Распространённость и клиническое значение саркопении у пациентов с хроническими миелопролиферативными заболеваниями: эпидемиология, диагностика и стратегии вмешательства

Гарифуллина А.Г., Бакиров Б.А., Ласынова Г.Х., Голдырев Е.О., Кудлай Д.А. Распространённость и клиническое значение саркопении у пациентов с хроническими миелопролиферативными заболеваниями: эпидемиология, диагностика и стратегии вмешательства // CardioСоматика. 2025. Т. 16, № 2. С. 147–155. DOI: 10.17816/CS677247 EDN: KCQOIT

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Garifullina AG, Bakirov BA, Lasynova GH, Goldyrev EO, Kudlay DA. Prevalence and Clinical Significance of Sarcopenia in Patients With Chronic Myeloproliferative Neoplasms: Epidemiology, Diagnosis, and Intervention Strategies. CardioSomatics. 2025;16(2):147–155. DOI: 10.17816/CS677247 EDN: KCQOIT

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Аннотация

Хронические миелопролиферативные заболевания (ХМПЗ) представляют собой группу клональных гемопоэтических расстройств, преимущественно встречающихся у пожилых пациентов. Эти заболевания ассоциируются с повышенным риском развития многочисленных осложнений. Одним из ключевых сопутствующих состояний у таких пациентов является саркопения — прогрессирующая потеря мышечной массы, силы и функциональности, которая значительно ухудшает качество жизни и прогноз основного заболевания. Цель работы — систематизировать современные данные о влиянии саркопении на прогноз пациентов с ХМПЗ и обобщить рекомендации по её ранней диагностике и коррекции для улучшения клинических исходов. В данном обзоре представлены данные об эпидемиологии, патогенезе и клиническом значении саркопении у пациентов с ХМПЗ. Особое внимание уделено роли хронического воспаления, нарушений белкового обмена, последствий противоопухолевой терапии и возрастных изменений в развитии мышечной атрофии. Подчёркивается важность ранней диагностики саркопении с использованием современных инструментов, таких как опросник SARC-F, биоимпедансометрия, различные тесты для оценки физической работоспособности. Представлены стратегии коррекции саркопении, включающие физические нагрузки, нутритивную поддержку и другие подходы, способные улучшить прогноз и качество жизни пациентов. Работа имеет важное значение для гематологов, гериатров и реабилитологов, занимающихся ведением пациентов с ХМПЗ. Исследование саркопении при ХМПЗ является актуальной задачей, поскольку её своевременная диагностика и коррекция могут существенно повлиять на клинические исходы.

Ключевые слова: хронические миелопролиферативные заболевания, саркопения, мышечная сила, мышечная масса

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Chronic myeloproliferative neoplasms (MPNs) are a group of clonal hematopoietic disorders that predominantly affect older patients. These conditions are associated with increased risk of numerous complications. One of the key comorbidities in these patients is sarcopenia—a progressive loss of skeletal muscle mass, strength, and function—that significantly worsens quality of life and the prognosis of the underlying disease. The work aimed to systematize current data on the impact of sarcopenia on outcomes in patients with MPNs and to summarize recommendations for its early diagnosis and management to improve clinical outcomes. The review presents data on the epidemiology, pathogenesis, and clinical relevance of sarcopenia in patients with MPNs. Particular attention is given to the role of chronic inflammation, protein metabolism disorders, the consequences of antitumor therapy, and age-related changes in the development of muscle atrophy. The importance of early diagnosis of sarcopenia using modern tools—such as the SARC-F questionnaire, bioelectrical impedance analysis, and various physical performance tests—is emphasized. Strategies for correcting sarcopenia are presented, including physical exercise, nutritional support, and other approaches that may improve patient prognosis and quality of life. This work is of particular relevance to hematologists, geriatricians, and rehabilitation specialists involved in the care of patients with MPNs. Research into sarcopenia in the context of MPNs remains highly relevant, as timely diagnosis and management may significantly influence clinical outcomes.

Keywords: myeloproliferative disorders, sarcopenia, muscle strength, muscle mass

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Авторы

А.Г. Гарифуллина*¹, Б.А. Бакиров¹, Г.Х. Ласынова¹, Е.О. Голдырев¹, Д.А. Кудлай^1,2,3

¹Башкирский государственный медицинский университет, Уфа, Республика Башкортостан;
²Первый Московский государственный медицинский университет им. И.М. Сеченова, Москва, Россия;
³Государственный научный центр «Институт иммунологии» ФМБА России, Москва, Россия
*nakieva-1@yandex.ru

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Adelina G. Garifullina*¹, Bulat A. Bakirov¹, Gulnaz H. Lasynova², Evgeny O. Goldyrev¹, Dmitry A. Kudlay^1,2,3

¹Bashkir State Medical University, Ufa, Republic of Bashkortostan;
²Sechenov First Moscow State Medical University, Moscow, Russia;
³National Research Center — Institute of Immunology FMBA of Russia, Moscow, Russia
*nakieva-1@yandex.ru

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