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Остеосаркопения при хроническом панкреатите
Остеосаркопения при хроническом панкреатите
Козлова И.В., Быкова А.П. Остеосаркопения при хроническом панкреатите. Терапевтический архив. 2021; 93 (8): 869–875. DOI: 10.26442/00403660.2021.08.200971
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Аннотация
Цель. Определить частоту, клинические особенности и некоторые механизмы развития остеосаркопении у пациентов с хроническим панкреатитом (ХП).
Материалы и методы. Проведено исследование случай–контроль на базе городского гастроэнтерологического центра ГУЗ «Саратовская городская клиническая больница №5» в 2015–2018 гг. пациентов с ХП. В исследование включен 161 пациент с ХП, в контрольную группу – 30 здоровых лиц. Пациенты разделены с учетом этиологии ХП: 79 – с токсико-метаболическим ХП, 82 – с билиарнозависимым. Для определения рисков низкоэнергетических переломов 154 пациентам выполнено тестирование Fracture risk assessment tool (FRAX). Наряду со стандартным обследованием 30 пациентам с ХП выполнена двухэнергетическая рентгеновская денситометрия. Для оценки состояния скелетной мускулатуры определяли индекс массы тела, выполняли кистевую динамометрию, для оценки физической работоспособности – набор тестов Short Physical Performance Battery (SPPB). Наряду с оценкой традиционных факторов риска остеосаркопении – пол, возраст, состояние репродуктивной функции у женщин, индекс массы тела, функциональное состояние поджелудочной железы – проведен анализ количественного содержания в колонобиоптатах интерлейкина (ИЛ)-2, ИЛ-6, ИЛ-8 методом иммуноферментного анализа.
Результаты. Остеодефицит по данным денситометрии выявлен у 70,0% пациентов с ХП, у 13,3% лиц контрольной группы. Пресаркопения выявлена у 62 (38,5%) пациентов с ХП, саркопения – у 34 (21,1%), в контрольной группе пресаркопении и саркопении не выявлено. Саркопения встречалась статистически значимо чаще при токсико-метаболическом ХП, чем при билиарнозависимом ХП (χ2=11,6; p<0,001). Выявлены корреляции Т-критерия поясничного отдела позвоночника и ИЛ-6 (r=-0,29; p=0,03), ИЛ-8 (r=-0,29; p=0,04). Определены корреляционные связи саркопении и концентрации цитокинов в слизистой оболочке толстой кишки при ХП (ИЛ-2: r=0,44; p<0,001; ИЛ-6: r=0,48; p<0,001; ИЛ-8: r=0,42; p<0,001).
Заключение. Развитие синдромов остеопении и саркопении при ХП взаимосвязано и ассоциировано как с традиционными факторами риска, так и с повышенной концентрацией цитокинов в слизистой оболочке толстой кишки.
Ключевые слова: хронический панкреатит, саркопения, остеопения, толстая кишка, цитокины
Materials and methods. A case–control study was conducted on the basis of the Saratov State Clinical Hospital 5 in 2015–2018 of patients with CP. In a study of 161 patients with CP included, the control group – 30 healthy individuals. Patients were divided into groups according to the etiology of CP: 79 – with toxic-metabolic CP, 82 – with biliary CP. To determine the risks of low-energy fractures, 154 patients were tested with the “Fracture risk assessment tool” (FRAX). Along with the standard examination, 30 patients with CP dual-energy X-ray absorptiometry was performed. To assess the state of skeletal muscles, body mass index was determined, hand-held dynamometry was performed, and a set of Short Physical Performance Battery (SPPB) tests was used. Along with the assessment of traditional risk factors for osteosarcopenia – gender, age, state of reproductive function in women, body mass index, functional state of the pancreas (pancreas) – the quantitative content of interleukins (IL)-2, 6, 8 in in colonic biopsies was analyzed by enzyme-linked immunosorbent assay (ELISA).
