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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2021№6
The problem of sarcopenia in...

The problem of sarcopenia in postmenopausal women. Prevention opportunities

DOI
https://dx.doi.org/10.18565/aig.2021.6.47-53

Sandakova E.A., Zhukovskaya I.G., Timofeeva E.P.

1) Academician E.A. Vagner Perm State Medical University, Ministry of Health of Russia, Perm, Russia; 2) Izhevsk State Medical Academy, Ministry of Health of Russia, Izhevsk, Russia
The review gives the definition of sarcopenia (2018), presenting it as “a syndrome characterized by a progressive and generalized loss of skeletal muscle mass and strength”; outlines the background, epidemiology, etiology, provides the concepts of myokines and muscle tissue as an endocrine organ, and considers the effect of hormones on muscle tissue, as well as the main pathogenetic mechanisms of the development of sarcopenia in postmenopause (a decrease in the level of sex hormones, DHEA-C, STH, thyroid hormones, insulin resistance); lifestyle (physical activity and nutrition); chronic systemic inflammation; fetal programming; mitochondrial dysfunction; deficiency of micronutrients, including vitamin D and its impaired reception; and neurodegenerative changes in muscle tissue. It presents the clinical signs of sarcopenia, modern diagnostic criteria based on specially developed tests (SarQol, SARC-F) and measurements of muscle strength (with hand dynamometers) and mass (using densitometry and bioimpedance analysis). The review highlights approaches to treating sarcopenia. There is evidence for the importance of regular physical activity, protein nutrition, and micronutrient supplementation. It gives the results of studying the effect of DHEA-C, STH, and sex hormone therapy on muscle tissue, as well as the results of menopausal hormone therapy in early and late postmenopause.
Conclusion. Thus, sarcopenia should be regarded as an attribute of postmenopause, which reduces quality of life and shortens its span. In this connection, there is a need for further investigations of the mechanisms of development of this disease, for the development and clinical introduction of therapeutic and diagnostic methods aimed at the prevention and therapy of sarcopenia in postmenopause. These programs can be really implemented within the interdisciplinary interaction of obstetricians/gynecologists, internists, endocrinologists, neurologists, and restorative medicine specialists. Besides maintaining the optimal protein metabolism and regular moderate physical exercise, it is necessary to assess the role of personalized menopausal hormone treatment to preserve proper muscle tissue metabolism and to prevent sarcopenia.

Keywords

sarcopenia
muscle tissue
myokines
postmenopause
lifestyle
estradiol
testosterone
menopausal hormone therapy
Full text (in Russian)

