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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rsp</journal-id><journal-title-group><journal-title xml:lang="ru">Научно-практическая ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Rheumatology Science and Practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-4484</issn><issn pub-type="epub">1995-4492</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47360/1995-4484-2023-320-329</article-id><article-id custom-type="elpub" pub-id-type="custom">rsp-3359</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Разработка порога вмешательства для мужчин Российской Федерации при подсчете 10-летней вероятности переломов по FRAX: консенсус экспертов Российской ассоциации по остеопорозу</article-title><trans-title-group xml:lang="en"><trans-title>FRAX-based intervention thresholds for men in the Russian Federation: Expert consensus of the Russian association on osteoporosis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6689-6941</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гладкова</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Gladkova</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>198015, Санкт-Петербург, ул. Кирочная, 41; 190068, Санкт-Петербург, ул. Большая Подьяческая, 30</p></bio><bio xml:lang="en"><p>191015, Saint Petersburg, Kirochnaya str., 41;190068, Saint Petersburg, Bolshaya Podyacheskaya str., 30</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6759-8367</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Никитинская</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Nikitinskaya</surname><given-names>O. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1763-0725</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Скрипникова</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Skripnikova</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>101990, Москва, Петроверигский пер., 10, стр. 3</p></bio><bio xml:lang="en"><p>101990, Moscow, Petroverigsky lane, 10, building 3</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0897-3811</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мягкова</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Myagkova</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>101990, Москва, Петроверигский пер., 10, стр. 3</p></bio><bio xml:lang="en"><p>101990, Moscow, Petroverigsky lane, 10, building 3</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2469-7346</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баранова</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Baranova</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>117997, Moscow, Ostrovitianova str., 1</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6674-6441</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белая</surname><given-names>Ж. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Belaya</surname><given-names>Zh. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>117292, Москва, ул. Дмитрия Ульянова, 11</p></bio><bio xml:lang="en"><p>117292, Moscow, Dmitriya Ulyanova str., 11</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7856-1567</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белова</surname><given-names>К. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Belova</surname><given-names>K. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>150000, Ярославль, ул. Революционная, 5</p></bio><bio xml:lang="en"><p>150000, Yaroslavl, Revolyutsionnaya str., 5</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4010-1888</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Евстигнеева</surname><given-names>Л. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Evstigneeva</surname><given-names>L. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>620102, Екатеринбург, ул. Волгоградская, 185</p></bio><bio xml:lang="en"><p>620102, Yekaterinburg, Volgogradskaya str., 185</p></bio><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7167-2187</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ершова</surname><given-names>О. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Ershova</surname><given-names>O. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>150000, Ярославль, ул. Революционная, 5</p></bio><bio xml:lang="en"><p>150000, Yaroslavl, Revolyutsionnaya str., 5</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8864-9570</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Заводовский</surname><given-names>Б. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zavodovskii</surname><given-names>B. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>400138, Волгоград, ул. им. Землячки, 76, корп. 2</p></bio><bio xml:lang="en"><p>400138, Volgograd, imeni Zemlyachki str., 76, korpus 2</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7036-4756</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Косматова</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kosmatova</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>101990, Москва, Петроверигский пер., 10, стр. 3</p></bio><bio xml:lang="en"><p>101990, Moscow, Petroverigsky lane, 10, building 3</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2365-5734</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оттева</surname><given-names>Э. