cfpdБюллетень физиологии и патологии дыханияBulletin Physiology and Pathology of Respiration1998-5029Дальневосточный научный центр физиологии и патологии дыхания10.36604/1998-5029-2023-88-135-146cfpd-1106Research ArticleОБЗОРЫREVIEWSХроническая обструктивная болезнь легких и остеопороз: современное состояние проблемыModern data on a combination of chronic obstructive pulmonary disease and osteoporosisПавленкоВ. И.PavlenkoV. I.

Валентина Ивановна Павленко, д-р мед. наук, профессор кафедры факультетской и поликлинической терапии, 

675000, г. Благовещенск, ул. Горького, 95

Valentina I. Pavlenko, MD, PhD, DSc (Med.), Professor of Department of Faculty and Polyclinic Therapy 

95 Gor'kogo Str., Blagoveshchensk, 675000

amurvip@front.ruЩегорцоваЮ. Ю.SchegortsovaY. Y.

Юлия Юрьевна Щегорцова, ассистент кафедры факультетской и поликлинической терапии, 

675000, г. Благовещенск, ул. Горького, 95

Yulia Y. Schegоrtsova, MD, Assistant of Department of Faculty and Polyclinic Therapy 

95 Gor'kogo Str., Blagoveshchensk, 675000

shchegortsova92@mail.ruБакинаА. А.BakinaА. А.

Анастасия Алексеевна Бакина, канд. мед. наук, ассистент кафедры факультетской и поликлинической терапии, 

675000, г. Благовещенск, ул. Горького, 95

Anastasia A. Bakina, MD, PhD (Med.), Assistant of Department of Faculty and Polyclinic Therapy 

95 Gor'kogo Str., Blagoveshchensk, 675000

anastasia_darchi@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Амурская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииAmur State Medical Academy202306072023088135146Copyright © Павленко В.И., Щегорцова Ю.Ю., Бакина А.А., 20232023Павленко В.И., Щегорцова Ю.Ю., Бакина А.А.Pavlenko V.I., Schegortsova Y.Y., Bakina А.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cfpd.elpub.ru/jour/article/view/1106

Введение. Важной характеристикой хронической обструктивной болезни легких (ХОБЛ) является развитие системного воспаления с вовлечением ряда органов и тканей c реализацией патофизиологических механизмов. Одним из наиболее серьезных и социально значимых системных проявлений ХОБЛ является остеопороз (ОП), который лимитирует социальную активность не только пациента, но и членов его семьи, а также приводит к большим материальным затратам в области здравоохранения и высокому уровню нетрудоспособности, включая инвалидность и смертность. Цель. Произвести обзор литературы по данным зарубежных и отечественных исследований о распространенности остеопенического синдрома и клиническом значении ОП у пациентов с ХОБЛ и патогенетических механизмах пульмоногенного ОП. Материалы и методы. В обзоре обобщены данные литературных источников, опубликованных, преимущественно, за последние пять лет в PubMed и eLibrary. По необходимости были включены и более ранние публикации. Результаты. По данным разных авторов, частота встречаемости остеопенического синдрома у пациентов с ХОБЛ варьирует от 60 до 86,7%, и степень потери минеральной плотности костной ткани пропорциональна тяжести заболевания. Частота возникновения компрессионных переломов позвоночника и переломов шейки бедра у больных ХОБЛ выше, чем у лиц без ХОБЛ. На сегодняшний день определяющая роль в патогенезе ОП при ХОБЛ отводится цитокинам. В тоже время исследования ограничены лишь значимостью цитокинов раннего ответа (интерлейкинов 1 и 6, фактора некроза опухолиальфа). Имеются лишь единичные исследования о роли адипокинов в ремоделировании костной ткани при ХОБЛ. Заключение. Для более глубокого понимания механизмов регулирования костного обмена цитокинами и другими иммунными факторами при ХОБЛ необходимы дальнейшие исследования.

Introduction. The development of systemic inflammation involving a number of organs and tissues with the implementation of pathophysiological mechanisms is an important characteristic of chronic obstructive pulmonary disease (COPD). Osteoporosis is one of the most serious and socially significant manifestation of the systemic effects of COPD. Osteoporosis limits the social activity of the patient and his family members, leads to high material costs and a high level of disability and mortality. Aim. To study the data of foreign and Russian studies on the prevalence of osteopenia, pathogenic mechanisms of development and the clinical meaning of osteoporosis in COPD. Materials and methods. The review includes literature data published mainly over the past five years in PubMed and eLibrary. Earlier publications were included in the review if necessary. Results. According to different authors, osteopenia occurs in 60-86.7% of patients with COPD. The degree of loss of mineral density of bones is proportional to the severity of COPD. Compression fractures of the spine and fractures and femoral neck are found in patients with COPD more often than in patients without COPD. Cytokines have a crucial role in the pathogenesis of the formation of osteoporosis in COPD. At the same time, studies are limited only by the significance of early response cytokines (interleukins 1 and 6, tumor necrosis factor-alpha). There are only single studies on the role of adipokines in bone remodeling with COPD. Conclusion. Further studies must be carried out for a deeper understanding of the mechanisms of regulating bone metabolism by cytokines and other immune factors in COPD. 

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