertebrae and femoral neck: 47,5% vs 37,1%, and 62,5% vs 44,3% as compared to Group 1 patients. Patients from Group 1 more often had BMD values corresponding to osteoporosis and osteopenia: 32,9 vs 22,5%, and 55,7 vs 37,5%, respectively, as compared to Group 2 patients, although not achieving statistical significance. These differences were still identifiable after 5-year interval. Absolute BMD values at the second examination in 5 years were indicative of statistically significant increase in femoral neck and total hip BMD in Group 2 patients with knee OA progression: 0,79 ± 0,11 vs 0,73 ± 0,16, р Thorough analysis of lumbar vertebrae BMD (g/cm2) relationship with OA stages revealed that in patients with stage IV OA lumbar BMD values were significantly higher than in patients with stages I-III OA (stage I OA - BMD 0,87±0,12 g/cm2; stage II OA - 0,92±0,21 g/cm2; stage III OA - 0,88±0,13 g/cm2, stage IV OA – BMD 1,07± 0,17 g/cm2) (Table1). Femoral BMD values didn’t show evident correlation with knee OA stage, although there was a trend towards higher BMD values in patients with stage IV OA compared to stage III OA (р = 0,06). Total hip BMD values were quite similar to lumbar BMD values (р = 0,01) (Table 2). BMD values were statistically significantly higher in patients with stage IV OA, than in patients with stages I and III (respectively, IV – 0,98 ± 0,13 g/cm2, I - 0,85 ± 0,10 g/cm2 and III - 0,86 ± 0,16 g/cm2). Correlation analysis also confirmed direct correlation between knee OA stage and BMD values in all evaluated compartments (p Conclusion Increasing during the 5-eyar follow up period femoral neck and total hip BMD values can be interpreted as the predictor of knee PA progression. More advanced OA stages are associated with higher BMD values. Future multicenter prospective studies are deemed to better establish the correlation between BMD and knee OA progression. Disclosure of Interests: Natalia Kashevarova: None declared, Elena Taskina Speakers bureau: Bayer, Sandoz, Boeringer-ingelheim, Ludmila Alekseeva Speakers bureau: Bayer, Boeringer-ingelheim, Gedeon-Richter, Servier, Nikolay Demin: None declared, Aleksandr Lila Speakers bureau: Sandoz, Pfizer, Abbvie, Novartis, Bayer

Background:Inflammation, decreased physical activity, hormonal disorders, and the use of glucocorticoids lead to changes in the composition of the body in rheumatoid arthritis (RA). Various combinations of decreased muscle and bone mass and increased adipose tissue have led to the release of various pathological phenotypes of the composition of the body.Objectives:To determine the frequency of pathological phenotypes of body composition in patients with RA.Methods:The study included 79 women with RA, with a median age of 60 y.o. [55; 65]. 92% of the women were postmenopausal. The median duration of the disease was 9 years [3; 11]. Basic anti-inflammatory therapy was received by 81% of patients. Methotrexate was used most often as the basic therapy – in 52% of cases. 49% of patients were treated with glucocorticoid drugs. All patients underwent dual-energy X-ray absorptiometry. The mineral density of the tissues was determined in the standard measurement areas - the spine and the proximal thigh, and the content of muscle and adipose tissue was analyzed. We calculated appendicular muscle mass (AMM), which is the sum of upper and lower limb muscle mass and appendicular muscle index (AMI), the ratio of appendicular muscle mass to the square of height. AMM< 15 kg, AMI < 6 kg / m2 corresponds to sarcopenia.Results:The average AMM was 17.8±3.0 kg. 18% patients had AMM Table 1.Pathological phenotypes of body compositionPathological phenotypes of body compositionn=79Osteoporosis, n (%)13 (16,5)Obesity, n (%)14 (17,7)Osteosarcopenia, n (%)7 (8,9)Osteopenic obesity, n (%)29 (36,7)Osteosarcopenic obesity, n (%)13 (16,5)Conclusion:The overall frequency of pathological phenotypes of body composition was high and amounted to 96.2% in women with RA. The most common pathological phenotype was an osteopenic obesity characterized by a decrease in BMD and an increase in fat mass.Disclosure of Interests:None declared

