sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20250420sibmed-2353Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEИммунологические маркеры и состояние костной и мышечной ткани у пациентов с ревматоидным артритомImmunological factors, bone and lean tissue status in patients with rheumatoid arthritishttps://orcid.org/0000-0002-2809-0197ДобровольскаяО. В.DobrovolskayaO. V.

Добровольская Ольга Валерьевна, к.м.н.

115522, г. Москва, Каширское ш., 34А

Olga V. Dobrovolskaya, candidate of medical sciences

115522, Moscow, Kashirskoe hwy., 34A

olgavdobr@mail.ruhttps://orcid.org/0000-0001-7501-9185СамаркинаЕ. Ю.SamarkinaE. Yu.

Самаркина Елена Юрьевна

115522, г. Москва, Каширское ш., 34А

Elena Yu. Samarkina

115522, Moscow, Kashirskoe hwy., 34A

samarkinale@list.ruhttps://orcid.org/0000-0002-0858-8369ДиатроптоваМ. А.DiatroptovaM. A.

Диатроптова Марина Анатольевна

115522, г. Москва, Каширское ш., 34А

Marina A. Diatroptova

115522, Moscow, Kashirskoe hwy., 34A

diatrop@inbox.ruhttps://orcid.org/0000-0003-0560-3495КозыреваМ. В.KozyrevaM. V.

Козырева Мария Витальевна

115522, г. Москва, Каширское ш., 34А

Maria V. Kozyreva

115522, Moscow, Kashirskoe hwy., 34A

doginya@yandex.ruhttps://orcid.org/0000-0002-8155-6101СорокинаА. О.SorokinaA. O.

Сорокина Арина Олеговна

115522, г. Москва, Каширское ш., 34А

Arina O. Sorokina

115522, Moscow, Kashirskoe hwy., 34A

ari1903@mail.ruТоропцоваН. В.ToroptsovaN. V.

Торопцова Наталья Владимировна, д.м.н.

115522, г. Москва, Каширское ш., 34А

Natalya V. Toroptsova, doctor of medical sciences

115522, Moscow, Kashirskoe hwy., 34A

torop@irramn.ruНИИ ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202505092025454187195Copyright © Добровольская О.В., Самаркина Е.Ю., Диатроптова М.А., Козырева М.В., Сорокина А.О., Торопцова Н.В., 20252025Добровольская О.В., Самаркина Е.Ю., Диатроптова М.А., Козырева М.В., Сорокина А.О., Торопцова Н.В.Dobrovolskaya O.V., Samarkina E.Y., Diatroptova M.A., Kozyreva M.V., Sorokina A.O., Toroptsova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/2353

Остеопороз (ОП) и саркопения являются частыми осложнениями при ревматоидном артрите (РА). Состояние костной и мышечной ткани может быть связано с активностью различных иммунологических маркеров. Цель исследования – изучить взаимосвязь между иммунологическими маркерами и состоянием костной и мышечной ткани у женщин с РА.

Материал и методы

Материал и методы. В исследование включены 163 женщины (возраст 61,0 [52,0; 66,0] года (медиана [нижний квартиль; верхний квартиль]) с подтвержденным РА. С помощью двухэнергетической рентгеновской абсорбциометрии оценивали минеральную плотность кости (МПК) и мышечную массу. Определяли уровень С-реактивного белка, ревматоидного фактора, антител к циклическому цитруллинированному пептиду, миостатина, фоллистатина, ИЛ-6, рецепторов к ИЛ-6, инсулиноподобного фактора роста-1, адипонектина, лептина, фактора роста фибробластов-23, фактора некроза опухоли SF12 и склеростина в сыворотке крови.

Результаты

Результаты. В зависимости от наличия ОП пациентки различались по содержанию склеростина, который у лиц с ОП был меньше, чем у женщин без ОП (р < 0,001). У пациенток с саркопеническим фенотипом концентрация ИЛ-6, рецепторов к ИЛ-6 и склеростина меньше (р = 0,038, р = 0,040 и р = 0,003 соответственно), а уровень инсулиноподобного фактора роста-1 – больше (р = 0,014), чем у лиц без саркопенического фенотипа. В многофакторном линейном регрессионном анализе установлена независимая позитивная связь содержания склеростина с МПК поясничного отдела позвоночника и шейки бедра (β = 0,28, р = 0,017 и β = 0,25, р = 0,028 соответственно) и отрицательная ассоциация между уровнем адипонектина и общей и аппендикулярной мышечной массой (β = –0,21, р = 0,045 и β = –0,25, р = 0,036 соответственно), аппендикулярным мышечным индексом (β = –0,30, р = 0,041).

Заключение

Заключение. У женщин с РА МПК взаимосвязана с уровнем склеростина, а мышечная масса – с содержанием адипонектина. Влияние различных цитокинов на МПК и мышечную массу у пациентов с РА требует дальнейшего изучения.

Osteoporosis (OP) and sarcopenia are common complications of rheumatoid arthritis (RA). The bone and muscle tissue status may be related to the activity of various immunological factors. Aim of the study was to investigate the association between immunological factors and the bone and lean tissue status in women with RA.

Material and methods

Material and methods. The study included 163 postmenopausal women with confirmed RA (age 61.0 [52.0; 66.0] years, median [lower quartile; upper quartile]). A clinical and laboratory examination was performed including dual-energy X-ray absorptiometry to assess bone mineral density (BMD) and lean mass. The levels of C-reactive protein, rheumatoid factor, antibodies to cyclic citrullinated peptide, myostatin, follistatin, IL-6, IL-6 receptors, insulin-like growth factor 1, adiponectin, leptin, fibroblast growth factor 23, tumor necrosis factor SF12 and sclerostin in blood serum were determined.

Results

Results. Persons with OP had higher level of sclerostin compared to those without it (р < 0.001). In sarcopenic patients IL 6, rIL 6, and sclerostin contents were lower (p = 0.038, p = 0.040, and p = 0.003, respectively), and insulin-like growth factor 1 concentration was higher (p = 0.014) than in those without sarcopenia. Multivariate linear regression revealed an independent positive association of sclerostin level with lumbar spine and femoral neck BMD (β = 0.28, p = 0.017 and β = 0.25, p = 0.028, respectively) and a negative association of adiponectin level with total and appendicular lean mass (β = –0.21, p = 0.045 and β = –0.25, p = 0.036, respectively) and appendicular lean mass index (β = –.30, p = 0.041).

Conclusions

Conclusions. In women with RA, BMD correlates with sclerostin level, and muscle mass – with adiponectin content. The effect of various cytokines on BMD and lean mass in patients with RA requires further study.

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