The Armenian Osteoporosis Association, an IOF member society, has reported on the successful satellite symposium entitled "Bone Loss Due to Cancer and Other Etiologies", which took place within the framework of the 6th International Medical Congress of Armenia (IMCA), on July 4, 2023. It was held at the Manoogian Hall of the American University of Armenia supported by the American University of Armenia and organized by Professor John Bilezikian, with lectures given by leading specialists from Armenia and the USA․  

-> Highlights of the Symposium are reviewed in an article in the Armenia journal Med Practic.

Topics and speakers at the Satelilite Symposium

John Bilezikian MD, Professor of Columbia University Medical Center, New York, NY, Vice Chair of the Dept. of Medicine for International Education and Research, Chief Emeritus, of the Division of Endocrinology, Director of the Metabolic Diseases Division, and board member of the international guidelines development organization, stated:

“The topic of cancer that we have targeted today is very relevant, because many people suffering from cancer have bone loss, and this issue is not much discussed, although it poses a serious danger. During this Congress, we presented some statistical data on myeloma, which is very informative for the specialists. We have targeted not only cancer but also diabetes, and thyroid diseases. The point is that in the case of the above-mentioned diseases use of certain drugs can adversely affect the bone system. So, it is crucial to have bone density screenings. I have visited Armenia every year since 2007 to organize different conferences, and they were regular visits before COVID-19. Our goal is not only to raise the scientific level of medical workers in Armenia, but to make Armenia a center of knowledge for the whole of Europe and Eurasia.”

Dr. Marian Manoukian, PhD, Stanford, Endocrinology and Metabolism, California, USA, talked about diabetes and bone fractures.

“I tried to find out where their connection is and where their paths, so-called, cross. Both diabetes and osteoporosis are very common diseases. Disease prevention is most important because advanced disease is difficult to treat. Although prevention is not easy, you cannot prevent it in an instant. Preventive measures should start from a young age: children must do sports, do different physical exercises, lead a healthy lifestyle, and eat properly. By the way, in the Soviet period team sports were popular, and it was right.

She added, "Unfortunately, I don't see children doing sports in Armenia today. It is clear: gym visits are not affordable, and insurance companies do not cover them." 

Dr. Armine Haroyan, Head of Rheumatology Department, Erebuni Medical Center, Armenia, stated:

 “As a rheumatologist, I emphasized glucocorticosteroids in my talk, referring to those patients who have rheumatoid arthritis, of which many use steroids. In other words, different hormonal drugs, which in turn favour osteoporosis disease. The most important thing here is that our doctors, especially the young ones, are unaware of how early preventive measures should be started to avoid complications such as osteoporosis as a consequence of the treatment of the above-mentioned diseases. It is very important to treat osteoporosis in time. We have been constantly talking about it since 2015, because not only rheumatologists should be aware of the problem, but also related specialists who also use hormones, including pulmonologists, and endocrinologists.”

Dr. Varduhi Petrosyan, PhD, Dean, AUA Turpanjian College of Health Sciences, Armenia, stated: 

“I would like to express our gratitude to Dr. Belizikian, who started this series of conferences more than 10 years ago, informing our doctors about the importance of osteoporosis prevention. Today's event showed that all parts of our health are interconnected. The event was dedicated to how bone health is affected when people have diabetes or cancer diseases. The course of treatment of these diseases can affect the bones, which, however, do not get attention, not only in Armenia but throughout the world. They do not study the condition of bones in a cancer patient or consider whether preventive measures should be applied or not so that the quality of life does not suffer. I value it a lot when different specialists get together to try to find out how to cooperate to maintain human health.”

Dr. Nicholas Hutchings, Internal Medicine-Primary care, UCLA, Los Angeles, USA, also spoke at the Congress.

“My talk was about thyroid disease and its effect on bones. It is a very important topic. In women over 65, we have to screen the thyroid gland and check for osteoporosis disease presence, both of which are common diseases. It seems that they are two independent and separate processes, but in fact, their paths cross. Thyroid disease itself can cause osteoporosis. Generally, women are advised to undergo thyroid screening every year and a bone density test every two years. If a thyroid problem is detected, bone density must be checked without further delay. Why only in women? - because after menopause changes in their endocrine profile occur, as a result of which both the thyroid body and bones are affected.

On Day Two of the Congress, on July 5th, the meeting of endocrinologists with Prof. John Bilezikian took place in a very warm and friendly atmosphere. The doctors had the opportunity to communicate directly with Prof. Bilezikian, who is a leading expert on parathyroid diseases, and this was a unique chance to ask many questions to the author of the guidelines. He kindly answered all the questions, and there were discussions around the presented medical cases which became another way of analyzing the guidelines.