References

  1. United Nations Department of Economic and Social Affairs Population Division. World Population Ageing 2017 – Highlights (ST/ESA/SER.A/397). 2017. Available at: http:// www.un.org/en/development/desa/population/publications/pdf/ ageing/WPA2017_Highlights.pdf
  2. Лесняк О.М., Белая Ж.Е., Баранова И.А. Остеопороз. Руководство для врачей. М.: ГЭОТАР-Медиа; 2016. 464с. [Lesnyak O.M., Belaya Zh.E., Baranova I.A. Osteoporosis: guidance for doctors. M.: GEOTAR-Media; 2016. 464 p. (in Russian)].
  3. Beaudart C., Zaaria M., Pasleau F., Reginster J.Y., Bruyère O. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS One. 2017; 12(1): e0169548. https://dx.doi.org/10.1371/journal.pone.0169548.
  4. Cruz-Jentoft A.J., Bahat G., Bauer J., Boirie Y., Bruyère O., Cederholm T. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019; 48(1): 16-31. https://dx.doi.org/10.1093/ageing/afy169.
  5. Critchley M. The neurology of old age. Lancet. 1931; 217(5625): 1331-7. https:/dx./doi.org/10.1016/S0140-6736(00)46849-2.
  6. Shock N.W. Physiologic aspects of aging. J. Am. Diet. Assoc. 1970; 56(6): 491-6.
  7. European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis. Age Ageing. 2010; 39(4): 412-23. https://dx.doi.org/10.1093/ageing/afq034.
  8. Beaudart C., Rolland Y., Cruz-Jentoft A.J., Bauer J.M., Sieber C., Cooper C. et al. Assessment of muscle function and physical performance in daily clinical practice: A position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Calcif. Tissue Int. 2019; 105(1): 1-14. https://dx.doi.org/10.1007/s00223-019-00545-w.
  9. Шостак Н.А., Мурадянц А.А., Кондрашов А.А. Саркопения и перекрестные синдромы – значение в клинической практике. Клиницист. 2016; 10(3): 10-4. [Shostak N.A., Muradyants A.A., Kondrashov A.A. Sarcopenia and overlapping syndromes – significance for clinical practice. Clinician. 2016; 10(3): 10-4. (in Russian)].
  10. Григорьева И.И., Раскина Т.А., Летаева М.В., Малышенко О.С., Аверкивева Ю.В., Масенко В.Л., Коков А.Н. Саркопения: особенности патогенеза и диагностики. Фундаментальная и клиническая медицина. 2019; 4(4): 105-16. [Grigorieva I.I., Raskina T.A., Letaeva M.V., Malyshenko O.S., Averkiveva Yu.V., Masenko V.L., Kokov A.N. Sarcopenia: characteristics of its pathogenesis and diagnostics. Fundamental and clinical medicine. 2019; 4(4): 105-16. (in Russian)]. https://dx.doi.org/10.23946/2500-0764-2019-4-4-105-11.
  11. Peterson S.J., Braunschweig C.A. Prevalence of sarcopenia and associated outcomes in the clinical setting. Nutr. Clin. Pract. 2016; 31(1): 40-8. https://dx.doi.org/10.1177/0884533615622537.
  12. Онучина Ю.С., Гурьева Е.В. Взаимосвязь саркопении и сахарного диабета типа 2. Эндокринология: новости, мнения, обучение. 2018; 7(4): 32-41. [Onuchina Y.S., Gurieva E.V. Interrelation between sarcopenia and type II diabetes mellitus. Endocrinology: news, viewpoints, training. 2018; 7(4): 32-41. (in Russian)].
  13. Зарудский А.А. Саркопения и ее компоненты у пациентов с систолической хронической сердечной недостаточностью. Современные проблемы здравоохранения и медицинской статистики 2020; 2: 132-43. [Zarudsky A.A. Sarcopenia and its components in patients suffering chronic systolic heart failure. Modern issues of healthcare and medical statistics. 2020; 2: 132-43. (in Russian)].
  14. Morley J.E., Anker S.D., von Haehling S. Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014. J. Cachexia Sarcopenia Muscle. 2014; 5(4): 253-9. https://dx.doi.org/10.1007/s13539-014-0161-y.
  15. Lang T., Streeper T., Cawthon P., Baldwin K., Taaffe D.R., Harris T.B. Sarcopenia: etiology, clinical consequences, intervention, and assessment. Osteoporos Int. 2010; 21(4): 543-59. https://dx.doi.org/10.1007/s00198-009-1059-y.
  16. García M.L., Fernández A., Solas M.T. Mitochondria, motor neurons and aging. J. Neurol. Sci. 2013; 330(1-2): 18-26. https://dx.doi.org/10.1016/j.jns.2013.03.019.
  17. Gonzalez-Freire M., de Cabo R., Studenski S.A., Ferrucci L. The neuro-muscular junction: aging at the crossroad between nerves and muscle. Front. Aging Neurosci. 2014; 6: 208. https://dx.doi.org/10.3389/ fnagi.2014.00208.
  18. Miller W.L. Steroid hormone synthesis in mitochondria. Mol. Cell. Endocrinol. 2013; 379(1-2): 62-73.
  19. Mason S., Wadley G.D. Skeletal muscle reactive oxygen species: a target of good cop/bad cop for exercise and disease. Redox Rep. 2014; 19(3): 97-106. https://dx.doi.org/10.1179/1351000213Y.0000000077.
  20. Carruthers M., Trinick T.R., Jankowska E., Traish A.M. Are the adverse effects of glitazones linked to induced testosterone deficiency? Cardiovasc. Diabetol. 2008; 7: 30. https://dx.doi.org/10.1186/1475-2840-7-30.
  21. Орлов С.Н., Капилевич Л.В., Дьякова Е.Ю., Захарова А.Н., Кабачкова А.В., Калининкова Ю.Г., Климанова Е.А., Кироненко Т.А., Милованова К.Г., Сидоренко С.В. Скелетные мышцы как эндокринный орган. Монография. Томск: Издательский Дом Томского государственного университета; 2018. [Orlov S.N., Kapilevich L.V., Dyakova E.Yu., Zakharova A.N., Kabachkova A.V., Kalininkova Yu.G. et al. Skeletal muscles as an endocrine organ: [monography]. Tomsk: Tomsk State University publishing house, 2018. (in Russian)]. URL: http://vital.lib.tsu.ru/vital/access/manager/Repository/vtls:000652911.
  22. Тюзиков И.А., Калинченко С.Ю. Саркопения: помогут ли только протеиновое питание и физическая активность? Роль половых стероидных гормонов в механизмах регуляции синтеза мышечного белка. Вопросы диетологии. 2017; 7(2): 41-50. [Tyusikov I.A., Kalinchenko S.Yu. Sarcopenia: can protein intake and physical activity alone be helpful in treating the disease? The role of sex steroids in muscle protein synthesis regulation. Nutrition issues. 2017; 7(2): 41-50. (in Russian)].