Background:Sarcopenia, characterized by low muscle strength and low muscle quantity or quality and associated with increased risks of falling and mortality. The prevalence of sarcopenia is 37% among patients with RA [1]. However, in clinical practice settings, sarcopenia among RA patients remains underdiagnosed. The SARC-F questionnaire [2] was recommended by the European Working Group on Sarcopenia in Older People (EWGSOP) before performing muscle strength tests and assessment muscle mass.Objectives:To evaluate the diagnostic value of the SARC-F questionnaire for the screening of sarcopenia (SP) in women with rheumatoid arthritis (RA).Methods:83 women (average age 59±8 years) with RA without aseptic bone necrosis, joint replacement and severe comorbidities were recruited. All patients were interviewed with the SARC-F questionnaire. The summation score ≥ 4 corresponded to cut-off for suspected sarcopenia. Sarcopenia was evaluated using the European Working Group on Sarcopenia in Older People (EWGSOP2), which included dual-energy X-ray absorptiometry (DXA), handgrip strength or chair stand test, and gait speed. The sensitivity, specificity, positive and negative prognostic values of the SARC-F questionnaire were estimated.Results:Confirmed SP was diagnosed in 20 (24%) RA patients, who had low muscle strength and mass. When conventional cut-off point (≥4) for SARC-F questionnaire was applied, only 30% of the patients with SP met this condition (sensitivity 30%, 95% confidence interval [95% CI] 13% to 54%), and 41% of the patients without SP did not meet this condition (specificity 41%, 95% CI 29% to 54%). Positive and negative prognostic values were 14% (95% CI 6% to 29%) and 65% (95% CI 48% to 79%), respectively.Conclusion:The SARC-F questionnaire alone is not adequate for screening of SP in RA patient. It is necessary to develop other simple screening methods that can easily be carried out in real clinical practice to identify individuals with possible SP for further diagnostic tests.References:[1]Torii M, Hashimoto M, Hanai A, et al. Prevalence and factors associated with sarcopenia in patients with rheumatoid arthritis. Modern Rheumatology, 2018;29(4):589-595. doi:10.1080/14397595.2018.1510565.[2]Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169.Disclosure of Interests:None declared

Background:A redistribution of body fat (abdominal obesity) is quite common in RA patients. Such parameters as body mass index (BMI) and waist circumference do not distinguish or quantify fat and lean (muscle) mass. For that purpose, dual-energy X-ray absorptiometry (DXA) is usually used.Objectives:to compare quantitative body composition in patients with early RA at baseline and after 24 weeks of therapy with different regimens.Methods:The study included 37pts (31 women /6 men) with early RA (ACR/EULAR criteria, 2010), 57 [46.5, 62,0] years old, naïve to treatment with glucocorticoids and disease-modifying anti-rheumatics (DMARDs). Pts were seropositive for IgM RF (76%) and anti-CCP (92%), with highly active RA (DAS28 5,5 [5,1; 6,0]; SDAI 32,4 [22,4; 42], CDAI 29,0 [19,7; 39,5]) scores, and median disease duration of 6.0 [5,5;15.5] months. Methotrexate (MTX) 10 [10-15] mg/week subcutaneously was initiated in all included patients as first line therapy for 12 weeks. By this time point therapy was reviewed in 19 patients (51%) due to MTX inefficacy and adalimumab (ADA) at 40 mg once every 2 weeks was added on top of MTX. DXA scan (HOLOGIC, USA) was used to measure body composition at baseline and after 6mths of treatment with the protocol assessing total body, body fat and lean muscle mass.Results:Based on therapeutic regimens at week 24 all study subjects were divided into 2 groups: Group I (n=18) receiving MTX monotherapy, Group II (n=19) – the combination of MTX and ADA (Table 1). Group I patients had lower body weight, lean and fat mass vs patients from Group II (62 kg vs. 73.7 kg; 40.6 kg vs. 49.7 kg; 21.0 kg vs. 25.8 kg, respectively (pTable 1.IndicesI group (n=18),monotherapy МТII group (n=19),combination therapy (MTX, ADA)baseline24 weeksΔ,%baseline24 weeksΔ,%Body fat mass, kg21,0 [17,2;26,2]**23,4 [17,5;29,7]+1125,8 [18,4;35,0]28,1 [21,4;37,9]*+9Lean mass, kg40,6 [37,3;44,7]**41,6 [38,2;46,4]***/*+2,549,7 [39,0;56,1]49,9 [41,0;57,6]0,4Total mass, kg62,0 [57,7;77,6]**64,1 [59,5;81,6]***+3,473,7 [64,5;97,9]75,8 [66,8;102,1]*+2,8*pConclusion:In general, RA patients on treatment tend to gain weight by week 24. Patients who failed on MTX monotherapy by week 24 and were switched to combination therapy had higher fat mass at baseline. Mediations used for RA treatment produce multidirectional effects on quantitative parameters of body composition: MTX monotherapy triggers some increase of lean mass, while combination of MTX and bDMARD results in weight gain and increase of total and fat mass. These data need to be confirmed in large-scale studies with longer follow-up period.Disclosure of Interests:None declared