Results. Bone disorders, according to densitometry, was detected in 70.0% of patients with CP, in 13.3% of the control group. Presarcopenia was detected in 62 (38.5%) patients with CP, sarcopenia – in 34 (21.1%), in the control group presarcopenia and sarcopenia were not detected. Sarcopenia was statistically significantly more common in toxic-metabolic CP than in biliary CP (χ2=11.6; p<0.001). Correlations of the lumbar spine T-score and IL-6 (r=-0.29; p=0.03), IL-8 (r=-0.29; p=0.04) were revealed. Correlations between sarcopenia and the concentration of cytokines in the in the colon mucosa in CP were determined (IL-2: r=0.44; p<0.001; IL-6: r=0.48; p<0.001; IL-8: r=0.42; p<0.001).
Conclusion. The development of osteopenia and sarcopenia syndromes in CP is interrelated and associated with both traditional risk factors and an increased concentration of cytokines in the in the colon mucosa.
Keywords: chronic pancreatitis, sarcopenia, osteopenia, colon, cytokines
Материалы и методы. Проведено исследование случай–контроль на базе городского гастроэнтерологического центра ГУЗ «Саратовская городская клиническая больница №5» в 2015–2018 гг. пациентов с ХП. В исследование включен 161 пациент с ХП, в контрольную группу – 30 здоровых лиц. Пациенты разделены с учетом этиологии ХП: 79 – с токсико-метаболическим ХП, 82 – с билиарнозависимым. Для определения рисков низкоэнергетических переломов 154 пациентам выполнено тестирование Fracture risk assessment tool (FRAX). Наряду со стандартным обследованием 30 пациентам с ХП выполнена двухэнергетическая рентгеновская денситометрия. Для оценки состояния скелетной мускулатуры определяли индекс массы тела, выполняли кистевую динамометрию, для оценки физической работоспособности – набор тестов Short Physical Performance Battery (SPPB). Наряду с оценкой традиционных факторов риска остеосаркопении – пол, возраст, состояние репродуктивной функции у женщин, индекс массы тела, функциональное состояние поджелудочной железы – проведен анализ количественного содержания в колонобиоптатах интерлейкина (ИЛ)-2, ИЛ-6, ИЛ-8 методом иммуноферментного анализа.
Результаты. Остеодефицит по данным денситометрии выявлен у 70,0% пациентов с ХП, у 13,3% лиц контрольной группы. Пресаркопения выявлена у 62 (38,5%) пациентов с ХП, саркопения – у 34 (21,1%), в контрольной группе пресаркопении и саркопении не выявлено. Саркопения встречалась статистически значимо чаще при токсико-метаболическом ХП, чем при билиарнозависимом ХП (χ2=11,6; p<0,001). Выявлены корреляции Т-критерия поясничного отдела позвоночника и ИЛ-6 (r=-0,29; p=0,03), ИЛ-8 (r=-0,29; p=0,04). Определены корреляционные связи саркопении и концентрации цитокинов в слизистой оболочке толстой кишки при ХП (ИЛ-2: r=0,44; p<0,001; ИЛ-6: r=0,48; p<0,001; ИЛ-8: r=0,42; p<0,001).
Заключение. Развитие синдромов остеопении и саркопении при ХП взаимосвязано и ассоциировано как с традиционными факторами риска, так и с повышенной концентрацией цитокинов в слизистой оболочке толстой кишки.
Ключевые слова: хронический панкреатит, саркопения, остеопения, толстая кишка, цитокины
________________________________________________
Materials and methods. A case–control study was conducted on the basis of the Saratov State Clinical Hospital 5 in 2015–2018 of patients with CP. In a study of 161 patients with CP included, the control group – 30 healthy individuals. Patients were divided into groups according to the etiology of CP: 79 – with toxic-metabolic CP, 82 – with biliary CP. To determine the risks of low-energy fractures, 154 patients were tested with the “Fracture risk assessment tool” (FRAX). Along with the standard examination, 30 patients with CP dual-energy X-ray absorptiometry was performed. To assess the state of skeletal muscles, body mass index was determined, hand-held dynamometry was performed, and a set of Short Physical Performance Battery (SPPB) tests was used. Along with the assessment of traditional risk factors for osteosarcopenia – gender, age, state of reproductive function in women, body mass index, functional state of the pancreas (pancreas) – the quantitative content of interleukins (IL)-2, 6, 8 in in colonic biopsies was analyzed by enzyme-linked immunosorbent assay (ELISA).