  23. Cioffi F., Senese R., Lanni A., Goglia F. Thyroid hormones and mitochondria: with a brief look at derivatives and analogues. Mol. Cell. Endocrinol. 2013; 379(1-2): 51-61.
  24. Horii N., Sato K., Mesaki N., Iemitsu M. DHEA administration activates transcription of muscular lipid metabolic enzymes via PPARα and PPARδ in obese rats. Horm. Metab. Res. 2016; 48(3): 207-12. https://dx.doi.org/10.1055/s-0035-1564132.
  25. Hardeland R. Melatonin and the theories of aging: a criti-cal appraisal of melatonin’s role in antiaging mechanisms. J. Pineal Res. 2013; 55(4): 325-56. https://dx.doi.org/10.1111/jpi.12090.
  26. Sipilä S., Narici M., Kjaer M., Pöllänen E., Atkinson R.A., Hansen M., Kovanen V. Sex hormones and skeletal muscle weakness. Biogerontology. 2013; 14(3): 231-45. https://dx.doi.org/10.1007/s10522-013-9425-8.
  27. Brown M. Skeletal muscle and bone: effect of sex steroids and aging. Adv. Physiol. Educ. 2008; 32(2): 120-6. https://dx.doi.org/10.1152/advan.90111.2008.
  28. Chen Z., Bassford T., Green S.B., Cauley J.A., Jackson R.D., LaCroix A.Z. et al. Postmenopausal hormone therapy and body composition – a substudy of the estrogen plus progestin trial of the Women's Health Initiative. Am. J. Clin. Nutr. 2005; 82(3): 651-6. https://dx.doi.org/10.1093/ajcn.82.3.651.
  29. Cruz-Jentoft A.J., Landi F., Schneider S.M., Zúñiga C., Arai H., Boirie Y. et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014; 43(6): 748-59. https://dx.doi.org/10.1093/ageing/afu115.
  30. Гуляев Н.И., Ахметшин И.М., Гордиенко А.В., Кузнецов В.В., Полтарейко Д.С. Саркопения. Взгляд терапевта. Клиническая патофизиология. 2019; 25(1): 3-8. [Gulyaev N.I., Akhmetshin I.M., Gordienko A.V., Kuznetsov V.V., Poltareyko D.S. Sarcopenia. A general practitioner’s viewpoint. Clinical pathophysiology. 2019; 25(1): 3-8. (in Russian)].
  31. Park C.H., Do J.G., Lee Y.T., Yoon K.J. Sarcopenic obesity associated with highsensitivity C-reactive protein in age and sex comparison: a two-center study in South Korea. BMJ Open. 2018; 8: e021232. https://dx.doi.org/10.1136/bmjopen-2017-021232.
  32. Мокрышева Н.Г., Крупинова Ю.А., Володичева В.Л., Мирная С.С., Мельниченко Г.А. Саркопения глазами эндокринолога. Ожирение и метаболизм. 2018; 15(3): 21-7. [Mokrysheva N.G., Krupinova Y.A., Volodicheva V.L., Mirnaya S.S., Melnichenko G.A. Sarcopenia from an endocrinologist’s viewpoint. Obesity and metabolism. 2018; 15(3): 21-7. (in Russian)]. https://dx.doi.org/10.14341/OMET9792.
  33. Scott D. Reducing the burden of sarcopenia: a healthy lifestyle throughout the lifetime D. In: World congress on osteoporosis, osteoarthritis and musculoskeletal diseases. WCO-IOF-ESCEO. 2018 April 19-22, Krakow, Poland: Springer; 2018: 99.
  34. Sayer A.A., Syddall H., Martin H., Patel H., Baylis D, Cooper C. The developmental origins of sarcopenia. J. Nutr. Health Aging. 2008; 12(7):427-32. https://dx.doi.org/10.1007/BF02982703.
  35. Ji H.M., Han J., Won Y.Y. Sarcopenia and osteoporosis. Hip Pelvis. 2015; 27(2): 72-6. https://dx.doi.org/10.5371/hp.2015.27.2.72.
  36. Carnevale V., Castriotta V., Piscitelli P.A., Nieddu L., Mattera M., Guglielmi G., Scillitani A. Assessment of skeletal muscle mass in older people: comparison between 2 anthropom-etry-based methods and dual-energy X-ray absorptiometry. J. Am. Med. Dir. Assoc. 2018; 19(9): 793-6. https://dx.doi.org/10.1016/j.jamda.2018.05.016.
  37. Beaudart C. Outcomes of the IOF-ESCEO sarcopenia Working Groups. In: World congress on osteoporosis, osteoarthritis and musculoskeletal diseases. WCO-IOF-ESCEO. 2018 April 19-22, Krakow, Poland: Springer; 2018: 77-8.
  38. Reginster J.-Y. Dairy products in the prevention and treatment of sarcopenia: outcomes of the ESCEO Working Groups. In: World congress on osteoporosis, osteoarthritis and musculoskeletal diseases. WCO-IOF-ESCEO. 2018 April 19-22, Krakow, Poland: Springer; 2018: 78.
  39. Javed A.A., Mirza M.B., Sham J.G., Ali D.M., Jones G.F., Sanjeevi S. et al. Association between hormone therapy and muscle mass in postmenopausal women: a systematic review and meta-analysis. JAMA Netw. Open. 2019; 2(8): e1910154. https://dx.doi.org/10.1001/jamanetworkopen.2019.10154.
  40. Smith G.I., Yoshino J., Reeds D.N., Bradley D., Burrows R.E., Heisey H.D. et al. Testosterone and progesterone, but not estradiol, stimulate muscle protein synthesis in postmenopausal women. J Clin Endocrinol Metab. 2014;99(1): 256-65.
  41. Park Y.M., Pereira R.I., Erickson C.B., Swibas T.A., Kang C., Van Pelt R.E. Time since menopause and skeletal muscle estrogen receptors, PGC-1α, and AMPK. Menopause. 2017; 24(7): 815-23. https://dx.doi.org/10.1097/GME.0000000000000829.
  42. Kim S.W., Kim R. The association between hormone therapy and sarcopenia in postmenopausal women. The Korea National Health and Nutrition Examination Survey, 2008-2011. Menopause. 2020; 27(5): 506-11. https://dx.doi.org/10.1097/GME.0000000000001509.
  43. Giannoulis M.G., Martin F.C., Nair K.S., Umpleby A.M., Sonksen P. Hormone replacement therapy and physical function in healthy older men. Time to talk hormones? Endocr. Rev. 2012; 33(3): 314-37. https://dx.doi.org/10.1210/er.2012-1002.
  44. Шарашкина Н.В., Рунихина Н.К., Ткачева О.Н., Остапенко В.С., Дудинская Е.Н. Распространенность, методы диагностики и коррекции саркопении у пожилых. Клиническая геронтология. 2016; 3-4: 46-51. [Sharashkina N.V., Runikhina N.K., Tkacheva O.N., Ostapenko V.S., Dudinskaya E.N. Sarcopenia morbidity and its diagnostic and correction methods in elderly persons. Clinical gerontology. 2016; 3-4: 46-51. (in Russian)].

