Increase in life expectancy is among the most significant achievements of modern medicine. Currently, the majority of patients are elderly, being characterised by multimorbidity and frailty. Sarcopenia, a progressive and generalized loss of skeletal muscle mass and strength, is associated with a reduced quality of life and high risk of adverse outcomes including disability and death in these patients. Age-related neuromuscular degeneration, decline of circulating anabolic hormones, chronic inflammation and oxidative stress considerably affect the development of sarcopenia. In addition, low intake of proteins and carbohydrates along with a decrease in physical activity also affect muscular homeostasis. Being combined with obesity, osteopenia/osteoporosis, and vitamin D deficiency, sarcopenia worsens the prognosis of the patient in terms of life expectancy. In this review, we discuss the current advances in epidemiology, pathophysiology, and diagnosis of sarcopenia.

Ankylosing spondylitis (AS) is one of the most common autoinflammatory diseases that lead to early disability and high premature mortality rates. Along with lower bone mineral density, patients with AS are characterized by muscle mass decrease, such as sarcopenia. Musculoskeletal losses due to chronic immune inflammation and limited physical functioning significantly worsen prognosis and result in an increased risk of falls and fractures in patients with AS.The review considers the pathogenetic mechanisms of the relationship between AS and sarcopenia and the main approaches to treating degenerative changes in muscle tissue in patients with AS.

Objective: to study bone mineral density (BMD) in elderly and senile women with knee and hip osteoarthritis (OA).Patients and methods. The investigation enrolled 124 women (mean age, 73.3±8.46 years) diagnosed with OA meeting the ACR diagnostic criteria. Lumbar spine (LI-IV) and femoral neck BMD values were determined; knee and hip X-ray in the frontal projection was carried out to assess the radiographic stage according to the Kellgren and Lawrence classification.Results and discussion. The overall incidence of osteoporosis (OP) and ostopenia in the study cohort was 28 and 41%, respectively. OP was diagnosed in 20% of women aged 60–74 years and in 38% of those aged 75–90 years (p<0.05); osteopenia was in 41 and 42%, respectively (p>0.05). In the age groups of 65–74 years and ≥75 years, women with stage III–IV hip OA had a significantly higher femoral neck BMD than those with Stage I–II (p<0.05). At the same time, the later radiographic stages of hip OA were associated with lower lumbar spine BMD (p<0.05). The patients of both age groups who had Stages III and IV knee OA had a significantly higher lumbar spine BMD than those with Stage I–II OA (p<0.05). The femoral neck BMD in patients with Stages I–II and III–IV knee OA was comparable in both age groups (p>0.05).Conclusion. The relationship between BMD and OA-related structural changes is contradictory and requires further investigation.

Objectives:To study the relationship of indicators of muscle mass, muscle strength and muscle function with bone mineral density (BMD) in men with coronary heart disease (CHD).Methods:79 men aged over 50 years with verified CHD were examined (mean age 63 (57; 66) years).The BMD (g/cm2) and T-criterion (standard deviation) of the femoral neck and lumbar spine (L1-L4) were evaluated using dual-energy x-ray absorptiometry (DXA) on the lunar Prodigy Primo bone densitometer (USA).To assess muscle mass, the total area (cm2) of the lumbar muscles of the axial section at the level of the 3rd lumbar vertebra (L3) was determined using multispiral computed tomography on a 64-slice computer tomograph “Somatom Sensation 64” (Siemens AG Medical Solution, Germany). The ratio of the obtained index of the area of skeletal muscle to the square of the patient’s growth index determined the “musculoskeletal index L3” (SMI). The media considered the threshold value to be 52.4 cm2/m2. Evaluation of muscle strength was performed using a mechanical wrist dynamometer DC-25. Muscle function was examined using a short physical performance battery (SPPB).Results:The data obtained from the results of correlation analysis show that there is a reliable direct correlation between BMD and hand dynamometry indicators (r=0.250; p=0.026 for the right hand and r=0.247; p=0.028 for the left hand), the T-criterion of the femoral neck and hand dynamometry indicators (r=0.245; p=0.030 for the right hand and r=0.242; p=0.032 for the left hand). A similar relationship was established between the BMD of the lumbar vertebra and the parameters of dynamometry (r=0.237; p=0.036 for the right hand and r=0.228; p=0.043 for the left hand) and T-criterion for the lumbar region and dynamometry parameters (r=0.232; p=0.039 for the right hand and r=0.220; p=0.051 for the left hand). There is no significant relationship between densitometry scores and the result of SPPB tests.There was a significant direct relationship between the total SPPB score and the area of skeletal muscle at the L3 level (r=0.249, p=0.026), the total SPPB score and the musculoskeletal index (r=0.233, p=0.039). A similar relationship was established between the result of the chair lift test and the total area of skeletal muscle at the L3 level (r=0.262, p=0.019) and the musculoskeletal index (r=0.220, p=0.050).A significant negative relationship between walking speed and the musculoskeletal index was found (r= -0.260, p=0.021). The relationship between muscle mass and strength could not be traced.Conclusion:A decrease in muscle strength correlates with the severity of bone loss, while a decrease in muscle function correlates with a decrease in muscle mass. The results obtained confirm the probability of common mechanisms in the development of sarcopenia and osteoporosis in patients with CHD.Disclosure of Interests:None declared