Background:The relationship between lean mass (LM), fat mass (FM) and bone mineral density (BMD) remains controversial. Some population studies have emphasized the positive association between them, while others have found an inverse relationship. RA patients are characterized by a decrease in muscle mass and an increase in fat mass. Such changes in body composition may be associated with low BMD.Objectives:To study the relationship between BMD, LM and FM in postmenopausal women with RA.Methods:68 postmenopausal women with RA (median age 59 [54; 63] years) were included in the study. BMD and body composition were evaluated using two-energy X-ray absorptiometry. Correlation analysis between body composition parameters and BMD was performed with the Spearman method, correlation coefficients R for pResults:The average L1-L4 BMD was 0,92±0,16 g/cm2, total hip BMD - 0,84±0,15 g/cm2 and femoral neck - 0,73±0,13 g/cm2. 33 (48.5%) women had osteopenia, and 17 (25.0%) - osteoporosis (OP). Low appendicular LM was found in 5 (7.4%) and low appendicular muscle index (appendicular LM/height2, AMI) – in 10 (14.7%) patients. Overfat was revealed in 47 (69.1%) women, but only 20 (29.4%) women had BMI corresponding to obesity. The positive correlations between BMD in L1-L4, total hip and femoral neck regions and body weight (R=0.46, R=0.56 and R=0.50, respectively), trunk fat (R=0.4, R=0.51 and R=0.37, respectively), total FM (R=0.27, R=0.43 and R=0.34, respectively), trunk LM (R=0.55, R=0.54 and R=0.51, respectively), total LM (R=0.51, R=0.50 and R=0.52, respectively), appendicular LM (R=0.31, R=0.29 and R=0.37, respectively) and AMI (R=0.26, R=0.33 and R=0.51, respectively) were found out. In the multivariate linear regression analysis total LM was associated with BMD of lumbar spine (β=0.638, p=0.001) and total hip (β=0.473, p=0.008), and AMI - with femoral neck BMD (β=0.360; p=0.014). We found that FM hadn’t a significant effect on BMD in any region.Conclusion:73.5% of patients with RA had a reduced BMD, and 14.7% women – low AMI. LM was positively associated with BMDs in different regions of interest, but FM had no effect on BMD. Further researches are needed to identify associations between body composition, inflammatory activity and bone health in patients with RA.Disclosure of Interests:None declared