Results. Bone disorders, according to densitometry, was detected in 70.0% of patients with CP, in 13.3% of the control group. Presarcopenia was detected in 62 (38.5%) patients with CP, sarcopenia – in 34 (21.1%), in the control group presarcopenia and sarcopenia were not detected. Sarcopenia was statistically significantly more common in toxic-metabolic CP than in biliary CP (χ2=11.6; p<0.001). Correlations of the lumbar spine T-score and IL-6 (r=-0.29; p=0.03), IL-8 (r=-0.29; p=0.04) were revealed. Correlations between sarcopenia and the concentration of cytokines in the in the colon mucosa in CP were determined (IL-2: r=0.44; p<0.001; IL-6: r=0.48; p<0.001; IL-8: r=0.42; p<0.001).
Conclusion. The development of osteopenia and sarcopenia syndromes in CP is interrelated and associated with both traditional risk factors and an increased concentration of cytokines in the in the colon mucosa.
Keywords: chronic pancreatitis, sarcopenia, osteopenia, colon, cytokines
Полный текст
Список литературы
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3. Lew D, Afghani E, Pandol S. Chronic pancreatitis: current status and challenges for prevention and treatment. Dig Dis Sci. 2017;62:1702-12. DOI:10.1007/s10620-017-4602-2
4. Machicado JD, Yadav D. Epidemiology of Recurrent Acute and Chronic Pancreatitis: Similarities and Differences. Dig Dis Sci. 2017;62(7):1683-91. DOI:10.1007/s10620-017-4510-5
5. Machicado JD, Amann ST, Anderson MA, et al. Quality of life in chronic pancreatitis is determined by constant pain, disability/unemployment, current smoking, and associated Co-Morbidities. Am J Gastroenterol. 2017;112:633-42. DOI:10.1038/ajg.2017.42
6. Olesen SS, Büyükuslu A, Køhler M, et al. Sarcopenia associates with increased hospitalization rates and reduced survival in patients with chronic pancreatitis. Pancreatology. 2019;19(2):245-51. DOI:10.1016/j.pan.2019.01.006
7. Duggan SN, Purcell C, Kilbane M, et al. An Association between Abnormal Bone Turnover, Systemic Inflammation, and Osteoporosis in Patients with Chronic Pancreatitis. A Case-Matched Study. Am J Gastroenterol. 2015;110:336-45. DOI:10.1038/ajg.2014.430
8. Duggan SN, Smyth ND, O’Sullivan M, et al. The prevalence of malnutrition and fat-soluble vitamin deficiencies in chronic pancreatitis. Nutr Clin Pract. 2014;29:348-54. DOI:10.1177/0884533614528361
9. O’Connor D, Kok T, Purcell C, et al. Investigating the prevalence of sarcopenia in chronic pancreatitis in an irsih cohort: a CT-scan based pilot study. Pancreatology. 2014;14:74. DOI:10.1016/j.pan.2014.05.628
10. Nikfarjam M, Wilson JS, Smith RC. Australasian Pancreatic Club Pancreatic Enzyme Replacement Therapy Guidelines Working Group. Diagnosis and management of pancreatic exocrine insufficiency. Med J Aust. 2017;207(4):161-5. DOI:10.5694/mja16.00851
11. Rasmussen HH, Irtun O, Olesen SS, et al. Nutrition in chronic pancreatitis. World J Gastroenterol. 2013;19:7267-75. DOI:10.3748/wjg.v19.i42.7267
12. Talukdar R, Sasikala M, Kumar PP, et al. T-helper cell-mediated islet inflammation contributes to β-cell dysfunction in chronic pancreatitis. Pancreas. 2016;3:434-42. DOI:10.1097/MPA.0000000000000479
13. Manohar M, Verma AK, Venkateshaiah SU, et al. Pathogenic mechanisms of pancreatitis. World J Gastrointest Pharmacol Ther. 2017;1(8):10-25. DOI:10.4292/wjgpt.v8.i1.10
14. Kirk B, Feehan J, Lombardi G, Duque G. Muscle, Bone, and Fat Crosstalk: the Biological Role of Myokines, Osteokines, and Adipokines. Curr Osteoporos Rep. 2020;18(4):388-400. DOI:10.1007/s11914-020-00599-y