Received 10.02.2021

Accepted 29.03.2021

About the Authors

Elena A. Sandakova, Dr. Med. Sci., Professor, Head of Obstetrics and Gynaecology Department №2; Academician E.A. Wagner Perm State Medical University,
Ministry of Health of the Russian Federation. E-mail: selena11perm@yandex.ru. 26, Petropavlovskaya str., Perm, Perm region, 614099, Russia.
Inna G. Zhukovskaya, Dr. Med. Sci., Associate Professor of Obstetrics and Gynaecology Department; Izhevsk State Medical Academy, Ministry of Health of the Russian Federation. Tel.: +7(922)505-61-41. E-mail: zhoukovskaya@mail.ru. 281, Kommunarov str., Izhevsk, 426034, Russia.
Ekaterina P. Timofeeva, 5th year student, Academician E.A. Wagner Perm State Medical University, Ministry of Health of the Russian Federation. E-mail: kate77tim@mail.ru.
26, Petropavlovskaya str., Perm, Perm region, 614099, Russia.

For citation: Sandakova E.A., Zhukovskaya I.G., Timofeeva E.P. The problem of sarcopenia in postmenopausal women. Prevention opportunities.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 6: 47-53 (in Russian)
https://dx.doi.org/10.18565/aig.2021.6.47-53

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