pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2019-29-1-94-105pulmo-1113Research ArticleОБЗОРЫREVIEWКостно-мышечные нарушения у больных хронической обструктивной болезнью легкихMusculoskeletal disorders in patients with chronic obstructive pulmonary diseaseСулеймановаА. К.SuleymanovaA. K.

Сулейманова Ангелина Курбановна – аспирант и ассистент кафедры госпитальной терапии педиатрического факультета.

117997, Москва, ул. Островитянова, 1; тел.: (916) 078-94-59.

Angelina K. Suleymanova - PhD student and Assistant Lecturer, Department of Hospital Internal Medicine, Pediatric Faculty.

ul. Ostrovityanova 1, Moscow, 117997; tel.: (916) 078-94-59.

angelina.suleymanova91@gmail.comБарановаИ. А.BaranovaI. A.

Баранова Ирина Александровна – доктор медицинских наук, профессор кафедры госпитальной терапии педиатрического факультета.

117997, Москва, ул. Островитянова, 1; тел.: (499) 780-08-16.

Irina A. Baranova - Doctor of Medicine, Professor, Department of Hospital Therapy, Pediatric Faculty.

ul. Ostrovityanova 1, Moscow, 117997; tel.: (499) 780-08-16.

iribaranova@yandex.ruРоссийский национальный исследовательский медицинский университет имени Н.И.Пирогова Министерства здравоохранения Российской ФедерацииРоссияN.I.Pirogov Federal Russian State National Research Medical University, Healthcare Ministry of RussiaRussian Federation20192204201929194105Copyright © Сулейманова А.К., Баранова И.А., 20192019Сулейманова А.К., Баранова И.А.Suleymanova A.K., Baranova I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1113

В обзоре представлены данные о костно-мышечных нарушениях у больных хронической обструктивной болезнью легких (ХОБЛ). Рассматриваются основные факторы риска и патогенетические механизмы остеопороза и дисфункции периферических скелетных мышц у пациентов с ХОБЛ, такие как табакокурение, низкая физическая активность, воспаление, прием глюкокортикостероидов и т. п. Описано влияние низкого уровня витамина D на развитие и прогрессирование костно-мышечных нарушений у больных ХОБЛ, при этом особое внимание уделено саркопении и перекрестным синдромам – кахексии и немощности; показаны основные критерии диагностики, а также вопросы их дифференциации. Приводится разъяснение нового медицинского термина «остеосаркопения», обосновано исследование и оценка этого синдрома у пациентов с ХОБЛ.

Musculoskeletal disorders in patients with chronic obstructive pulmonary disease (COPD) were reviewed in the article. Main risk factors of osteoporosis and peripheral musculoskeletal dysfunction in those patients are smoking, low physical activity, chronic systemic inflammation, and treatment with glucocorticoids. Low levels of vitamin D could contribute to development and progression of musculoskeletal disorders in COPD patients. The authors described main diagnostic and differentiation criteria of sarcopenia and cachexia-frailty overlap syndrome. Recently, a new term "osteosarcopenia" is used and can also be applied to COPD patients.

