PSI - Issue 40

A.V. Akimova et al. / Procedia Structural Integrity 40 (2022) 12–16 A. V. Akimova at al./ Structural Integrity Procedia 00 (2022) 000 – 000

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Tobacco smoking impact was assessed by the smoker index (SI) which was calculated as: SI = number of daily cigarettes consumption × years of smoking /20 . 10-point visual analogue scale (VAS) was used to assess joint and back pain. Patient reported outcomes included the Asthenic State Inventory (ASI), a derivative of the Minnesota Multiphasic Personality Inventory (MMPI)” . ASI value of 30-50 points corresponds the absence of asthenia, 51-75 points refer to “mild asthenia”, 76 - 100 points detect “moderate asthenia”, and 101 -120 points mean “severe asthenia” . Magnesium deficiency symptoms were assessed by the UNESCO Institute of Trace Elements Test. Test results were ranged as following: 38-54 points were estimated as severe magnesium deficiency; 28-37 referred to magnesium deficiency; 18-27 corresponded to moderate magnesium deficiency; 8-17 points signed magnesium deficiency risk; and 0 to 7 points value was for no magnesium deficiency. Statistica 13.0. (License No. JPZ904I805602ARCN25ACD-6) software was used to process the data. Mann Whitney, χ2 criteria, Spearman rank correlation coefficient were used. The differences were considered significant at P<0.05. The study was approved by the local Independent Ethics Committee of the Federal State- owned Institution “5 Military Clinical Hospital of the National Gu ard Troops of the Russian Federation” (Protocol No. 2 of 15.03.2018). 3. Results and discussion In toto, 458 persons aged from 18 to 65, the median age was 22 (25%-75%: 20-23) years. Main Group consisted of 290 patients (63.3%) who met the UCTD criteria. The Control Group included 168 persons who had no UCTD (36.7%). History of bone fractures was reported by 143 participants (31.2%): 74 persons had 1 fracture, 26 patients had 2 fractures, and 43 persons had a history of 3 to 23 fractures. All persons with multiple fractures (7 or more) belonged to the main group. In the control group, there was one subject with a history of 9 fractures acquired simultaneously during a severe car accident. A significant predominance of individuals with fractures in the UCTD group was revealed: in the control group, 134 persons (79.8%) c 34 persons (20.2%) had fractures; while in the main group, 181 subjects (62.4%) had no history of fractures and 109 subjects (37.6%) had fractures (χ2=14.11, p<0.0001). In the main group, total number of fractures was 302 (mean = 2.77fx per person). In the control group, there were 70 fractures per 34 persons (mean = 2.06fx per person). However, the differences were not statistically significant (χ2=1.28, p=0.26). Weak positive correlations of the total number of fractures with the number of external signs of UCTD (r=0.16, t=3.63,p<0.0001), with the total number of external and internal signs of CTD (r=0.22, t=4.88, p<0.0001), with the Beighton score (r=0.19, t=4.16, p<0.0001);with height (r=0.11, t=2.32, p=0.02), arm span (r=0.12, t=2.52, p=0.011) and SI (r=0.12, t=2.57, p=0.01) were revealed. A fracture that occurred in childhood has been reported to be associated with low BMD and smaller bone size in young men but not in young women. In another study, fractures in young men have been shown to associate with a longer limb length and a shorter trunk, which corresponds to Marfan syndrome phenotype. In general, our data confirm these reports. External UCTD signs positively correlated with the number of hands fractures (r=0.14, p=0.005), foot (r=0.2, p=0.000) and radius fractures (r=0.13, p=0.008). The number of internal UCTD signs was also found to be in a positive correlation with the number of fractures of the hand (r=0.14, p=0.003) and vertebrae (r=0.11, p=0.014). The sum of external and internal signs of UCTD positively correlated with the number of fractures of the hand (r=0.18, p<0.0001), foot (r=0.18, p<0.0001), vertebrae (r=0.12, p=0.013), skull bones (r=0.11, p=0.016), radius (r=0.09, p=0.053). Beighton joints hypermobility score positively correlated with the number of fractures of the bones of the hand (r=0.11, p=0.015), foot (r=0.16, p<0.0001), radius (r=0.22, p=p<0.0001), vertebrae (r=0.1, p=0.032). Thus, various signs of UCTD correlate with fractures of the bones of the hand, foot, and radius. These localization of fractures in most cases occurred with a minimal level of injury. This fact suggests the presence of reduced bone strength in individuals with UCTD.