medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-149medsovet-9056Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYАнтропометрические показатели как маркеры саркопенииAnthropometric parameters as marker of sarcopeniahttps://orcid.org/0000-0002-2809-0197ДобровольскаяО. В.DobrovolskayaO. V.

Добровольская Ольга Валерьевна, к.м.н., научный сотрудник лаборатории остеопороза

115522, Москва, Каширское шоссе, д. 34А

Olga V. Dobrovolskaya, Cand. Sci. (Med.), Researcher of the Osteoporosis Laboratory

34А, Kashirskoe Shosse, Moscow, 115522

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

Козырева Мария Витальевна, младший научный сотрудник лаборатории остеопороза

115522, Москва, Каширское шоссе, д. 34А

Maria V. Kozyreva, Junior Researcher of the Osteoporosis Laboratory

34А, Kashirskoe Shosse, Moscow, 115522

doginya@yandex.ruhttps://orcid.org/0000-0003-0961-9785ДеминН. В.DeminN. V.

Демин Николай Викторович, младший научный сотрудник лаборатории остеопороза

115522, Москва, Каширское шоссе, д. 34А

Nikolay V. Demin, Junior Researcher of the Osteoporosis Laboratory

34А, Kashirskoe Shosse, Moscow, 115522

deminick@rambler.ruhttps://orcid.org/0000-0003-4739-4302ТоропцоваН. В.ToroptsovaN. V.

Торопцова Наталья Владимировна, д.м.н., заведующая лабораторией остеопороза

115522, Москва, Каширское шоссе, д. 34А

Natalia V. Toroptsova, Dr. Sci. (Med.), Head of the Osteoporosis Laboratory

34А, Kashirskoe Shosse, Moscow, 115522

torop@irramn.ruНаучно-исследовательский институт ревматологии имени В.А. НасоновойРоссияNasonova Research Institute of RheumatologyRussian Federation20250405202505120125Copyright © Добровольская О.В., Козырева М.В., Демин Н.В., Торопцова Н.В., 20252025Добровольская О.В., Козырева М.В., Демин Н.В., Торопцова Н.В.Dobrovolskaya O.V., Kozyreva M.V., Demin N.V., 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://www.med-sovet.pro/jour/article/view/9056Введение

Введение. Редкое выявление саркопении (СП) у пациентов с ревматоидным артритом (РА) связано с низкой информативностью имеющихся скрининговых методов, тестов оценки мышечной силы и ограниченной доступностью методов инструментального определения состава тела. Поэтому требуется разработка доступных методов скрининга СП с хорошей чувствительностью и специфичностью.

Цель

Цель. Установить чувствительность и специфичность измерения окружности плеча и голени как методов оценки мышечной массы в сравнении с данными, полученными с помощью двухэнергетической рентгеновской абсорбциометрии (dual X-ray absorptiometry, DXA) для скрининга СП у женщин с РА.

Материалы и методы

Материалы и методы. Обследована 201 женщина (средний возраст 59,3 ± 9,0 года) с подтвержденным диагнозом РА. Всем пациенткам проведено стандартное клиническое обследование, а также измерены окружности плеча, голени, выполнен анализ состава тела с помощью DXA. Чувствительность и специфичность антропометрических показателей для скрининга СП определены с использованием ROC-анализа.

Результаты

Результаты. С помощью DXA определен аппендикулярный мышечный индекс (АМИ). АМИ < 5,5 кг/м2 выявлен у 37 (18,4%) пациенток. Окружности плеча и голени прямо коррелировали с АМИ (r = 0,56 и r = 0,52 соответственно, р < 0,001). Окружности плеча ≤ 26,0 см и голени ≤ 33,8 см обладали оптимальным соотношением чувствительности и специфичности для скрининга низкой мышечной массы (67,6 и 84,2% соответственно – для окружности плеча; 73,0 и 76,2% соответственно – для окружности голени). Площадь под кривой для окружности плеча составила 0,822 (95% доверительный интервал (ДИ) 0,762–0,873, р < 0,001); для окружности голени – 0,789 (95% ДИ 0,762–0,844, p < 0,001). Одновременное использование обоих показателей обеспечило чувствительность 62,2% и специфичность 90,2%.

Выводы

Выводы. У больных РА для скрининга СП можно использовать показатели окружности плеча или голени с сопоставимой диагностической значимостью. Использование двух измерений одновременно не улучшило диагностическую точность скрининга СП. Необходима дальнейшая оценка легкодоступных методик для скрининга СП.

Introduction

Introduction. The rare detection of sarcopenia (SP) in patients with rheumatoid arthritis (RA) is associated with the low informative value of available screening methods and muscle strength assessing, and limited availability of instrumental body composition determination. Therefore, it is necessary to develop affordable screening methods for SP with good sensitivity and specificity.

Aim

Aim. To establish the sensitivity and specificity of mid-upper arm circumference (MUAC) and calf circumference (CC) measurements as methods for assessing muscle mass in comparison with data obtained using dual-energy X-ray absorptiometry (DXA) for detection of SP in women with RA.

Materials and methods

Materials and methods. 201 women (mean age 59.3 ± 9.0 years) with confirmed RA were examined by a standard clinical examination, as well as measurement of MUAC and CC. Body composition analysis using DXA was done. The sensitivity and specificity of anthropometric indicators for SP screening were determined using ROC-analysis.

Results

Results. The appendicular muscle index (AMI) was determined using DXA. AMI < 5.5 kg/m2 was detected in 37 (18.4%) patients. MUAC and CC had a direct correlation with AMI (r = 0.56 and r = 0.52, respectively, p < 0.001). MUAC ≤ 26.0 cm and CC ≤ 33.8 cm were determined, which had the optimal ratio of sensitivity and specificity for low muscle mass screening (67.6% and 84.2%, respectively, for MUAC; 73.0% and 76.2%, respectively, for CC). The area under the curve (AUC) for the MUAC was 0.822 (95% confidence interval (CI) 0.762–0.873, p < 0.001), and for the CC – 0.789 (95% CI 0.762–0.844, p < 0.001). Simultaneous use of the both indicators had a sensitivity of 62.2% and a specificity of 90.2%.

Conclusions

Conclusions. In patients with RA, MUAC or CC had comparable diagnostic significance and can be used for SP screening. Simultaneous use of two measurements did not improve the diagnostic value. Further evaluation of available screening methods is needed.

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