medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2021-33-42-48medalphabet-2325Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYПоказатели минеральной плотности кости у больных мужского пола пожилого и старческого возраста с остеоартритом коленного сустава в зависимости от состояния мышечного аппаратаIndicators of mineral bone density in male patients with osteoarthritis of knee joint of elderly and old age depending on condition of muscular systemhttps://orcid.org/0000-0002-0184-7997КоролеваМ. В.KorolevaM. V.

Королева Марина Валерьевна, к. м. н., ассистент кафедры

г. Кемерово

Koroleva Marina V., PhD Med, assistant at Dept of Propedeutics of Internal Diseases

Kemerovo

576078@mail.ruhttps://orcid.org/0000-0003-3907-7120ЛетаеваМ. В.LetaevaM. V.

Летаева Марина Васильевна, к. м. н., доцент кафедры

г. Кемерово

Letaeva Marina V., PhD Med, associate professor at Dept of Propedeutics of Internal Diseases

Kemerovo

letaeva@yandex.ruhttps://orcid.org/0000-0002-5804-4298РаскинаТ. А.RaskinaT. A.

Раскина Татьяна Алексеевна, д. м. н., проф., зав. кафедрой

г. Кемерово

Raskina Tatiana A., DM Sci (habil.), professor, head of Dept of Propedeutics of Internal Diseases

Kemerovo

rassib@mail.ruhttps://orcid.org/0000-0001-6713-2049МалышенкоО. С.MalyshenkoO. S.

Малышенко Ольга Степановна, к. м. н., доцент кафедры

г. Кемерово

Malyshenko Olga S., PhD Med, associate professor at Dept of Propedeutics of Internal Diseases

Kemerovo

malyshenko.mos@yandex.ruhttps://orcid.org/0000-0001-8020-4545АверкиеваЮ. В.AverkievaY. V.

Аверкиева Юлия Валерьевна, к. м. н., ассистент кафедры

г. Кемерово

Averkieva Yulia V., PhD Med, assistant at Dept of Propedeutics of Internal Diseases

Kemerovo

doctorjulia@rambler.ruКафедра пропедевтики внутренних болезней ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава РоссииРоссияKemerovo State Medical UniversityRussian Federation202113122021033Ревматология в общей врачебной практике (2)4248Copyright © Королева М.В., Летаева М.В., Раскина Т.А., Малышенко О.С., Аверкиева Ю.В., 20212021Королева М.В., Летаева М.В., Раскина Т.А., Малышенко О.С., Аверкиева Ю.В.Koroleva M.V., Letaeva M.V., Raskina T.A., Malyshenko O.S., Averkieva Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/2325Цель

Цель. Оценить показатели минеральной плотности кости (МПК) у больных мужского пола пожилого и старческого возраста с остеоартритом (ОА) коленного сустава в зависимости от состояния мышечного аппарата.

Материалы и методы

Материалы и методы. В исследование включены 32 больных с установленным диагнозом «ОА коленного сустава». Средний возраст пациентов составил 68,7 (66,1; 70,3) года. Диагноз «ОА коленного сустава» установлен согласно диагностическим критериям Американской коллегии ревматологов (ACR) 1991 года. Для сравнительного анализа все больные были разделены на три группы в зависимости от состояния мышечного аппарата (EWGSOP, 2010. Мышечную массу оценивали методом мультиспиральной компьютерной томографии, мышечную силу измеряли с использованием кистевого динамометра, мышечную функцию исследовали с помощью батареи коротких тестов): первая – 9 больных без саркопении, вторая – 11 пациентов с пресаркопенией, третья – 12 больных с саркопенией. МПК оценивали методом двуэнергетической рентгеновской абсорбциометрии в шейке и проксимальном отделе бедра в целом и в поясничном отделе позвоночника.