15. Oradova ASh, Saduakasova KZ, Lesova SD. Laboratory diagnosis of cytokines. Vestnik KazNMU. 2017;2:200-3 (in Russian)
16. Bykova AP, Kozlova IV. Clinical-endoscopic and morphological features of the colon in chronic pancreatitis. Experimental and Clinical Gastroenterology. 2017;139(3):22-7 (in Russian)
17. Etemad B, Whitcomb DC. Chronic pancreatitis. Diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120(3):682-707. DOI:10.1053/gast.2001.22586
18. Ivashkin VT, Khazanov AI, Piskunov GG, et al. About the classification of chronic pancreatitis. Clinical medicine. 1990;10:96-9 (in Russian)
19. Tarasova ZhS, Bordin DS, Kileynikov DV, Kucheryavy YuA. Pancreatogenic Diabetes Mellitus: Endocrinologist’s and Gastroenterologist’s Point of View. Effective Pharmacotherapy. 2020; 16(15):92-100 (in Russian) DOI:10.33978/2307-3586-2020-16-15-92-100
20. Leeds JS, Oppong K, Sanders DS. The role of fecal elastase-1 in detecting exocrine pancreatic disease. Nat Rev Gastroenterol Hepatol. 2011;7:405-15. DOI:10.1038/nrgastro.2011.91
21. Cauley JA, Fuleihan GEL, Arabi A, et al. Official positions for FRAX clinical regarding international differences. J Clin Densitom. 2011;14:240-62. DOI:10.1016/j.jocd.2011.05.015
22. Kanis JA, on behalf of the WHO Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaboraiting Centre, University of Sheffield, UK, 2008.
23. Guralnik YM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55:221-31. DOI:10.1093/gerona/55.4.m221
24. Bezdenezhnyh AV, Sumin AN. Sarcopenia: prevalence, detection and clinical significance. Clinical medicine. 2012;10:16-24 (in Russian)
25. Lang TA, Secic M. How to report statistics in medicine. Annotated guidelines or authors, editors, and reviewers. Moscow: Prakticheskaia meditsina, 2016 (in Russian)
26. Kirk B, Zanker J, Duque G. Osteosarcopenia: epidemiology, diagnosis, and treatment-facts and numbers. J Cachexia Sarcopenia Muscle. 2020;11(3):609-18. DOI:10.1002/jcsm.12567
27. Marco B, Bonewald L. Bone and Muscle: Interactions beyond Mechanical. Bone. 2015;80:109-14. DOI:10.1016/j.bone.2015.02.010
28. Lustosa LP, Batista PP, Pereira DS, et al. Comparison between parameters of muscle performance and inflammatory biomarkers of non-sarcopenic and sarcopenic elderly women. Clin Interv Aging. 2017;12:1183-91. DOI:10.2147/CIA.S139579
29. Byun MK, Cho EN, Chang J, et al. Sarcopenia correlates with systemic inflammation in COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:669-75.
DOI:10.2147/COPD.S130790
30. Bykova AP, Kozlova IV. Cytokines in large intestine mucosa and intestinal microbiota in patients with chronic pancreatitis. Medical News of North Caucasus. 2017;2(12):157-60 (in Russian) DOI:10.14300/mnnc.2017.12044
31. Chakaroun RM, Massier L, Kovacs P. Gut Microbiome, Intestinal Permeability, and Tissue Bacteria in Metabolic Disease: Perpetrators or Bystanders? Nutrients. 2020;12(4):1082. DOI:10.3390/nu12041082
32. Vonlaufen A, Spahr L, Apte MV, Frossard JL. Alcoholic pancreatitis. A tale of spirits and bacteria. World J Gastrointest Pathophysiol. 2014;5:82-90. DOI:10.4291/wjgp.v5.i2.82
2. Ивашкин В.Т., Маев И.В., Охлобыстин А.В., и др. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению хронического панкреатита. Рос. журн. гастроэнтерологии, гепатологии, колопроктологии. 2014;4:70-97 [Ivashkin VT, Maev IV, Okhlobystin AV, et al. Guidelines of the Russian gastroenterological association on diagnostics and treatment of a chronic pancreatitis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2014;4:70-97 (in Russian)].