Background:Objectives:To assess the frequency of fragility fractures and the 10-year risk of major osteoporotic fractures using the fracture risk assessment tool (FRAX) tool in patients with systemic sclerosis (SSc).Methods:The study included 136 patients with SSc who met the ACR/EULAR 2013 criteria: 110 (80.9%) postmenopausal women and 26 (19.1%) men over 50 years of age, mean age 59,3 + 7.5 years. The duration of the disease was 10,0 [6.0; 15.0] years in women and 6,0 [3.5; 9.0] years in men. A questionnaire was conducted and the risk of major osteoporotic fractures was calculated according to FRAX tool, as a result of which patients were divided into groups of low, moderate or high risk. Individuals at moderate risk underwent dual-energy X-ray absorptiometry (DXA) of the proximal femur, followed by a 10-year probability of major osteoporotic fractures recalculation with the inclusion of the femoral neck T-score. According to the obtained fracture risk assessment tool value, patients were assigned as having a low, high or very high risk.Results:Fragility fractures of various localization were found in 50 (36,7%) people: 41 (37,3%) women and 9 (34.6%) men. Vertebral and peripheral bone fractures occurred with the same frequency (19,8%) without significant differences depending on the patient’s gender. Only 1 (3,8%) male had a history of proximal femoral fracture. Fractures of both the vertebra and the peripheral bone occurred in 4 (2,9%) people: 3 (2,7%) women and 1 (3,8%) man.9 (8,2%) women and 16 (61,5%) men had a low risk of major osteoporotic fractures according to FRAX, 60 (54,5%) and 10 (38,5%) - a moderate risk, respectively, while 41 (37,3%) women were at high risk. Among 86 patients without a history of low-energy fractures (69 women and 17 men), 8 (11,6%) women and 16 (94,1%) men were at low risk of major osteoporotic fractures, and 57 (82,6%) and 1 (5,9%), respectively, were at moderate risk. Only 4 (5,8%) women were assigned to the high-risk group. After recalculation of the fracture risk assessment tool with inclusion of the femoral neck T-score in persons with moderate risk without a history of fragility fractures, 9 (13,0%) women and 1 (5,9%) man were found to be at high risk, 14 (20,3%) women - at very high risk and 34 (49,3%) women - at low risk.Among moderate-risk patients with prior fractures after FRAX recalculation 3 (7,3%) women and 7 (77,8%) men became at low risk, 1 (11,1%) male - at high and 1(11,1%) male – at very high risk. Thus, 55 (50,0%) women and 1 (3,8%) man were at very high, 12 (10,9%) and 2 (7,7%), respectively, - at high, and 43 (39,1%) and 23 (88,5%), respectively, - at low risk of major osteoporotic fractures.Conclusion:In the examined cohort of patients with SSc, the frequency of fragility fractures was 37,3% in women and 34,6% in men. A high and very high risk of major osteoporotic fractures was found in 60,9% of women and 11,5% of men. 3 (2,7%) women and 6 (23,1%) men with a history of previous fractures were in the low-risk group by FRAX, but they need to consider the appointment of anti-osteoporotic therapy as for patients at high and very high risk.Disclosure of Interests:None declared.

Background:Sarcopenia can be age associated (primary form) or secondary to chronic disorders, including rheumatic inflammatory disorders. Systemic sclerosis (SSc) is a chronic autoimmune rheumatic disease characterized by widespread vasculopathy, progressive fibrosis of the skin and other internal organs, such as lung, kidneys, gastrointestinal tract, cardiovascular system. Different from the other chronic rheumatic inflammatory disorders, sarcopenia has not been well evaluated in SSc patients.Objectives:To assess the body composition (BC) and to identify the frequency of sarcopenia (SP) in SSc patients.Methods:A total of 44 women who met the ACR/EULAR 2013 classification criteria were included. Mean age was 53,2 + 8,8 years. The median disease duration was 7,0 [4,0;12,0] years. 26 (59,1%) patients had limited and 18 (40,9%) - diffuse cutaneous subtype. Body composition was measured using Dual-energy X-ray absorptiometry (DXA) of whole body. The appendicular lean mass index (ALMI) was calculated as the ratio of appendicular lean mass (ALM) to height (kg/m2). Handgrip measurement and chair stand test were performed. Physical function was measured with the Short Physical Performance Battery (SPPB). SP was diagnosed in agreement with the 2019 revised consensus on definition and diagnosis of SP of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2): handgrip 15 seconds for 5 rises, ALM 35%.Results:The median bone mineral content was 2.0 [1.8; 2.2] kg, total lean mass - 39,5 [35,7; 45,5] kg, ALM - 16,3 [14,5;19,4] kg, ALMI – 6,5 [5,7; 7,2] kg/m2, trunk fat mass – 13,5 [9,1; 16,7] kg and total fat mass - 26,6 [20,1; 34,5] kg. Body fat percentage was 38,8% [34,2; 42,7].9 (20,5%) women had low ALM and low ALMI, 6 (13,6%) – only low ALM. Healthy BC was found in 5 (11,3%), low ALM or low ALMI – in 7 (15,9%), overfat – in 24 (54,5%), low ALM + overfat – in 8 (18,2%) patients. We found no differences in BC between SSc patients with limited and diffuse cutaneous subtype.Low muscle strength (SP probable) was found in 21 (47,7%) women, meanwhile confirmed SP (low muscle strength and muscle mass) was diagnosed in 10 (22,7%) patients, among them 5 (11,4%) persons had severe SP. No significant difference in SP frequency among patients with limited and diffuse cutaneous SSc 4 (15,4%) and 6 (33,3%), respectively, (p=0,27). Osteoporosis was found in 6 (60%) patients with SP without differences in SSc subtypes.Conclusion:Healthy BC was found only in 11,3% cases, while overfat - in 72,7% and low ALM – in 34,1% SSc patients. SP was detected in 22.7% of women, among them in half of cases - severe SP, without any differences between the limited and diffuse subtypes of the disease.Disclosure of Interests:None declared