Dr. Varta Babalyan, President of Armenian Osteoporosis Association and Executive Director of the Osteoporosis Center, also spoke at the Symposium and highlighted Professor John Bilezikian's outstanding contributions to the field of osteoporosis in Armenia: 

“Professor Bilezikian has made great contributions to the field of osteoporosis in Armenia. In 2007, when he visited Armenia for the first time within the framework of an international symposium, there was only 1 densitometer in Armenia. He brought another densitometer with him. At the moment, 15 densitometers are in operation in Armenia, including Artsakh and regions, 11 of which were donated by Prof. Bilezikian. In 2016, he founded the Osteoporosis Center to increase knowledge of osteoporosis among doctors and society. Continuous courses are held in the center, and guidelines of leading international universities and organizations are presented.

The results of the densitometric studies carried out in the center are given in accordance with ISCD guidelines, specialists (endocrinologists, rheumatologist, family doctors) provide consultations, and relevant literature is provided. Within the scope of the center's activities, research is also carried out, the results of which contribute to the implementation of new programs. All doctors of the center are trained in the field of osteoporosis through international conferences and trainings.

“The reason for Prof. Bilezikian's two-year delay in arriving in Armenia was the COVID-19 pandemic, but he participated in scientific conferences held in Armenia online during that time. With his activities, he is trying to make Armenia known to the whole world: he organized three international summits, where international leading specialists in the field of osteoporosis were invited. When participating at various medical conferences, he wears a tie and wristwatch in the colors of the tricolor flag of Armenia, thus reminding of Armenia.”

The Osteoporosis Center of Armenia – a pillar of education and research in Armenia

The Osteoporosis Center founded by Professor Bilezikian in 2016 aims to increase knowledge of osteoporosis among doctors and society. To increase awareness, knowledge, and quality of osteoporosis management by doctors in Armenia, courses and seminars are regularly held by specialists who have undergone international training in this area. For example, from September to December 2023, more than 17 interactive workshops were held for doctors from various fields on several topics. These included, among others, a discussion of the prevention and treatment of diseases of the musculoskeletal system; the role of calcium and vitamin D in the prevention and treatment of osteoporosis; osteoarthritis; back pain; detection of vertebral fractures; diagnosis and treatment of osteoporosis in the elderly; and osteoporosis and concomitant diseases. The participating doctors included therapists, endocrinologists, rheumatologists, gynecologists, family doctors, traumatologists, radiologists, and neurologists. 

In addition to the regular educational courses and the presentation of guidelines of leading international universities and organizations, the Osteoporosis Center has received recognition from authorities, has been involved in the organization of three summits for Eurasian and Eastern European societies, has held an international DXA course, and also conducts or is involved in new research related to osteoporosis in Armenia. Below is a list of recent research articles: 

• Hutchings N, et al. Vitamin D Status in Armenian Women: A Stratified Cross-Sectional Cluster Analysis. Eur J Clin Nutr 76, 220–226 (2022)
• Bilezikian JP, et al. Mechanisms in Endocrinology: Vitamin D and COVID-19. Eur J Endocrinol. 2020 Nov;183(5):R133-R147. 
• Hutchings N, et al. Patients hospitalized with COVID-19 have low levels of 25-hydroxyvitamin D. Endocrine. 2021 Jan 16: 1–3. 
• Tadevosyan N, et al. Residues of xenobiotics in the environment and phytotoxic activity in Armenia. J Environ Sci Health A Tox Hazad Subst Environ Eng. 2019 54:10, 1011-1018 
• Hutchings N, et al. A stratified cross-sectional cluster model survey of iodine nutrition in Armenia after a decade of universal salt iodization. Endocr Pract. 2019 Oct;25(10):987-993. 
• Hutchings N, et al. Constituent analysis of iodine intake in Armenia. Public Health Nutr. 2018 Nov;21(16):2982-2988 
• Hutchings N, et al. Neonatal thyrotropin (TSH) screening as a tool for monitoring iodine nutrition in Armenia. Eur J Clin Nutr. 2018 Aug 31. 
• Hutchings N, et al. Iodine Nutrition in the Republic of Artsakh (Nagorno Karabakh). Endocr Pract. 2018 May;24(5):468-472. 
• Lesnyak O, et al. Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate. Arch Osteoporos. 2017 Nov 7;12(1):98

IOF congratulates the Osteoporosis Center on its continued dedication and many noteworthy achievements since its launch. All the Center's efforts have helped to expand and improve knowledge of osteoporosis among Armenian healthcare professionals and the public at large.