Журнал «Боль. Суставы. Позвоночник» Том 12, №4, 2022

Саркопенія характеризується втратою маси скелетних м’язів, зниженням м’язової сили та/або зниженням фізичної працездатності і є однією з основних причин обмеження повсякденної діяльності в осіб літнього віку. Це пов’язано зі збільшенням частоти багатьох несприятливих наслідків, зокрема таких як падіння, м’язова слабкість, госпіталізація, інвалідність і смертність. Первинну саркопенію як складову процесу старіння і вторинну саркопенію внаслідок мальабсорбції, постільного режиму, голодування, гіпотиреозу, остеопорозу, імуноопосередкованих ревматичних захворювань об’єднує хронічний запальний процес різного ступеня вираженості. Саркопенія підтверджує одну з найбільш широко прийнятих теорій про те, що хронічне запалення низького ступеня є важливим у патогенезі багатьох захворювань. Тривалий час саркопенія розглядалась як вікасоційоване захворювання, проте останнім часом повідомляється про її поширеність серед молодих людей з автоімунними захворюваннями. Зокрема, детально вивчено зв’язок між саркопенією та ревматичним захворюванням, таким як ревматоїдний артрит. Хоча патогенез саркопенії при автоімунних захворюваннях остаточно не з’ясований, вважають, що хронічний запальний процес сприяє втраті м’язової маси й сили та є різним залежно від основного захворювання. Визначення саркопенії відрізняється за даними досліджень, що ускладнює та обмежує прямі порівняння. Тому в цьому огляді ми розглядаємо різні діагностичні критерії саркопенії, акцентуючи увагу на її поширеності серед пацієнтів з ревматичними захворюваннями, включно з ревматоїдним артритом, ювенільним ідіопатичним артритом, аксіальним спондилітом, псоріатичним артритом та системною склеродермією. Нами розроблена структурована стратегія пошуку публікацій англійською мовою в PubMed з використанням пошукового терміна «саркопенія» у поєднанні із такими ключовими словами: «запалення», «діагноз», «критерії», «м’язова маса», «сила», «наслідки», «інвалідність», «смертність», «патофізіологія», «ревматоїдний артрит», «ювенільний артрит», «аксіальний спондиліт», «псоріатичний артрит», «системний склероз». Ми зосередилися на клінічних дослідженнях, метааналізах і оглядових статях. Були відібрані статті, опубліковані після 2000 р., хоча ми не виключили основні внески, опубліковані раніше. Пошук було завершено 8 жовтня 2022 р.

Sarcopenia is characterized by a loss of skeletal muscle mass, a decrease in muscle strength and/or physical performance, and is one of the main causes for limiting daily activities in the elderly. This is associated with an increased incidence of many adverse events such as dysfunction, falls, frailty, hospitalization, disability, and mortality. Primary (considered as a part of the aging process) and secondary sarcopenia (due to malabsorption, immobility/bed rest, starvation, hypothyroidism, osteoporosis, immune-mediated rheumatic diseases) are united by a chronic inflammatory process of different degrees. Sarcopenia supports one of the most widely accepted theories that low-grade chro­nic inflammation is important in the pathogenesis of many di­seases. For a long time, sarcopenia was considered an age-related disease, but recently it has been reported to be more common in young subjects with autoimmune diseases. In particular, the relationship between sarcopenia and rheumatic diseases such as rheumatoid arthritis has been studied in detail. Although the pathogenesis of sarcopenia in autoimmune diseases is not fully understood, it is believed that a chronic inflammatory process contri­butes to the development of loss of muscle mass and strength, and is different depending on the underlying disease. The definition of sarcopenia varies between studies, which complicates and li­mits direct comparisons. Therefore, in this review, we demonstrate various diagnostic criteria for sarcopenia, focusing on its pre­valence in patients with rheumatic diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, axial spondylitis, psoriatic arthritis, and systemic sclerosis. We developed a structured search strategy for English language publications in PubMed using the term “sarcopenia” in combination with the following keywords: “inflammation”, “diagnosis”, “criteria”, “muscle mass”, “strength”, “outcomes”, “disability”, “mortality”, “pathophysiology”, “rheumatoid arthritis”, “juvenile arthritis”, “axial spondylitis”, “psoriatic arthritis”, “systemic sclerosis”. We focused on clinical trials, meta-analyses and review articles. Articles published only after 2000 year were included, however, we did not include major contributions published before. The search was completed on October 8, 2022.

саркопенія; запалення; ревматичні захворювання; літературний огляд

sarcopenia; inflammation; rheumatic diseases; review

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