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Otteva</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>680009, Хабаровск, ул. Краснодарская, 9</p></bio><bio xml:lang="en"><p>680009, Khabarovsk, Krasnodarskaya str., 9</p></bio><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3022-4166</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Полякова</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Polyakova</surname><given-names>Yu. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>400138, Волгоград, ул. им. Землячки, 76, корп. 2</p></bio><bio xml:lang="en"><p>400138, Volgograd, imeni Zemlyachki str., 76, korpus 2</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0965-6060</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сивордова</surname><given-names>Л. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Sivordova</surname><given-names>L. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>400138, Волгоград, ул. им. Землячки, 76, корп. 2</p></bio><bio xml:lang="en"><p>400138, Volgograd, imeni Zemlyachki str., 76, korpus 2</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2387-0370</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сулейманова</surname><given-names>А. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Suleymanova</surname><given-names>A. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>117997, Moscow, Ostrovitianova str., 1</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4739-4302</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Торопцова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Toroptsova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9074-2291</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цориев</surname><given-names>Т. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsoriev</surname><given-names>T. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>101990, Москва, Петроверигский пер., 10, стр. 3</p></bio><bio xml:lang="en"><p>101990, Moscow, Petroverigsky lane, 10, building 3</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0143-0614</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лесняк</surname><given-names>О. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Lesnyak</surname><given-names>O. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>198015, Санкт-Петербург, ул. Кирочная, 41; 190068, Санкт-Петербург, ул. Большая Подьяческая, 30</p></bio><bio xml:lang="en"><p>191015, Saint Petersburg, Kirochnaya str., 41;190068, Saint Petersburg, Bolshaya Podyacheskaya str., 30</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России;&#13;
СПб ГБУЗ «Клиническая ревматологическая больница № 25»<country>Россия</country></aff><aff xml:lang="en">North-Western State Medical University named after I.I. Mechnikov;&#13;
Saint Petersburg Clinical Rheumatology Hospital N 25<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»<country>Россия</country></aff><aff xml:lang="en">V.A. Nasonova Research Institute of Rheumatology<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр терапии и профилактической медицины» Минздрава России<country>Россия</country></aff><aff xml:lang="en">National Medical Research Center for Therapy and Preventive Medicine<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru">ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России<country>Россия</country></aff><aff xml:lang="en">N.I. Pirogov Russian National Research Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru">ГНЦ РФ ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России<country>Россия</country></aff><aff xml:lang="en">National Medical Research Center for Endocrinology<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru">ФГБОУ ВО «Ярославский государственный медицинский университет» Минздрава России<country>Россия</country></aff><aff xml:lang="en">Yaroslavl State Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru">ГАУЗ Свердловской области «Свердловская областная клиническая больница № 1»<country>Россия</country></aff><aff xml:lang="en">Sverdlovsk Regional Clinical Hospital N 1<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru">ФГБНУ «Научно-исследовательский институт клинической и экспериментальной ревматологии имени А.Б. Зборовского»<country>Россия</country></aff><aff xml:lang="en">Research Institute of Clinical and Experimental Rheumatology named after A.B. Zborovsky<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru">КГБОУ ДПО «Институт повышения квалификации специалистов здравоохранения» Министерства здравоохранения Хабаровского края<country>Россия</country></aff><aff xml:lang="en">Postgraduate Institute for Public Health Workers<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>28</day><month>06</month><year>2023</year></pub-date><volume>61</volume><issue>3</issue><fpage>320</fpage><lpage>329</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Гладкова Е.Н., Никитинская О.А., Скрипникова И.А., Мягкова М.А., Баранова И.А., Белая Ж.Е., Белова К.Ю., Евстигнеева Л.П., Ершова О.Б., Заводовский Б.В., Косматова О.В., Оттева Э.Н., Полякова Ю.В., Сивордова Л.Е., Сулейманова А.К., Торопцова Н.В., Цориев Т.Т., Лесняк О.М., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Гладкова Е.Н., Никитинская О.А., Скрипникова И.А., Мягкова М.А., Баранова И.А., Белая Ж.Е., Белова К.Ю., Евстигнеева Л.П., Ершова О.Б., Заводовский Б.В., Косматова О.В., Оттева Э.Н., Полякова Ю.В., Сивордова Л.