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Background. According to the GOLD guidelines, glucocorticoids (GCs) are recommended for exacerbations of chronic obstructive pulmonary disease (COPD). Bone mineral density (BMD) can be reduced in case of the use of therapeutic doses of GCs. The aim of the study was to determine the influence of GCs on BMD and the frequency of osteoporosis in patients with COPD depending on the prescribed therapy. Materials and methods. We examined 202 patients with COPD (group E) in the acute phase. Group I consisted of 129 patients taking basic dual treatment, group II — 73 patients taking triple therapy with inhaled GCs. During exacerbations, systemic GCs were prescribed at the cumulative dose of 352.94 ± 30.51 mg/year. The bone state was examined using an ultrasound densitometer SONOST-2000. A Speed of Sound (SOS), Broadband Ultrasound Attenuation (BUA), Stiffness index (SI), and T- and Z-scores were determined. Results. Decreases in SI, BUA, T- and Z- scores were established in 43.51 % of the patients from the I group and 83.56 % from the II group (p < 0.05). In the II group, SI was lower by 9.54 %, BUA — by 14.35 %, SOS — by 14.57 %, T- score — by 6.9 %, Z- score — by 25.86 %; in subjects with GOLD 3: BUA — by 40.27 %, SI — by 3.25 %, T- score — by 17.9 %; in patients with GOLD 4: SI — by 19.9 %, BUA — by 77.8 %, T- score — by 5.6 % compared to the I group. Conclusions. Glucocorticoid-induced osteoporosis was diagnosed in 10.71 % of patients from the I group and 20.55 % of the II group. Its frequency depended on the stage of COPD: GOLD 3 — in 22.22 % of patients, GOLD 4 — in 50.0 % of the subjects.

Background. Chronic obstructive pulmonary disease (COPD) is often associated with musculoskeletal dysfunction, including skeletal muscle dysfunction, sarcopenia, osteoporosis, and obesity. The purpose was to assess skeletal muscle status and determine the prevalence of sarcopenia and sarcopenic obesity in patients with COPD. Materials and methods. 66 patients with COPD and 35 healthy subjects had been examined. Sarcopenia was established using EWGSOP2 criteria, and sarcopenic obesity was defined in the presence of sarcopenia with a body mass index > 25 kg/m2. Results. In 59.1 % of the patients with COPD, a decrease in skele­tal muscle strength was found, in particular, by 28.2 % in women and by 39.1 % in men at GOLD 4 in comparison with GOLD 1 and by 40.7 % and 54.3 %, respectively, compared to the control. A decrease in leg circumference (by 16.3 % in women and by 20.8 % in men) was determined at GOLD 4 compared to GOLD 1. A decrease in wal­king speed by 20 % in women and by 27.3 % in men was determined at GOLD 4 in comparison with GOLD 1 and a reliable correlation inverse connection between age and wal­king speed (r = –0.72 — in women and r = –0.61 — in men). A significant decrease in the lean mass of the limbs was established in COPD patients over 45 years old and with GOLD 2, lean and fat mass indices — with GOLD 3, appendicular lean mass — with GOLD 4 and over 60 years old. A direct correlation link was established between the severity of COPD and android type of obesity (r = 0.41; p

Background. The objective of the work is to study the effect of chronic obstructive pulmonary disease (COPD) on mi­neral density (BMD) and trabecular bone score (TBS), depen­ding on the degree of severity and women's age. Materials and me­thods. We have examined 30 women aged 57.43 ± 7.87 years, patients with COPD of various stages (GOLD 1–4). We have studied the BMD Total, BMD the lumbar spine (L1–L4), BMD Femur, and BMD Radius by means of dual-energy X-ray absorptiometry (DEXA). TBS of the lumbar spine (L1–L4) was determined by the TBS iNsight method (Med-Imaps, Pessac, France). Results. A significant decrease of the BMD was found at every skeletal area star­ting from GOLD 3, whereas at the L1–L4 level the BMD began to decrease at GOLD 2. The correlation was found between the severity of COPD and BMD Femur (r = –0.75, p < 0.05), BMD Radius (r = –0 73, p

Population aging remains one of the most important demographic processes in recent decades. Representatives of the older age groups make up a significant proportion of various patient profiles. Among the specific features of these patients there is not only comorbidity, but also age-related changes in the peripheral tissues. Although formally they remain physiological, such changes may significantly burden the patient's condition. One of the processes accompanying aging is the loss of muscle tissue – sarcopenia. At the same time, hypertension is the most common cardiovascular disease, which develops in people over 40 years of age, and among the elderly its prevalence is 30–40%. The development of hypertension-associated complications, comorbidity in the elderly is directly related to disability, loss of self-care capacities and loss of physical independence. Redu­cing physical activity may contribute to the progression of muscle tissue involution, which negatively affects the quality of life, as well as life span prognosis. Taking into account the above mentioned facts, the review deals with the pathogenetic mechanisms of communication of arterial hypertension and sarcopenia, their mutual influence on the clinical course in people of the older age groups. The emphasis lies on the negative effects of potentiating synergism of sarcopenia, sarcopenic obesity, disorders of the hemostasis system and autonomic regulation on the development of hemodynamic disorders associated with hypertension, especially in the elderly. This article is of interest to a wide range of internists, which care for the older patient groups.

Background. Under bronchial obstruction caused by the bronchial asthma (BA), one may observe a change in blood gas factor, development of oxidative stress, electrolyte and metabolic imbalance, which lead to lung emphysema and chronic respiratory failure formation. This was accompanied by changes in respiratory muscles, particularly in the diaphragm, which are characterized by an advanced atrophy and a further loss of muscle strength and mass. The question arises to which extent BA affects the state of skeletal muscles as they determine tolerance for physical activity and quality of life in these patients. The purpose was to determine functional capa­city of skeletal muscles and frequency of sarcopenia in patients with BA. Materials and methods. Seventy people aged 47.82 ± 13.54 years were examined. The first group included 35 persons who had BA, while the second group consisted of 35 healthy persons. An 8-step test for walking speed was applied to assess the functional capacity of skeletal muscles. The skeletal muscle power was evaluated with the help of spring hand dynamometer. Circumference of the tibia determined the criterion of satisfactory muscle mass. Quality of life was assessed by means of O.S. Chaban’s questionnaire. Results. When evaluating skeletal muscle power, wrist dynamometry was reduced by 22 % in case of severe BA compared to moderate BA, the corresponding index made 29 % when compared to the wrist dynamometry of healthy persons. An inverse correlation was found between BA severity and wrist strength in females (r = –0.65) and males (r = –0.3); walking speed in females (r = –0.72) and males (r = –0.6); circumfe­rence of the tibia in females (r = –0.17) and males (r = –0.28). A decrease in skeletal muscle power and tolerance for physical activity were associated with the loss of muscle component among 80 % of patients with BA. Conclusions. Sarcopenia was diagnosed in 5.71 % of persons from the control group, and in 25.71 % of patients with BA. Depending on BA severity and the age of patients, sarcopenia was detected in 9.5 % of patients who had moderate BA, and in 35.71 % of patients with severe BA; in 10.53 % of persons under the age of 45, and in 31.25 % of those over 45.