Background:Chronic inflammatory rheumatic diseases are risk factors of bone loss and fractures. Systemic sclerosis (SSc) has been recognized to be another potential inflammatory joint disease that may affect bone tissue.Objectives:to evaluate bone mineral density (BMD) and risk factors of low BMD in women with SSc.Methods:173 women, among them 110 postmenopausal (median age 60[55,63] years) and 63 premenopausal (median age 35[31,44] years). BMD was measured at lumbar spine (LS), femoral neck (FN) and total hip (TH) by dual energy X-ray absorptiometry (DXA, Hologic 4500A). Low BMD was diagnosed if the T-score was < -1.0 standard deviation (SD) in postmenopausal women and if the Z-score was < -2.0 SD in premenopausal women. The relationship between BMD and SSc patients’ characteristics was evaluated using univariate linear regression analysis.Results:Low BMD was found in 66% patients: 79% - in postmenopausal and 18% - in premenopausal women. Among postmenopausal persons osteoporosis was discovered in 47% and osteopenia – in 32% cases. In postmenopausal woman BMD of LS, FN and TH were associated with body mass index (BMI) (β=0.27, p=0.010; β=0.47, pConclusion:Low BMD was diagnosed in 66% of women with SSc. Low BMI, GCs cumulative dose and duration of GCs using were independent risk factors for low BMD in both premenopausal and postmenopausal persons. Additional factors as SSc duration and low vitamin D level were found out for premenopausal and current GCs dose and C-reactive protein level for postmenopausal women.Disclosure of Interests:None declared

Background:Rheumatoid arthritis (RA) is a complex inflammatory disease that modifies body composition. Using the dual-energy x-ray absorptiometry (DXA) in RA patients could be a method for body composition changes detection.Objectives:To study the body composition using DXA in patients with RA.Methods:The study involved 79 women with RA, median age 60 [55; 65] years. The bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry using «Discovery A» (Hologic, USA). Assessment of body composition was carried out, using the program «Whole body». Sarcopenia (SP) was diagnosed as a decrease in appendicular mass index (AMI) 2. Osteoporosis (OP) was diagnosed as a decrease in T-score 2, osteosarcopenic obesity - T-score was 2and total fat was >35%.Results:The mean duration of RA was 9 [3; 11] years. The mean body mass index (BMI) was 27.6±4.8 kg/m2. Disease activity score in 28 joints-erythrocyte sedimentation rate was 4.5±1.3 points for the group. 39 (49.3%) patients used oral glucocorticoids continuously. Appendicular muscle mass and AMI were on average 17.8±3.0 kg and 6.8±1.0 kg/m2, respectively. AMI 2was detected in 20 (25.3%) patients. 56 (70.9%) women with RA had total fat > 35%, while only 22 (27.8%) of women with RA had obesity according to BMI (BMI >30 kg/m2). Isolated OP was found in 13 (16.5%), osteosarcopenia in 7 (8.9%) and osteosarcopenic obesity in 13 (16.5%) patients RA. No cases with isolated sarcopenia or sarcopenic obesity were detected. Only 3 (3.8%) patients did not have appendicular muscle mass, AMI and BMD decrease and overfat or obesity.Conclusion:About 97% women with RA had abnormal body composition phenotype: 16,5% - OP, 8.9% -osteosarcopenia, 16,5% - osteosarcopenic obesity and 54,4% - overfat.Disclosure of Interests:None declared