3. Lew D, Afghani E, Pandol S. Chronic pancreatitis: current status and challenges for prevention and treatment. Dig Dis Sci. 2017;62:1702-12. DOI:10.1007/s10620-017-4602-2
4. Machicado JD, Yadav D. Epidemiology of Recurrent Acute and Chronic Pancreatitis: Similarities and Differences. Dig Dis Sci. 2017;62(7):1683-91. DOI:10.1007/s10620-017-4510-5
5. Machicado JD, Amann ST, Anderson MA, et al. Quality of life in chronic pancreatitis is determined by constant pain, disability/unemployment, current smoking, and associated Co-Morbidities. Am J Gastroenterol. 2017;112:633-42. DOI:10.1038/ajg.2017.42
6. Olesen SS, Büyükuslu A, Køhler M, et al. Sarcopenia associates with increased hospitalization rates and reduced survival in patients with chronic pancreatitis. Pancreatology. 2019;19(2):245-51. DOI:10.1016/j.pan.2019.01.006
7. Duggan SN, Purcell C, Kilbane M, et al. An Association between Abnormal Bone Turnover, Systemic Inflammation, and Osteoporosis in Patients with Chronic Pancreatitis. A Case-Matched Study. Am J Gastroenterol. 2015;110:336-45. DOI:10.1038/ajg.2014.430
8. Duggan SN, Smyth ND, O’Sullivan M, et al. The prevalence of malnutrition and fat-soluble vitamin deficiencies in chronic pancreatitis. Nutr Clin Pract. 2014;29:348-54. DOI:10.1177/0884533614528361
9. O’Connor D, Kok T, Purcell C, et al. Investigating the prevalence of sarcopenia in chronic pancreatitis in an irsih cohort: a CT-scan based pilot study. Pancreatology. 2014;14:74. DOI:10.1016/j.pan.2014.05.628
10. Nikfarjam M, Wilson JS, Smith RC. Australasian Pancreatic Club Pancreatic Enzyme Replacement Therapy Guidelines Working Group. Diagnosis and management of pancreatic exocrine insufficiency. Med J Aust. 2017;207(4):161-5. DOI:10.5694/mja16.00851
11. Rasmussen HH, Irtun O, Olesen SS, et al. Nutrition in chronic pancreatitis. World J Gastroenterol. 2013;19:7267-75. DOI:10.3748/wjg.v19.i42.7267
12. Talukdar R, Sasikala M, Kumar PP, et al. T-helper cell-mediated islet inflammation contributes to β-cell dysfunction in chronic pancreatitis. Pancreas. 2016;3:434-42. DOI:10.1097/MPA.0000000000000479
13. Manohar M, Verma AK, Venkateshaiah SU, et al. Pathogenic mechanisms of pancreatitis. World J Gastrointest Pharmacol Ther. 2017;1(8):10-25. DOI:10.4292/wjgpt.v8.i1.10
14. Kirk B, Feehan J, Lombardi G, Duque G. Muscle, Bone, and Fat Crosstalk: the Biological Role of Myokines, Osteokines, and Adipokines. Curr Osteoporos Rep. 2020;18(4):388-400. DOI:10.1007/s11914-020-00599-y
15. Орадова А.Ш., Садуакасова К.З., Лесова С.Д. Лабораторная диагностика цитокинов (обзорная статья). Вестник КазНМУ. 2017;2:200-3 [Oradova ASh, Saduakasova KZ, Lesova SD. Laboratory diagnosis of cytokines. Vestnik KazNMU. 2017;2:200-3 (in Russian)].