Е., Сулейманова А.К., Торопцова Н.В., Цориев Т.Т., Лесняк О.М.</copyright-holder><copyright-holder xml:lang="en">Gladkova E.N., Nikitinskaya O.A., Skripnikova I.A., Myagkova M.A., Baranova I.A., Belaya Z.E., Belova K.Y., Evstigneeva L.P., Ershova O.B., Zavodovskii B.V., Kosmatova O.V., Otteva E.N., Polyakova Y.V., Sivordova L.E., Suleymanova A.K., Toroptsova N.V., Tsoriev T.T., Lesnyak O.M.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://rsp.mediar-press.net/rsp/article/view/3359">https://rsp.mediar-press.net/rsp/article/view/3359</self-uri><abstract><p>Согласно европейским рекомендациям по остеопорозу (ОП), у мужчин следует использовать тот же порог вмешательства по FRAX (Fracture Risk Assessment Tool), что и у женщин. Вместе с тем в исследованиях, проведенных в Российской Федерации (РФ), определяется крайне низкая доля мужчин, которым показана терапия ОП на основании указанного подхода, – от 1,1 до 4%. Цель исследования – разработать и оценить различные варианты порога вмешательства при подсчете 10-летней вероятности переломов по калькулятору FRAX для мужчин Российской Федерации и принять консенсусом наиболее приемлемый порог вмешательства. Материал и методы. Проведено голосование методом Делфи среди 18 российских экспертов, отобранных на основании имеющихся публикаций и персональных сообщений об опыте работы с калькулятором FRAX. Для обсуждения были представлены 5 вариантов порога вмешательства с соответствующим обоснованием исходя из литературной справки, а также доля мужчин разного возраста, которым показано назначение лечения при каждом из вариантов, определявшаяся на основании ряда популяционных исследований , проведенных в России. Проведено анонимное голосование по методу Делфи с помощью опросника, размещенного в виде Google Формы, в котором было предложено оценить все варианты порогов вмешательства по 9-балльной шкале Лайкерта. Консенсус считался достигнутым при получении определенным порогом вмешательства оценки по шкале Лайкерта 7 баллов и более у 80% и более экспертов. Рейтинг каждого варианта порога вмешательства выражался в виде среднего и стандартного отклонения. Результаты голосования. При первом раунде голосования максимальные рейтинг и процент согласия достигнуты для варианта фиксированного порога вмешательства в 9%, основанного на подсчете FRAX. Рейтинг составил 7,72±1,6 балла, процент согласия экспертов – 88,9%. С учетом фиксированного порога в 9% терапия ОП показана 13–19,5% мужчин в возрасте 50 лет и старше, при этом их доля увеличивалась до 26–38% в возрасте 85 лет и старше. Заключение. Консенсус экспертов Российской ассоциации по ОП предлагает назначать лечение ОП мужчинам РФ при 10-летней вероятности основных остеопорозных переломов по FRAX 9% и выше.</p></abstract><trans-abstract xml:lang="en"><p>According to the European guidelines for osteoporosis, the same FRAX intervention threshold is suggested for men as for women. At the same time, in the Russian Federation, according to research data, an extremely low proportion of identified men who are subject to the initiation of osteoporosis therapy. The female intervention threshold identifies only 1.1 to 4% of men for treatment. Aim – to develop and evaluate various options for the intervention threshold using the FRAX calculator for men in the Russian Federation and adopt the most acceptable intervention threshold by consensus. Material and methods. Delphi voting was conducted among 18 Russian experts who have publications and personal reports about their experience with the FRAX calculator. For discussion, 5 intervention threshold options with the corresponding rationale based on the literature reference were presented, as well as the proportion of men of different ages to be initiated in each of the options (based on several Russian population-based studies). Anonymous voting was carried out using the Delphi method with questionnaire placed in the Google form. It was proposed to evaluate all options for intervention thresholds on a 9-point Likert scale. Consensus was considered reached if the intervention threshold reached a Likert score of 7 or more points in 80% or more of the experts. The rating of each intervention threshold option was expressed as mean and standard deviations. Results. In the first round of voting, the maximum rating and percentage of agreement is reached for the 9% fixed interference threshold option based on the FRAX calculation. The rating was 7.72±1.6 points, the percentage of experts’ agreement was 88.9%. A fixed threshold of 9% determined 13–19.5% of men aged 50 years and older to be treated for osteoporosis, while their proportion increased to 26–38% at the age of 85 years and older. Conclusion. The consensus of experts of the Russian association on osteoporosis suggests initiating treatment of osteoporosis in Russian men with a 10-year probability of major osteoporotic fractures according to FRAX of 9% or higher.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>FRAX</kwd><kwd>порог вмешательства у мужчин</kwd><kwd>Делфи голосование</kwd></kwd-group><kwd-group xml:lang="en"><kwd>FRAX</kwd><kwd>intervention threshold in men</kwd><kwd>Delphi voting</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Lesnyak O, Zakroyeva A, Babalyan V, Cazac V, Gabdulina G, Ismailov S, et al. 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