Результаты

Результаты. Остеопенический синдром в исследуемой когорте диагностирован у 23 (71,9 %) пациентов: остеопения – у 19 (59,4 %) больных, остеопороз – у 4 (12,5 %). Нормальные показатели МПК отмечены у 9 (28,1 %) пациентов. Остеопенический синдром определялся у больных с саркопенией значимо чаще по сравнению с пациентами без саркопении (p > 0,05) и с пресаркопенией (p = 0,05). Показатели МПК у больных с саркопенией в шейке и проксимальном отделе бедра в целом были статистически значимо ниже, чем у пациентов без саркопении и с пресаркопенией (p < 0,05). Установлена прямая корреляционная связь между общей площадью скелетной мускулатуры на уровне LIII и денситометрическими показателями шейки бедра.

Выводы

Выводы. Саркопения ассоциируется с низкими показателями МПК в шейке и проксимальном отделе бедра в целом у больных мужского пола пожилого и старческого возраста с ОА коленного сустава.

Objective

Objective. To evaluate bone mineral density (BMD) indices in elderly and old age male patients with knee osteoarthritis (OA) depending on the state of the muscular system.

Subjects and methods

Subjects and methods. The trial enrolled 32 patients with knee OA. The mean age of the patients was 68.7 (66.1; 70.3) years. The diagnosis of knee OA was established according to the diagnostic criteria of the American College of Rheumatologists (ACR, 1991). For comparative analysis, all patients with knee OA were divided into 3 groups according to muscle condition (EWGSOP, 2010: muscle mass was assessed by multispiral computed tomography, muscle strength was measured using a wrist dynamometer, muscle function was examined using a battery of short tests): the 1st – 9 patients without sarcopenia, the 2nd – 11 patients with presarcopenia, and the 3rd – 12 patients with sarcopenia. BMD was assessed by dual-energy X-ray absorptiometry in the neck and proximal femur as a whole and in the lumbar spine.

Results

Results. Osteopenic syndrome in the study cohort was diagnosed in 23 (71,9%) patients: osteopenia – in 19 (59,4%) patients, osteoporosis – in 4 (12,5%). Normal BMD values were observed in 9 (28.1%) patients. Osteopenic syndrome was detected in patients with sarcopenia signifcantly more often compared to patients without sarcopenia (p > 0.05) and with presarcopenia (p = 0.05). BMD indices in patients with sarcopenia in the neck and proximal femur in general were statistically signifcantly lower than in patients without sarcopenia and with presarcopenia (p < 0.05). There was a direct correlation between total skeletal muscle area at the LIII level and densitometric indices of the femoral neck.

Conclusions

Conclusions. Sarcopenia is associated with low BMD indices in the neck and proximal femur in general in elderly and senile male patients with knee OA