16. Быкова А.П., Козлова И.В. Клинико-эндоскопические и морфологические особенности слизистой оболочки толстой кишки при хроническом панкреатите. Эксперим. и клин. гастроэнтерология. 2017;139(3):22-7 [Bykova AP, Kozlova IV. Clinical-endoscopic and morphological features of the colon in chronic pancreatitis. Experimental and Clinical Gastroenterology. 2017;139(3):22-7 (in Russian)].
17. Etemad B, Whitcomb DC. Chronic pancreatitis. Diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120(3):682-707. DOI:10.1053/gast.2001.22586
18. Ивашкин В.Т., Хазанов А.И., Пискунов Г.Г., и др. О классификации хронического панкреатита. Клин. медицина. 1990;10:96-9 [Ivashkin VT, Khazanov AI, Piskunov GG, et al. About the classification of chronic pancreatitis. Clinical medicine. 1990;10:96-9 (in Russian)].
19. Тарасова Ж.С., Бордин Д.С., Килейников Д.В., Кучерявый Ю.А. Панкреатогенный сахарный диабет: взгляд эндокринолога и гастроэнтеролога. Эффективная фармакотерапия. 2020; 16(15):92-100 [Tarasova ZhS, Bordin DS, Kileynikov DV, Kucheryavy YuA. Pancreatogenic Diabetes Mellitus: Endocrinologist’s and Gastroenterologist’s Point of View. Effective Pharmacotherapy. 2020; 16(15):92-100 (in Russian)]. DOI:10.33978/2307-3586-2020-16-15-92-100
20. Leeds JS, Oppong K, Sanders DS. The role of fecal elastase-1 in detecting exocrine pancreatic disease. Nat Rev Gastroenterol Hepatol. 2011;7:405-15. DOI:10.1038/nrgastro.2011.91
21. Cauley JA, Fuleihan GEL, Arabi A, et al. Official positions for FRAX clinical regarding international differences. J Clin Densitom. 2011;14:240-62. DOI:10.1016/j.jocd.2011.05.015
22. Kanis JA, on behalf of the WHO Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaboraiting Centre, University of Sheffield, UK, 2008.
23. Guralnik YM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55:221-31. DOI:10.1093/gerona/55.4.m221
24. Безденежных А.В, Сумин А.Н. Cаркопения: распространенность, выявление и клиническое значение. Клин. медицина. 2012;10:16-24 [Bezdenezhnyh AV, Sumin AN. Sarcopenia: prevalence, detection and clinical significance. Clinical medicine. 2012;10:16-24 (in Russian)].
25. Ланг Т.А., Сесик М. Как описывать статистику в медицине. Руководство для авторов, редакторов и рецензентов. М.: Практическая медицина, 2016 [Lang TA, Secic M. How to report statistics in medicine. Annotated guidelines or authors, editors, and reviewers. Moscow: Prakticheskaia meditsina, 2016 (in Russian)].
26. Kirk B, Zanker J, Duque G. Osteosarcopenia: epidemiology, diagnosis, and treatment-facts and numbers. J Cachexia Sarcopenia Muscle. 2020;11(3):609-18. DOI:10.1002/jcsm.12567
27. Marco B, Bonewald L. Bone and Muscle: Interactions beyond Mechanical. Bone. 2015;80:109-14. DOI:10.1016/j.bone.2015.02.010
28. Lustosa LP, Batista PP, Pereira DS, et al. Comparison between parameters of muscle performance and inflammatory biomarkers of non-sarcopenic and sarcopenic elderly women. Clin Interv Aging. 2017;12:1183-91. DOI:10.2147/CIA.S139579
29. Byun MK, Cho EN, Chang J, et al. Sarcopenia correlates with systemic inflammation in COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:669-75.
