Клиническая медицина Медицина и экология, 2021, 3

23 
Клиническая медицина 
Медицина и экология, 2021, 3 
many factors: the method and equipment used, 
ethnicity, age, sex, anthropometric, behavioral 
and other parameters of the patient, etc. [22]. 
Table 3 shows the indicators of bone tissue 
metabolism in children living in the oil and gas 
region and in the control group (table 3). 
Osteocalcin (OC) is synthesized by osteo-
blasts and is the most abundant non-collagenous 
protein in the bone matrix, specific to bone tissue 
and dentin. OC is considered as one of the most 
informative biochemical markers of bone for-
mation and the rate of "bone turnover". 
The study revealed that the concentration 
of osteocalcin in the blood of children from the oil 
and gas region, when compared with the control 
group, was significantly reduced (p <0.05) (fig. 
1). 
PTH is a powerful regulator of Ca homeo-
stasis, a stimulator of bone resorption. It slows 
down the excretion of Ca in the urine and indi-
rectly promotes its absorption in the intestine. Its 
effect on the P level is characterized by the oppo-
site effect. The effects of PTH are opposite to the 
action of calcitonin - it reduces the level of calci-
um, bone resorption, and reduces the reabsorp-
tion of Ca and P in the kidneys. PTH indicators of 
the study group compared with the control group 
are presented (figure 2). 
Figure 2 shows that PTH values are re-
duced compared to the comparison group. 
Calcium and phosphorus are microele-
ments, their main role in maintaining the structur-
al basis of the body. The optimal ratio of calcium 
to phosphorus intake is 2: 1. The blood calcium 
and phosphorus levels in the compared regions 
do not differ significantly. 
Calcitonin is a single-chain polypeptide 
hormone of 32 amino acids. The N-terminal disul-
fide bridge between the cysteine residues at posi-
tions 1 and 7 creates a ring structure of 7 amino 
acids, and there is also a C-terminal amidated 
proline [23]. The physiological effects of calciton-
in are known to occur via receptor-mediated pro-
cesses, and interactions involving the N-terminal 
ring and the C-terminal end appear to be involved 
in receptor binding and signal transduction [23, 
24]. Also, there were no significant differences in 
the studied regions. 
It is known that the intensive production 
of bone mass in childhood is provided by increas-
ing the synthesis of bone matrix. A reflection of 
this process is the level of the total aminoterminal 
propeptide of the first type of procollagen-P1NP, 
which is formed during the formation of bone 
tissue by osteoblasts and fibroblasts from which 
collagen type 1 is subsequently formed, and is a 
marker of bone tissue formation. As a result of 
the study, it was found that in children of the oil 
and gas region, the serum P1NP level is lower 
than in children of the control group (p=0.0156) 
(fig. 3). 
The study group of adolescents also 
showed a decrease in the level of 
β
-Crosslaps (a 
degradation product of type 1 collagen, which 
makes up more than 90% of the organic matrix 
of the bone), compared with the control group, 
which indicates a violation of mineral metabolism 
due to the prevalence of resorptive processes (p 
= 0.039) in bone tissue (fig. 4) 
Thus, the optimization of the diagnosis of 
osteodeficiency, along with instrumental studies, 
undoubtedly requires an additional assessment of 
the state of bone metabolism [17]. 

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