Background:The onset of the disease in young and middle age is typical for rheumatic diseases (RDS), but most studies on osteoporosis were conducted in patients (pts) older than 50 years, which included postmenopausal women.Objectives:To assess bone mineral density (BMD), fracture frequency and the factors associated with low BMD in premenopausal women with RDs.Methods:160 women (median age, 36 [29; 43] years): 120 pts with RDs (43 rheumatoid arthritis (RA), 53 systemic sclerosis (SSc) and 24 psoriatic arthritis (PsA)) and 40 age-matched healthy controls were enrolled in the study. We performed a dual-energy X-ray absorptiometry (DXA, Hologic Discovery A, USA) to measure BMD in lumbar spine, femoral neck and total hip. BMD decreasing grade was evaluated by the Z-score Results:25% pts with RDs and only 8% healthy controls have low BMD (p=0.02). RA, SSc and PsA pts had low BMD in 37%, 21% and 13%, respectively, that was more often than in healthy women (p=0.004, p=0.046 and p= 0.081, respectively). 9,3% RA pts and 7,5% SSc pts had low energy fractures. BMD of RDs pts in all areas of measurement demonstrated a direct correlation with height, weight, body mass index, and serum vitamin D concentration and an inverse correlation with the cumulative dose of glucocorticoids. Also, proximal femur BMD inversely correlated with RDs duration. BMD of femoral neck and total hip inversely correlated with C-reactive protein level in SSc pts. In RA women we found a direct correlation between lumbar spine and femur neck BMD and ESR.Conclusion:25% of premenopausal women with RDs had reduced BMD and needed monitoring and osteoporosis prevention, while 9.3% pts with RA and 7.5% women with SSc needed anti-osteoporotic treatment.Disclosure of Interests:None declared

Background:The problem of sarcopenia (SP) in rheumatoid arthritis (RA) is particularly significant in terms of assessing the risk of fractures, since SP leads to falls, which are an independent risk factor for fractures along with RA and osteoporosis.Objectives:To evaluate the bone mineral density (BMD) and fracture risk in women with RA and SP.Methods:79 women with RA based on the 2010 ACR/EULAR classification criteria were included: 20 (25%) women with confirmed SP (age median 59 [53; 64]) according to EWGSOP2 criteria and 59 (75%) women without SP (age median 60 [55; 67]) (p>0.05). We assessed clinical data: age, body mass index (BMI), disease duration, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR), previous medication use including glucocorticoids and methotrexate, muscle strength and function. Dual-energy X-ray absorptiometry (DXA) to measure BMD of lumbar spine (LS), femoral neck (FN) and total hip (TH) was performed. The 10-year probability of major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture) and the 10-year probability hip fracture was calculated using the Russian version of the FRAX® tool. Statistical analysis was performed using non-parametric methods. All patients signed an informed consent to participate.Results:Median BMD in LS was 0.892 [0.772; 1.024] g/cm2in patients with SP and 0.910 [0.785; 1.028] g/cm2- without SP (p>0.05). There was significant difference between groups in the proximal femur BMD: 0.760 [0.731; 0.826] g/cm2in TH and 0.681 [0.607; 0.703] g/cm2in FN in patients with SP and 0.838 [0.735; 0.921] g/cm2in TH and 0.719 [0.622; 0.804] g/cm2in FN in patients without SP (p=0.009 and p=0.048, respectively). The frequency of osteoporosis was 35% and 22% in patients with and without SP (p>0,05). The 10-year probability of major osteoporotic fracture with / without femoral neck BMD data was 22,0% [17,0; 32,0] / 19,5% [18,5; 22,5 and 13,3% [9,8; 18,5] / 12,8% [9,3; 17,0] in patients with SP and without SP (рConclusion:There were no differences in the frequency of osteoporosis between patients with SP and without SP, however women with SP had proximal femur BMD less than women without SP. The probability of major osteoporotic fracture and hip fracture was significantly higher in patients with RA and SP compared with patients without SP.Disclosure of Interests:None declared