DOI:10.2147/COPD.S130790
30. Быкова А.П., Козлова И.В. Цитокины в слизистой оболочке толстой кишки и кишечная микробиота у пациентов с хроническим панкреатитом. Мед. вестн. Северного Кавказа. 2017;2(12):157-60 [Bykova AP, Kozlova IV. Cytokines in large intestine mucosa and intestinal microbiota in patients with chronic pancreatitis. Medical News of North Caucasus. 2017;2(12):157-60 (in Russian)]. DOI:10.14300/mnnc.2017.12044
31. Chakaroun RM, Massier L, Kovacs P. Gut Microbiome, Intestinal Permeability, and Tissue Bacteria in Metabolic Disease: Perpetrators or Bystanders? Nutrients. 2020;12(4):1082. DOI:10.3390/nu12041082
32. Vonlaufen A, Spahr L, Apte MV, Frossard JL. Alcoholic pancreatitis. A tale of spirits and bacteria. World J Gastrointest Pathophysiol. 2014;5:82-90. DOI:10.4291/wjgp.v5.i2.82
________________________________________________
2. Ivashkin VT, Maev IV, Okhlobystin AV, et al. Guidelines of the Russian gastroenterological association on diagnostics and treatment of a chronic pancreatitis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2014;4:70-97 (in Russian)
3. Lew D, Afghani E, Pandol S. Chronic pancreatitis: current status and challenges for prevention and treatment. Dig Dis Sci. 2017;62:1702-12. DOI:10.1007/s10620-017-4602-2
4. Machicado JD, Yadav D. Epidemiology of Recurrent Acute and Chronic Pancreatitis: Similarities and Differences. Dig Dis Sci. 2017;62(7):1683-91. DOI:10.1007/s10620-017-4510-5
5. Machicado JD, Amann ST, Anderson MA, et al. Quality of life in chronic pancreatitis is determined by constant pain, disability/unemployment, current smoking, and associated Co-Morbidities. Am J Gastroenterol. 2017;112:633-42. DOI:10.1038/ajg.2017.42
6. Olesen SS, Büyükuslu A, Køhler M, et al. Sarcopenia associates with increased hospitalization rates and reduced survival in patients with chronic pancreatitis. Pancreatology. 2019;19(2):245-51. DOI:10.1016/j.pan.2019.01.006
7. Duggan SN, Purcell C, Kilbane M, et al. An Association between Abnormal Bone Turnover, Systemic Inflammation, and Osteoporosis in Patients with Chronic Pancreatitis. A Case-Matched Study. Am J Gastroenterol. 2015;110:336-45. DOI:10.1038/ajg.2014.430
8. Duggan SN, Smyth ND, O’Sullivan M, et al. The prevalence of malnutrition and fat-soluble vitamin deficiencies in chronic pancreatitis. Nutr Clin Pract. 2014;29:348-54. DOI:10.1177/0884533614528361
9. O’Connor D, Kok T, Purcell C, et al. Investigating the prevalence of sarcopenia in chronic pancreatitis in an irsih cohort: a CT-scan based pilot study. Pancreatology. 2014;14:74. DOI:10.1016/j.pan.2014.05.628
10. Nikfarjam M, Wilson JS, Smith RC. Australasian Pancreatic Club Pancreatic Enzyme Replacement Therapy Guidelines Working Group. Diagnosis and management of pancreatic exocrine insufficiency. Med J Aust. 2017;207(4):161-5. DOI:10.5694/mja16.00851
11. Rasmussen HH, Irtun O, Olesen SS, et al. Nutrition in chronic pancreatitis. World J Gastroenterol. 2013;19:7267-75. DOI:10.3748/wjg.v19.i42.7267
12. Talukdar R, Sasikala M, Kumar PP, et al. T-helper cell-mediated islet inflammation contributes to β-cell dysfunction in chronic pancreatitis. Pancreas. 2016;3:434-42. DOI:10.1097/MPA.0000000000000479
13. Manohar M, Verma AK, Venkateshaiah SU, et al. Pathogenic mechanisms of pancreatitis. World J Gastrointest Pharmacol Ther. 2017;1(8):10-25. DOI:10.4292/wjgpt.v8.i1.10
14. Kirk B, Feehan J, Lombardi G, Duque G. Muscle, Bone, and Fat Crosstalk: the Biological Role of Myokines, Osteokines, and Adipokines. Curr Osteoporos Rep. 2020;18(4):388-400. DOI:10.1007/s11914-020-00599-y
