Almanac of Clinical MedicineAlmanac of Clinical MedicineАльманах клинической медицины2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)11510.18786/2072-0505-2015-43-90-99REVIEW ARTICLEОБЗОРSYSTEMIC SCLEROSIS AND OSTEOPOROSISСИСТЕМНАЯ СКЛЕРОДЕРМИЯ И ОСТЕОПОРОЗAlekperovR. T.АлекперовА. Р.
Russian Federation

Alekperov Rizvan Tair oglu – MD, PhD, Professor, Chair of Internal Diseases, Postgraduate Training Faculty of MONIKI , Senior Research Fellow

* 61/2-9 Shchepkina ul.,Moscow, 129110,Russian Federation. Tel.: +7 (495) 681 68 40. E-mail: ralekperov@list.ru 

Алекперов Ризван Таир оглы – доктор медицинских наук, профессор кафедры терапии факультета усовершенствования врачей МОНИКИ, ст. научный сотрудник

*129110, г. Москва, ул. Щепкина, 61/2–9, Российская Федерация. Тел.: +7 (495) 681 68 40. E-mail: ralekperov@list.ru

ralekperov@list.ruToroptsovaN. V.ТоропцоваН. В.
Russian Federation

Toroptsova Natal'ya V. – MD, PhD, Head of Laboratory of Osteoporosis

* 34А Kashirskoe shosse,Moscow, 115522,Russian Federation. Tel.: +7 (499) 614 42 80. E-mail: torop@irramn.ru

Торопцова Наталья Владимировна – доктор медицинских наук, заведующая лабораторией остеопороза

* 115522, г. Москва, Каширское шоссе, 34А, Российская Федерация. Тел.: +7 (499) 614 42 80. E-mail: torop@irramn.ru

torop@irramn.ruMoscow Regional Research and Clinical Institute (MONIKI)Московский областной научно-исследовательский клинический институт им. М.Ф. ВладимирскогоV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical SciencesНаучно-исследовательский институт ревматологии им. В.А. Насоновой, Москва151220154390991302201613022016Copyright ©; 2015, Alekperov R.T., Toroptsova N.V.Copyright ©; 2015, Алекперов А.Р., Торопцова Н.В.2015Alekperov R.T., Toroptsova N.V.Алекперов А.Р., Торопцова Н.В.https://creativecommons.org/licenses/by/4.0https://almclinmed.ru/jour/article/view/115

Systemic sclerosis is an autoimmune inflammatory disease of connective tissue with multi-syndrome clinical manifestations. Skeletal damage is considered to be one of significant contributors to the quality of life of these patients. The purpose of this review was to assess the prevalence of osteoporosis and associated fractures in systemic sclerosis. We performed a search in Medline database by the following key words: “systemic sclerosis”, “bone mineral density” and “osteoporosis”. From 118 publications we selected for further analysis 18 papers which contained comparisons of bone mineral density in patients with systemic sclerosis and in control groups of healthy subjects or in patients with other rheumatic disorders. These trials showed various proportions of systemic sclerosis patients with decreased bone mineral density in the range of 32 to 77%. Osteoporosis was found in 22 to 60% women with systemic sclerosis which was significantly more frequent that in healthy age-matched women (from 8 to 23%). The rates of osteoporotic fractures in patients with systemic sclerosis, according to data given by various authors, were in the range of 2 to 38%, being higher than in healthy controls (from 2 to 10%). In the majority of publications, there was an association of osteoporosis with conventional risk factors, and in some studies there was an association of osteoporosis with clinical characteristics of systemic sclerosis. The studies were performed in relatively small patient groups and their results vary widely. Further studies are necessary to elucidate the mechanisms of osteoporosis and improve its treatment and prevention in patients with systemic sclerosis.

Системная склеродермия – аутоиммунное воспалительное заболевание соединительной ткани с полисиндромной клинической картиной. Одним из факторов, существенно влияющих на качество жизни таких больных, считается поражение скелета. Целью настоящего обзора стала оценка частоты остеопороза и связанных с ним переломов при системной склеродермии. Поиск работ проводился в системе Medline по ключевым словам: «системная склеродермия» (systemic sclerosis), «минеральная плотность костей» (bone mineral density) и «остеопороз» (osteoporosis). Из 118 публикаций для анализа были отобраны 18 работ, в которых проводилось исследование минеральной плотности костей у больных системной склеродермией и в контрольной группе здоровых лиц или в группах сравнения, включавших пациентов с другими ревматическими заболеваниями. По данным этих исследований, снижение минеральной плотности костей у больных системной склеродермией выявлялось с разной частотой – от 32 до 77%. Развитие остеопороза наблюдалось у 22–60% женщин с системной склеродермией и встречалось значимо чаще, чем у здоровых женщин соответствующего возраста, – в 8–23%. Частота остеопоротических переломов у больных системной склеродермией, по данным разных авторов, составила от 2 до 38% и также была больше, чем у здоровых лиц контрольной группы (от 2 до 10%). В большинстве работ выявлена ассоциация остеопороза с традиционными факторами риска, а в отдельных исследованиях отмечалась ассоциация остеопороза с клиническими характеристиками системной склеродермии. Исследования проводились в относительно небольших группах больных; представленные результаты варьируют в широком диапазоне. Для уточнения механизмов развития остеопороза и его лечения и профилактики у больных системной склеродермией требуются дальнейшие исследования. 

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