rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2021-592-598rsp-3080Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHФакторы риска низкой минеральной плотности костей у женщин в постменопаузе с системной склеродермиейRisk factors for low bone mineral density in postmenopausal women with systemic sclerosishttps://orcid.org/0000-0002-8155-6101ЕфремоваА. О.EfremovaA. O.

Ефремова Арина Олеговна

115522, Российская Федерация, Москва, Каширское шоссе, 34а

Arina Efremova

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

ari1903@mail.ruhttps://orcid.org/0000-0003-4739-4302ТоропцоваН. В.ToroptsovaN. V.

115522, Российская Федерация, Москва, Каширское шоссе, 34а

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-2809-0197ДобровольскаяО. В.DobrovolskayaO. V.

115522, Российская Федерация, Москва, Каширское шоссе, 34а

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-1004-9647СтаровойтоваМ. Н.StarovoitovaM. N.

115522, Российская Федерация, Москва, Каширское шоссе, 34а

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-4688-9637ДесиноваО. В.DesinovaO. V.

115522, Российская Федерация, Москва, Каширское шоссе, 34а

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0001-6759-8367НикитинскаяО. А.NikitinskayaO. A.

115522, Российская Федерация, Москва, Каширское шоссе, 34а

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202131102021595592598Copyright © Ефремова А.О., Торопцова Н.В., Добровольская О.В., Старовойтова М.Н., Десинова О.В., Никитинская О.А., 20212021Ефремова А.О., Торопцова Н.В., Добровольская О.В., Старовойтова М.Н., Десинова О.В., Никитинская О.А.Efremova A.O., Toroptsova N.V., Dobrovolskaya O.V., Starovoitova M.N., Desinova O.V., Nikitinskaya O.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3080

Цель исследования – определить частоту остеопороза (ОП) и выявить факторы риска снижения минеральной плотности кости (МПК) у женщин в постменопаузе с системной склеродермией (ССД).Материалы и методы. В исследование включены 113 женщин (медиана возраста – 60,0 [54,0; 63,0] лет) в постменопаузе с достоверным диагнозом ССД по критериям ACR/EULAR (2013). Критерием исключения было наличие overlap-синдромов. Все женщины были опрошены по унифицированной анкете, им проведено лабораторное и инструментальное обследование, включавшее денситометрию.Результаты. ОП и остеопения хотя бы в одной области измерения диагностированы у 45,1 и 48,7% женщин соответственно. При многофакторном линейном регрессионном анализе выявлено негативное влияние общей длительности приема глюкокортикоидов (ГК) на величину МПК в поясничном отделе позвоночника (b=–0,005; R2=0,136; p=0,017). Индекс массы тела (ИМТ) (b=0,007; R2=0,208; p<0,001), скорость клубочковой фильтрации (СКФ) (b=0,313; R2=0,213; p<0,001) позитивно, а кумулятивная доза ГК (b=–0,269; R2=0,134; p<0,001), длительность приема ингибиторов протонной помпы (ИПП) (b=–0,277; R2=0,291; p<0,001) и длительность постменопаузы (b=–0,223; R2=0,134; p<0,001) негативно влияли на МПК шейки бедра. МПК в проксимальном отделе бедра в целом позитивно коррелировала с ИМТ (b=0,493; R2=0,244; p<0,001), СКФ (b=0,313; R2=0,150; p<0,001), уровнем 25-гидрокси кальциферола (b=0,273; R2=0,284; p=0,001) и негативно – с кумулятивной дозой ГК (b=–0,219; R2=0,289; p<0,001).Заключение. Сниженную МПК имели 93,8% женщин в постменопаузе с ССД. Из традиционных факторов риска на состояние МПК оказывали влияние лишь ИМТ, длительность постменопаузы и уровень витамина D, а среди специфичных – кумулятивная доза и длительность приема ГК, ИПП и СКФ.

Aim of the research – to determine the frequency of osteoporosis (OP) and to identify risk factors for a decrease in bone mineral density (BMD) in postmenopausal women with systemic sclerosis (SSс).Subjects and methods. The study included 113 postmenopausal women (median age – 60.0 [54.0; 63.0] years) with a reliable diagnosis of SSc according to the ACR/EULAR criteria (2013). The exclusion criterion was the presence of overlap syndromes. All women were interviewed according to a unified questionnaire, a laboratory and instrumental examination was conducted, including Dual-energy X-ray absorptiometry.Results. OP and osteopenia in at least one measurement area were diagnosed in 45.1% and 48.7% of women, respectively. Multivariate linear regression analysis revealed a negative effect of the total experience of taking glucocorticoids (GCs) on the value of BMD in the lumbar spine (b=–0.005; R2=0.136; p=0.017). Body mass index (BMI) (b=0.007; R2=0.208; p<0.001), glomerular filtration rate (GFR) (b=0.313; R2=0.213; p<0.001) is positive, and the cumulative dose of GCs (b=–0.269; R2=0.134; p<0.001), the duration of taking proton pump inhibitors (PPI) (b=–0.277; R2=0.291; p<0.001) and the duration of postmenopause (b=–0,223; R2=0.134; p<0.001) negatively affected the BMD of the femoral neck. BMD in the total hip (TH) was generally positively associated with BMI (b=0.493; R2=0.244; p<0.001), GFR (b=0.313; R2=0.150; p<0.001), 25-hydroxy calciferol level (b=0.273; R2=0.284; p=0.001), and negatively – with the cumulative dose of GCs (b=–0.219; R2=0.289; p<0.001).Conclusion. 93.8% of postmenopausal women with SSс had reduced BMD. Of the traditional risk factors, only BMI, the duration of postmenopause and the level of vitamin D had an impact on the state of BMD, and among the specific ones – the cumulative dose and duration of taking GCs, PPI and GFR.

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