15. Oradova ASh, Saduakasova KZ, Lesova SD. Laboratory diagnosis of cytokines. Vestnik KazNMU. 2017;2:200-3 (in Russian)
16. Bykova AP, Kozlova IV. Clinical-endoscopic and morphological features of the colon in chronic pancreatitis. Experimental and Clinical Gastroenterology. 2017;139(3):22-7 (in Russian)
17. Etemad B, Whitcomb DC. Chronic pancreatitis. Diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120(3):682-707. DOI:10.1053/gast.2001.22586
18. Ivashkin VT, Khazanov AI, Piskunov GG, et al. About the classification of chronic pancreatitis. Clinical medicine. 1990;10:96-9 (in Russian)
19. Tarasova ZhS, Bordin DS, Kileynikov DV, Kucheryavy YuA. Pancreatogenic Diabetes Mellitus: Endocrinologist’s and Gastroenterologist’s Point of View. Effective Pharmacotherapy. 2020; 16(15):92-100 (in Russian) DOI:10.33978/2307-3586-2020-16-15-92-100
20. Leeds JS, Oppong K, Sanders DS. The role of fecal elastase-1 in detecting exocrine pancreatic disease. Nat Rev Gastroenterol Hepatol. 2011;7:405-15. DOI:10.1038/nrgastro.2011.91
21. Cauley JA, Fuleihan GEL, Arabi A, et al. Official positions for FRAX clinical regarding international differences. J Clin Densitom. 2011;14:240-62. DOI:10.1016/j.jocd.2011.05.015
22. Kanis JA, on behalf of the WHO Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaboraiting Centre, University of Sheffield, UK, 2008.
23. Guralnik YM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55:221-31. DOI:10.1093/gerona/55.4.m221
24. Bezdenezhnyh AV, Sumin AN. Sarcopenia: prevalence, detection and clinical significance. Clinical medicine. 2012;10:16-24 (in Russian)
25. Lang TA, Secic M. How to report statistics in medicine. Annotated guidelines or authors, editors, and reviewers. Moscow: Prakticheskaia meditsina, 2016 (in Russian)
26. Kirk B, Zanker J, Duque G. Osteosarcopenia: epidemiology, diagnosis, and treatment-facts and numbers. J Cachexia Sarcopenia Muscle. 2020;11(3):609-18. DOI:10.1002/jcsm.12567
27. Marco B, Bonewald L. Bone and Muscle: Interactions beyond Mechanical. Bone. 2015;80:109-14. DOI:10.1016/j.bone.2015.02.010
28. Lustosa LP, Batista PP, Pereira DS, et al. Comparison between parameters of muscle performance and inflammatory biomarkers of non-sarcopenic and sarcopenic elderly women. Clin Interv Aging. 2017;12:1183-91. DOI:10.2147/CIA.S139579
29. Byun MK, Cho EN, Chang J, et al. Sarcopenia correlates with systemic inflammation in COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:669-75.
DOI:10.2147/COPD.S130790
30. Bykova AP, Kozlova IV. Cytokines in large intestine mucosa and intestinal microbiota in patients with chronic pancreatitis. Medical News of North Caucasus. 2017;2(12):157-60 (in Russian) DOI:10.14300/mnnc.2017.12044
31. Chakaroun RM, Massier L, Kovacs P. Gut Microbiome, Intestinal Permeability, and Tissue Bacteria in Metabolic Disease: Perpetrators or Bystanders? Nutrients. 2020;12(4):1082. DOI:10.3390/nu12041082
32. Vonlaufen A, Spahr L, Apte MV, Frossard JL. Alcoholic pancreatitis. A tale of spirits and bacteria. World J Gastrointest Pathophysiol. 2014;5:82-90. DOI:10.4291/wjgp.v5.i2.82
Авторы
И.В. Козлова*, А.П. Быкова
ФГБУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России, Саратов, Россия
*kozlova@inbox.ru
Razumovsky Saratov State Medical University, Saratov, Russia
*kozlova@inbox.ru
ФГБУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России, Саратов, Россия
*kozlova@inbox.ru
________________________________________________
Razumovsky Saratov State Medical University, Saratov, Russia
*kozlova@inbox.ru
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