Background Rheumatoid arthritis (RA) is a systemic inflammatory disease associated with polyarthritis, progressive joint damage, and physical impairment that can lead to osteoporosis and sarcopenia, increasing the risk of fractures and leading to a greater loss of autonomy in RA patients. Objectives To assess frequency of osteoporosis, sarcopenia and osteosarcopenia in women with RA. Methods 40 female patients with RA (mean age 63±7 years) and 40 female controls without RA (mean age 64±9 years) were enrolled in this study. Body composition and bone mineral density (BMD) in lumbar spine and proximal hip were assessed by using dual X-ray absorptiometry (DXA, Hologic Discovery A). Sarcopenia in women was defined as a skeletal muscle index (SMI) ≤5.67 kg/m 2 1 and osteosarcopenia – if sarcopenia and low BMD were present together. 2 The participants performed Short Physical Performance Battery (SPPB) and handgrip strength was measured. Body mass index (BMI) and Disease Activity Score (DAS28) were calculated. Results Low BMD at least in one of measured area was found out in 19 (48%) RA persons and in 18 (45%) controls. Sarcopenia occurred in 10 (25%) RA patients and in 5 (12,5%) people without RA (p>0,05). Among them osteosarcopenia was found in 6 (15%) RA women and 2 (5%) controls. Skeletal muscle index (SMI) was lower in patients with RA (6.43±0.978) than in controls (7.01±1. 064, p Conclusions In RA patients 48% had osteoporosis and 25% – sarcopenia, among them 15% women – osteosarcopenia. The risk of sarcopenia and osteosarcopenia was higher in nonobese patients. References [1] Cruz-Jentoft AJ, et al. Sarcopenia: European consensus on definition and diagnosis. Age and Agening2010;39:412–423. [2] Hassan EB, Duque G. Osteosarcopenia: A new geriatric syndrome. Aust Fam Physician2017Nov;46(11):849–853. Disclosure of Interest None declared

Background The prevalence of low bone mass or osteoporosis in patients with systemic sclerosis (SSc) varies significantly between studies performed in different countries and vary from 3% to 51% (Omair MA et al. 2013). Objectives To determine the frequency of osteoporosis (OP) in postmenopausal women with SSc in comparison with healthy control. Methods 163 postmenopausal women were enrolled in the study: 83 with SSc (mean age 58.5±8.1 years, mean disease duration 9.7±6.8 years) and 80 healthy control (mean age 59.2±6.6 years). Demographic characteristics and risk factors for OP in study groups are summarised in table 1. BMD was measured at lumbar spine, femoral neck and total hip by dual energy X-ray absorptiometry (DXA, Hologic 4500A). BMD decreasing grade was determined in according to WHO criteria. Results BMD in women with SSc was significantly lower than in control group at any site: lumbar spine – 0.832±0119 vs 0.867±0,098 g/sm2 (p=0.031); femoral neck – 0.633±0.098 vs 0.739±0.114 g/sm2 (p OP was significantly more often in SSc patients taking oral glucocorticoids compared to those without glucocorticoid therapy (39% and 20%, respectively, p Conclusions OP in postmenopausal women with SSc were detected among 1/3 of cases, significantly exceeded its frequency in healthy control. Risk factors for OP were age, oral glucocorticoids and interstitial lung disease. Reference [1] Omair MA, Pagnoux C, McDonald-Blumer H, Johnson SR. Low bone density in systemic sclerosis. A systematic review. J Rheumatol.2013;40(11):1881–90. doi:10.3899/jrheum.130032 Disclosure of Interest None declared

The local environment of Ga, Se, and Tl atoms in InTe-based solid solutions was studied by EXAFS technique. It was shown that all investigated atoms are substitutional impurities, which enter the In(1), Te, and In(2) positions in the InTe structure, respectively. The electrical measurements revealed that In$_{1-x}$Ga$_x$Te and InTe$_{1-x}$Se$_x$ solid solutions become semiconductors at $x>0.24$ and $x>0.15$, respectively., 6 pages, 6 figures, 1 table