остеоартритпожилой и старческий возрастмужской полсаркопенияминеральная плотность костиosteoarthritiselderly and old agemalesarcopeniabone mineral densityReferencesUnited Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision, Key Findings and Advance Tables. Working Paper No. ESA/P/WP/248. https://www.un.org/development/desa/publications/world-population-prospects-the-2017-revision.html.United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision, Key Findings and Advance Tables. Working Paper No. ESA/P/WP/248. https://www.un.org/development/desa/publications/world-population-prospects-the-2017-revision.html.Ткачева О. Н. Гериатрия. Под ред. Ткачевой О. Н., Фроловой Е. В., Яхно Н. Н. Москва: ГЭОТАР-Медиа, 2019. 608 с. (Серия «Национальные руководства»).Tkacheva O.N. Geriatrics. Ed. by Tkacheva O.N., Frolova E.V., Yakhno N.N. Moscow: GEOTAR-Media, 2019. 608 p. (Series ‘National Guidelines’).Cruz-Jentoft A.J., Bahat G., Bauer J. et al. Sarcopenia: revised European consensus on defnition and diagnosis. Age Ageing. 2019; 48 (1): 16–31. DOI: 10.1093/ageing/afy169.Cruz-Jentoft A.J., Bahat G., Bauer J. et al. Sarcopenia: revised European consensus on defnition and diagnosis. Age Ageing. 2019; 48 (1): 16–31. DOI: 10.1093/ageing/afy169.Sarcopenia Defnition: The Position Statements of the Sarcopenia Defnition and Outcomes Consortium. The American Geriatrics Society. JAGS2020; 00: 1–9. DOI: 10.1111/jgs.16372.Sarcopenia Defnition: The Position Statements of the Sarcopenia Defnition and Outcomes Consortium. The American Geriatrics Society. JAGS2020; 00: 1–9. DOI: 10.1111/jgs.16372.Клинические рекомендации. Остеопороз. 2021. http://disuria.ru/_ld/10/1015_kr21M81mz.pdf.Clinical guidelines. Osteoporosis. 2021. http://disuria.ru/_ld/10/1015_kr21M81mz.pdf.Галушко Е. А., Насонов Е. Л. Распространенность ревматических заболеваний в России. Альманах клинической медицины. 2018; 46 (1): 32–39.Galushko E.A., Nasonov E.L. Prevalence of rheumatic diseases in Russia. Al'manakh klinicheskoi meditsiny (Almanac of Clinical Medicine). 2018; 46 (1): 32–39. DOI: 10.18786/2072–0505–2018–46–1–32–39.Shorter E., Sannicandro A.J., Poulet B. et al. Skeletal Muscle Wasting and Its Relationship with Osteoarthritis: A Mini-Review of Mechanisms and Current Interventions. Curr. Rheumatol Rep. 2019; 21: 40. DOI:10.1007/s11926–019–0839–4.Shorter E., Sannicandro A.J., Poulet B. et al. Skeletal Muscle Wasting and Its Relationship with Osteoarthritis: A Mini-Review of Mechanisms and Current Interventions. Curr. Rheumatol Rep. 2019; 21: 40. DOI:10.1007/s11926–019–0839–4.Kahn J., Shwartz Y., Blitz E. et al. Muscle contraction is necessary to maintain joint progenitor cell fate. Dev Cell. 2009; 16 (5): 734–743. DOI: 10.1016/j.devcel.2009.04.013.Kahn J., Shwartz Y., Blitz E. et al. Muscle contraction is necessary to maintain joint progenitor cell fate. Dev Cell. 2009; 16 (5): 734–743. DOI: 10.1016/j.devcel.2009.04.013.Silva J.M.S., Alabarse P.V.G., Teixeira V.O.N. et al. Muscle wasting in osteoarthritis model induced by anterior cruciate ligament transection. PLoS One. 2018; 13 (4): e0196682. DOI: 10.1371/journal.pone.0196682.Silva J.M.S., Alabarse P.V.G., Teixeira V.O.N. et al. Muscle wasting in osteoarthritis model induced by anterior cruciate ligament transection. PLoS One. 2018; 13 (4): e0196682. DOI: 10.1371/journal.pone.0196682.Chu S-F., Liou T-H., Chen H-C., Huang S-W., Liao C-D. Relative Effcacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021; 13 (6): 1992. DOI: 10.3390/nu13061992.Chu S-F., Liou T-H., Chen H-C., Huang S-W., Liao C-D. Relative Effcacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021; 13 (6): 1992. DOI: 10.3390/nu13061992.Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., et al. Sarcopenia: European consensus on defnition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing 2010; 39: 412–23. DOI: 10.1093/ageing/afq034.Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., et al. Sarcopenia: European consensus on defnition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing 2010; 39: 412–23. DOI: 10.1093/ageing/afq034.Шостак Н.А., Мурадянц А.А., Кондрашов А.А. Саркопения и перекрестные синдромы – значение в клинической практике. Клиницист. 2016; 10 (3): 10–14.Shostak N.A., Muradyantz A.A., Kondrashov A.A. Sarcopenia and Overlapping Syndromes: Their Value in Clinical Practice. Klinitsist (The Clinician). 2016; 10 (3): 10–14. DOI: 10.17650/1818–8338–2016–10–3–10–14.Кашеварова Н.Г., Таскина Е.А., Алексеева Л.И., и др. Изменения минеральной плотности кости при прогрессировании остеоартрита коленных суставов. Терапевтический архив, 2019; 91 (5): 61–67.Kashevarova N. G., Taskina E. A., Alekseeva L. I. et al. The сhanges of bone mineral density on the risk of progression of osteoarthritis of the knee. Terapevticheskii arkhiv (Therapeutic Archive). 2019; 91 (5): 61–67. DOI: 10.26442/00403660.2019.05.000194.Kapuš O., Gába A., Svoboda Z. et al. Relationship between body composition and bone mineral density of the lumbar spine and proximal femur: influence of years since menopause. Mod. Rheumatol. 2014; 24 (3): 505–510. DOI: 10.3109/14397595.2013.844393.Kapuš O., Gába A., Svoboda Z. et al. Relationship between body composition and bone mineral density of the lumbar spine and proximal femur: influence of years since menopause. Mod. Rheumatol. 2014; 24 (3): 505–510. DOI: 10.3109/14397595.2013.844393.Ilesanmi-Oyelere B.L., Coad J., Roy N. et al. Lean body mass in the prediction of bone mineral density in postmenopausal women. Biores Open Access. 2018; 7 (1): 150–158. DOI: 10.1089/biores.2018.0025.Ilesanmi-Oyelere B.L., Coad J., Roy N. et al. Lean body mass in the prediction of bone mineral density in postmenopausal women. Biores Open Access. 2018; 7 (1): 150–158. DOI: 10.1089/biores.2018.0025.Pereira F.B., Leite A.F., Paula A.P. et al. Relationship between pre-sarcopenia, sarcopenia and bone mineral density in elderly men. Arch. Endocrinol. Metab. [Internet]. 2015; 59 (1): 59–65. Available from: http://www.scielo.br/scielo.php?script = sci_arttext&pid = S2359–39972015000100059&lng = en. DOI: 10.1590/2359–3997000000011.Pereira F.B., Leite A.F., Paula A.P. et al. Relationship between pre-sarcopenia, sarcopenia and bone mineral density in elderly men. Arch. Endocrinol. Metab. [Internet]. 2015; 59 (1): 59–65. Available from: http://www.scielo.br/scielo.php?script = sci_arttext&pid = S2359–39972015000100059&lng = en. DOI: 10.1590/2359–3997000000011.Ning H.-T., Du Y., Zhao L.-J., Tian Q. Racial and gender differences in the relationship between sarcopenia and bone mineral density among older adults. Osteoporosis International. 2021; 32: 841–851. DOI: 10.1007/s00198–020–05744-y.Ning H.-T., Du Y., Zhao L.-J., Tian Q. Racial and gender differences in the relationship between sarcopenia and bone mineral density among older adults. Osteoporosis International. 2021; 32: 841–851. DOI: 10.1007/s00198–020–05744-y.Coin A., Perissinotto E., Enzi G. et al. Predictors of low bone mineral density in the elderly: the role of dietary intake, nutritional status and sarcopenia. Eur J Clin Nutr. 2008; 62: 802–9. DOI: 10.1038/sj.ejcn.1602779.Coin A., Perissinotto E., Enzi G. et al. Predictors of low bone mineral density in the elderly: the role of dietary intake, nutritional status and sarcopenia. Eur J Clin Nutr. 2008; 62: 802–9. DOI: 10.1038/sj.ejcn.1602779.Gonnelli S., Caffarelli C., Tanzilli L. et al. The associations of body composition and fat distribution with bone mineral density in elderly Italian men and women. J. Clin. Densitom. 