rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2023-2958MIKPOMrpcardio-2958Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯRelationship between parameters of subclinical atherosclerosis and osteoporosis and their prognostic significance: data from the prospective studiesВзаимосвязь показателей субклинического атеросклероза и остеопороза и их прогностическая значимость (по данным проспективных исследований)https://orcid.org/0000-0002-1763-0725СкрипниковаИ. А.SkripnikovaI. A.

Скрипникова Ирина Анатольевна – доктор медицинских наук, руководитель отдела профилактики остеопороза и коморбидных состояний.

Москва

Irina A. Skripnikova.

Moscow

Ira_Skrip@mail.ruhttps://orcid.org/0000-0002-8164-8946КолчинаМ. А.KolchinaM. A.

Колчина Мария Александровна - младший научный сотрудник отдела профилактики остеопороза и коморбидных состояний.

Москва

Mariya A. Kolchina.

Moscow

MKolchina@gnicpm.ruhttps://orcid.org/0000-0001-7036-4756КосматоваО. В.KosmatovaO. V.

Косматова Ольга Владимировна – кандидат медицинских наук, научный сотрудник отдела профилактики остеопороза и коморбидных состояний.

Москва

Ol’ga V. Kosmatova.

Moscow

okosmatova@gnicpm.ruhttps://orcid.org/0000-0001-9074-2291ЦориевТ. Т.TsorievT. T.

Цориев Тимур Тамерланович - кандидат медицинских наук, научный сотрудник отдела профилактики остеопороза и коморбидных состояний.

Москва

Timur T. Tsoriev.

Moscow

TTsoriev@gnicpm.ruhttps://orcid.org/0000-0002-8939-0716ИсайкинаО. Ю.IsaykinaO. Yu.

Исайкина Олеся Юрьевна - кандидат медицинских наук, ведущий научный сотрудник отдела первичной профилактики хронических неинфекционных заболеваний в системе здравоохранения.

Москва

Olesya Yu. Isaykina.

Moscow

OIsaykina@gnicpm.ruhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Драпкина Оксана Михайловна – доктор медицинских наук, профессор, академик РАН, главный внештатный специалист по терапии и общемедицинской практике Минздрава России, директор, заведующий кафедрой терапии и профилактической медицины.

Москва

Oxana M. Drapkina.

Moscow

ODrapkina@gnicpm.ruНациональный медицинский исследовательский центр терапии и профилактической медициныРоссияNational Medical Research Center for Therapy and Preventive MedicineRussian Federation202310102023195502507Copyright © Skripnikova I.A., Kolchina M.A., Kosmatova O.V., Tsoriev T.T., Isaykina O.Y., Drapkina O.M., 20232023Скрипникова И.А., Колчина М.А., Косматова О.В., Цориев Т.Т., Исайкина О.Ю., Драпкина О.М.Skripnikova I.A., Kolchina M.A., Kosmatova O.V., Tsoriev T.T., Isaykina O.Y., Drapkina O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2958

We analyzed modern publications on the relationship between cardiovascular diseases (CVDs) and osteoporosis and, in particular, their preclinical manifestations. Most of the papers on this issue are observational, cross-sectional, or study associations of preclinical markers with disease risk or outcomes. However, the results of these studies do not always coincide and are contradictory. Therefore, it is not possible to define cause-effect relationship between vascular changes and decreased bone mass, as well as persistence of its relationship. Due to the difficulties in management of prospective studies, in the last decade only a few studies have appeared with long-term follow-up of patients without symptoms with subsequent assessment of preclinical manifestations. A strong relationship has been demonstrated between intima-media thickness, plaque presence, coronary artery calcification and low bone density of the spine and proximal femur, as well as between vascular stiffness (pulse wave velocity) and proximal femur bone density. The data obtained indicate combined disorders of vascular wall morphology and bone tissue, not only in postmenopausal women, but also in elderly men, and can be used to justify indications for screening for decreased bone density in patients with CVD. At the same time, larger-scale prospective studies to explore associations between markers of preclinical manifestations of CVD and decreased bone mass, including in the Russian population, are required.

Проведен анализ современных публикаций, посвященных взаимосвязи сердечно-сосудистых заболеваний (ССЗ) с остеопорозом и, в частности, их доклинических проявлений. Большинство из исследований, затрагивающих этот вопрос, являются наблюдательными одномоментными или прослеживают ассоциации доклинических маркеров заболеваний с риском развития заболеваний или исходами. Однако результаты этих исследований не всегда совпадают, иногда носят противоречивый характер и не позволяют сделать однозначные выводы о причинно-следственной связи изменений сосудистой стенки и снижения костной массы, а также об устойчивости выявленных ассоциаций. Ввиду сложности выполнения проспективных исследований в последней декаде появились лишь единичные работы с многолетним наблюдением пациентов без клинических симптомов заболеваний с последующей оценкой динамики доклинических проявлений. Была доказана устойчивая связь между толщиной комплекса интима-медиа, наличием атеросклеротических бляшек, кальцификацией коронарных артерий и низкой минеральной плотностью костной ткани в позвоночнике и проксимальном отделе бедра, а также между сосудистой жесткостью (скоростью распространения пульсовой волны) и минеральной плотностью костной ткани в проксимальном отделе бедра. Полученные данные свидетельствуют о наличии сочетанных нарушений структуры сосудистой стенки и костной ткани, причем не только у женщин в постменопаузальном периоде, но и у мужчин пожилого возраста, и могут быть использованы для обоснования показаний к скринингу снижения минеральной плотности костной ткани у пациентов с ССЗ. При этом остается очевидной необходимость проведения более масштабных проспективных исследований по изучению ассоциаций между маркерами доклинических проявлений ССЗ и снижения костной массы, в том числе в российской популяции.

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