**4. Conclusion**

The demographic situation worldwide is characterized by a steady increase in the number of elderly people. With steady aging of the population, the problem of increased number of socially significant diseases in women is gaining increased interest. The most common causes of disability and mortality in older postmenopausal women include clinical consequences of AS and OP: cardiovascular accidents and bone fractures. It is known that many factors influencing bone metabolism are involved in the mechanisms of vascular diseases. There is a similarity in the course of these diseases, since they can be asymptomatic for many years and often have clinical manifestations after menopause.

Recently, the role of a nonspecific immune inflammatory vascular response as a link in general pathogenetic mechanisms of atherosclerotic lesions of the vascular bed and phenomenon of destructive bone changes has attracted great attention.

The multimarker approach in the study of common links in the pathogenesis of socially significant diseases enabled the clarification of the main risk factors, laboratory levels of nonspecific immune inflammatory response markers, and parameters of hormonal and vitamin status, which determine a degree of impairment of the elastic properties of the vascular wall and the risk of progression of OP can be predictors of CVD and degenerative bone complications in postmenopausal women with AH.

In our study, the following markers of vascular inflammation were increased: hs-CRP, HYC, IL-8, endothelin-1, parathyroid hormone, total cholesterol, and atherogenic lipid fractions, with a simultaneous decrease in the levels of estrogen, progesterone, calcium, and vitamin D. Multiple regression relationships between inflammatory parameters and the parameters of lipid metabolism and hormonal-vitamin status were observed.

The results of the study indicate early examinations of women with AH to detect increased rigidity of the vascular wall and reduced bone mineral density, which create the conditions for increased risk of development and progression of subclinical AS and OP prior to postmenopause.

Timely in-depth examination of women with AH in premenopause should become the main strategy for the development of a personalized prevention and therapy for women in order to prevent socially significant cardiovascular and bone complications such as coronary artery disease, stroke, and low-trauma fractures.

## **4.1 Limitations of the study**

This is a pilot project, which requires an expansion of the patient sample to clarify the subtle mechanisms of the interrelationship of the processes under study. The planned comparative characteristics of the studied parameters between groups of

women and men will require an expansion of the range of statistical methods for processing the studied data.