2013; 16 (2): 168–177. DOI: 10.1016/j.jocd.2012.02.013.Gonnelli S., Caffarelli C., Tanzilli L. et al. The associations of body composition and fat distribution with bone mineral density in elderly Italian men and women. J. Clin. Densitom. 2013; 16 (2): 168–177. DOI: 10.1016/j.jocd.2012.02.013.Qi H., Sheng Y., Chen S. et al. Bone mineral density and trabecular bone score in Chinese subjects with sarcopenia. Aging Clin Exp Res 31, 1549–1556 (2019). DOI: 10.1007/s40520–019–01266–8.Qi H., Sheng Y., Chen S. et al. Bone mineral density and trabecular bone score in Chinese subjects with sarcopenia. Aging Clin Exp Res 31, 1549–1556 (2019). DOI: 10.1007/s40520–019–01266–8.Frost H.M. The Utah paradigm of skeletal physiology: an overview of its insights for bone, cartilage and collagenous tissue organs. J Bone Miner Metab. 2000; 18 (6): 305–16. DOI: 10.1007/s007740070001.Frost H.M. The Utah paradigm of skeletal physiology: an overview of its insights for bone, cartilage and collagenous tissue organs. J Bone Miner Metab. 2000; 18 (6): 305–16. DOI: 10.1007/s007740070001.Hasselstrоm H., Karlsson K.M., Hansen S.E. et al. Sex differences in bone size and bone mineral density exist before puberty. The Copenhagen School Child Intervention Study (CoSCIS). Calcif Tissue Int. 2006 Jul; 79 (1):7–14. DOI: 10.1007/s00223–006–0012–8. Epub 2006 Jul 24.Hasselstrоm H., Karlsson K.M., Hansen S.E. et al. Sex differences in bone size and bone mineral density exist before puberty. The Copenhagen School Child Intervention Study (CoSCIS). Calcif Tissue Int. 2006 Jul; 79 (1):7–14. DOI: 10.1007/s00223–006–0012–8. Epub 2006 Jul 24.Li Y.Z., Zhuang H.F., Cai S.Q. et al. Low grip strength is a strong risk factor of osteoporosis in postmenopausal women. Orthop Surg. 2018 Feb; 10 (1): 17–22. DOI: 10.1111/os.12360. Epub 2018 Feb 12.Li Y.Z., Zhuang H.F., Cai S.Q. et al. Low grip strength is a strong risk factor of osteoporosis in postmenopausal women. Orthop Surg. 2018 Feb; 10 (1): 17–22. DOI: 10.1111/os.12360. Epub 2018 Feb 12.Ahedi H., Aitken D., Scott D. et al. The association between hip muscle crosssectional area, muscle strength, and bone mineral density. Calcif Tissue Int. 2014 Jul; 95 (1): 64–72. DOI: 10.1007/s00223–014–9863–6. Epub 2014 May 15.Ahedi H., Aitken D., Scott D. et al. The association between hip muscle crosssectional area, muscle strength, and bone mineral density. Calcif Tissue Int. 2014 Jul; 95 (1): 64–72. DOI: 10.1007/s00223–014–9863–6. Epub 2014 May 15.Wu C.H., Yang K.C., Chang H.H., Yen J.F., Tsai K.S. Huang KC. Sarcopenia is related to increased risk for low bone mineral density. J Clin Densitom. 2013 Jan-Mar; 16 (1): 98–103. DOI: 10.1016/j.jocd.2012.07.010. Epub 2012 Sep 10. PMID: 22975297.Wu C.H., Yang K.C., Chang H.H., Yen J.F., Tsai K.S. Huang KC. Sarcopenia is related to increased risk for low bone mineral density. J Clin Densitom. 2013 Jan-Mar; 16 (1): 98–103. DOI: 10.1016/j.jocd.2012.07.010. Epub 2012 Sep 10. PMID: 22975297.Sutter T., Toumi H., Valery A. et al. Relationships between muscle mass, strength and regional bone mineral density in young men. PLoS One. 2019 Mar 8; 14 (3): e0213681. DOI: 10.1371/journal.pone.0213681. PMID: 30849119; PMCID: PMC6407768Sutter T., Toumi H., Valery A. et al. Relationships between muscle mass, strength and regional bone mineral density in young men. PLoS One. 2019 Mar 8; 14 (3): e0213681. DOI: 10.1371/journal.pone.0213681. PMID: 30849119; PMCID: PMC6407768

The authors declare that there are no conflicts of interest present.