хроническая обструктивная болезнь легкихостеопороздисфункция скелетных мышцмышечная атрофиякостная плотностьдвуэнергетическая рентгеновская абсорбциометрияостеопоротические переломыдефицит витамина Dсаркопениякахексиянемощностьглюкокортикостероидывоспалениеchronic obstructive pulmonary diseaseоsteoporosisskeletal muscle dysfunctionmuscle wastingbone densityabsorptiometryphotonfragility fracturesvitamin D deficiencysarcopeniacachexiafrailtyglucocorticoidsinflammationReferencesGlobal Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2018 Report. Available at: https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdfGlobal Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2018 Report. Available at: https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdfBarnes P.J., Celli B.R. Systemic manifestations and comorbidities of COPD. Eur. Respir. J. 2009; 33 (5): 1165–1185. DOI: 10.1183/09031936.00128008.Barnes P.J., Celli B.R. Systemic manifestations and comorbidities of COPD. Eur. Respir. J. 2009; 33 (5): 1165–1185. DOI: 10.1183/09031936.00128008.Parker C.M., Voduc N., Aaron S.D. et al. Physiological changes during symptom recovery from moderate exacerbations of COPD. Eur. Respir. J. 2005; 26 (3): 420–428. DOI: 10.1183/09031936.05.00136304.Parker C.M., Voduc N., Aaron S.D. et al. Physiological changes during symptom recovery from moderate exacerbations of COPD. Eur. Respir. J. 2005; 26 (3): 420–428. DOI: 10.1183/09031936.05.00136304.Jackman R.W., Kandarian S.C. The molecular basis of skeletal muscle atrophy. Am. J. Physiol. Cell Physiol. 2004; 287 (4): 834–843. DOI: 10.1152/ajpcell.00579.2003.Jackman R.W., Kandarian S.C. The molecular basis of skeletal muscle atrophy. Am. J. Physiol. Cell Physiol. 2004; 287 (4): 834–843. DOI: 10.1152/ajpcell.00579.2003.Fabbri L.M., Luppi F., Beghe B., Rabe K.F. Complex chronic comorbidities of COPD. Eur. Respir. J. 2008; 31 (1): 204–212. DOI: 10.1183/09031936.00114307.Fabbri L.M., Luppi F., Beghe B., Rabe K.F. Complex chronic comorbidities of COPD. Eur. Respir. J. 2008; 31 (1): 204–212. DOI: 10.1183/09031936.00114307.Jaramillo J.D., Wilson C., Stinson D.J. et al. Reduced bone density and vertebral fractures in smokers. Men and COPD patients at increased risk. Ann. Am. Thorac. Soc. 2015; 12 (5): 648–656. DOI: 10.1513/AnnalsATS.201412-591OC.Jaramillo J.D., Wilson C., Stinson D.J. et al. Reduced bone density and vertebral fractures in smokers. Men and COPD patients at increased risk. Ann. Am. Thorac. Soc. 2015; 12 (5): 648–656. DOI: 10.1513/AnnalsATS.201412-591OC.Leech J.A., Dulberg C., Kellie S. et al. Relationship of lung function to severity of osteoporosis in women. Am. Rev. Respir. Dis. 1990; 141 (1): 68–71. DOI: 10.1164/ajrccm/141.1.68.Leech J.A., Dulberg C., Kellie S. et al. Relationship of lung function to severity of osteoporosis in women. Am. Rev. Respir. Dis. 1990; 141 (1): 68–71. DOI: 10.1164/ajrccm/141.1.68.Lombardi I. Jr, Oliveira L.M., Mayer A.F. et al. Evaluation of pulmonary function and quality of life in women with osteoporosis. Osteoporos Int. 2005; 16 (10): 1247–1253. DOI: 10.1007/s00198-005-1834-3.Lombardi I. Jr, Oliveira L.M., Mayer A.F. et al. Evaluation of pulmonary function and quality of life in women with osteoporosis. Osteoporos Int. 2005; 16 (10): 1247–1253. DOI: 10.1007/s00198-005-1834-3.Bon J., Fuhrman C.R., Weissfeld J.L. et al. Radiographic emphysema predicts low bone mineral density in a tobacco-exposed cohort. Am. J. Respir. Crit. Care Med. 2011; 183 (7): 885–890. DOI: 10.1164/rccm.201004-0666OC.Bon J., Fuhrman C.R., Weissfeld J.L. et al. Radiographic emphysema predicts low bone mineral density in a tobacco-exposed cohort. Am. J. Respir. Crit. Care Med. 2011; 183 (7): 885–890. DOI: 10.1164/rccm.201004-0666OC.Jorgensen N.R., Schwarz P., Holme I. et al. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease – A cross sectional study. Respir. Med. 2007; 101 (1): 177–185. DOI: 10.1016/j.rmed.2006.03.029.Jorgensen N.R., Schwarz P., Holme I. et al. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease – A cross sectional study. Respir. Med. 2007; 101 (1): 177–185. DOI: 10.1016/j.rmed.2006.03.029.Baron J.A., Comi R.J., Cryns V. et al. The effect of cigarette smoking on adrenal cortical hormones. J. Pharmacol. Exp. Ther. 1995; 272 (1): 151–155.Baron J.A., Comi R.J., Cryns V. et al. The effect of cigarette smoking on adrenal cortical hormones. J. Pharmacol. Exp. Ther. 1995; 272 (1): 151–155.Kanis J.A., Johnell O., Oden A. et al. Smoking and fracture risk: a meta-analysis. Osteoporosis Int. 2005; 16 (2): 155–162. DOI: 10.1007/s00198-004-1640-3.Kanis J.A., Johnell O., Oden A. et al. Smoking and fracture risk: a meta-analysis. Osteoporosis Int. 2005; 16 (2): 155–162. DOI: 10.1007/s00198-004-1640-3.Law M.R., Hackshaw A.K. A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture; recognition of a major effect. Br. Med. J. 1997; 315 (7112): 841–846. DOI: 10.1136/bmj.315.7112.841.Law M.R., Hackshaw A.K. A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture; recognition of a major effect. Br. Med. J. 1997; 315 (7112): 841–846. DOI: 10.1136/bmj.315.7112.841.Nelson H.D., Nevitt M.C., Scott J.C. et al. Smoking, alcohol, and neuromuscular and physical function of older women. Study of Osteoporotic Fractures Research Group. JAMA. 1994; 272 (23): 1825–1831.Nelson H.D., Nevitt M.C., Scott J.C. et al. Smoking, alcohol, and neuromuscular and physical function of older women. Study of Osteoporotic Fractures Research Group. JAMA. 1994; 272 (23): 1825–1831.Biskobing D.M. COPD and osteoporosis. Chest. 2002; 121 (2): 609–620.Biskobing D.M. COPD and osteoporosis. Chest. 2002; 121 (2): 609–620.1983 metropolitan height and weight tables. Stat. Bull. Metrop. Life Found. 1983; 64 (1): 3–9.1983 metropolitan height and weight tables. Stat. Bull. Metrop. Life Found. 1983; 64 (1): 3–9.Schols A.M., Soeters P.B., Dingemans A.M. et al. Prevalence and characteristics of nutritional depletion in patients with stable COPD eligible for pulmonary rehabilitation. Am. Rev. Respir. Dis. 1993; 147 (5): 1151–1156. DOI: 10.1164/ajrccm/147.5.1151.Schols A.M., Soeters P.B., Dingemans A.M. et al. Prevalence and characteristics of nutritional depletion in patients with stable COPD eligible for pulmonary rehabilitation. Am. Rev. Respir. Dis. 1993; 147 (5): 1151–1156. DOI: 10.1164/ajrccm/147.5.1151.Jones A., Fay J.K., Burr M. et al. Inhaled corticosteroid effects on bone metabolism in asthma and mild chronic obstructive pulmonary disease. Сochrane Database Syst. Rev. 2002; (1): CD003537. DOI: 10.1002/14651858.CD003537.Jones A., Fay J.K., Burr M. et al. Inhaled corticosteroid effects on bone metabolism in asthma and mild chronic obstructive pulmonary disease. Сochrane Database Syst. Rev. 2002; (1): CD003537. DOI: 10.1002/14651858.CD003537.Jorgensen N.R., Schwarz P., Holme I. et al. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease: a cross sectional study. Respir. Med. 2007; 101 (1): 177–185. DOI: 10.1016/j.rmed.2006.03.029.Jorgensen N.R., Schwarz P., Holme I. et al. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease: a cross sectional study. Respir. Med. 2007; 101 (1): 177–185. DOI: 10.1016/j.rmed.2006.03.029.Jain R.K., Vokes T. Physical activity as measured by accelerometer in NHANES 2005–2006 is associated with better bone density and trabecular bone score in older adults. Arch. Osteoporos. 2019; 14: 29. DOI: 10.1007/s11657-019-0583-4.Jain R.K., Vokes T. Physical activity as measured by accelerometer in NHANES 2005–2006 is associated with better bone density and trabecular bone score in older adults. Arch. Osteoporos. 2019; 14: 29. DOI: 10.1007/s11657-019-0583-4.Le Jemtel T.H., Padeletti M., Jelic S. Diagnostic and therapeutic challenges in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure. J. Am. Coll. Cardiol. 2007; 49 (2): 171–180. DOI: 10.1016/j.jacc.2006.08.046.Le Jemtel T.H., Padeletti M., Jelic S. Diagnostic and therapeutic challenges in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure. J. Am. Coll. Cardiol. 2007; 49 (2): 171–180. DOI: 10.1016/j.jacc.2006.08.046.Adler R.A., Funkhouser H.L., Petkov V.I. et al. Osteoporosis in pulmonary clinic patients. Does point-of-care screening predict central dual-energy X-ray absorptiometry? Chest. 2003; 123 (6): 2012–2018.Adler R.A., Funkhouser H.L., Petkov V.I. et al. Osteoporosis in pulmonary clinic patients. Does point-of-care screening predict central dual-energy X-ray absorptiometry? Chest. 2003; 123 (6): 2012–2018.Mannino D.M., Buist A.S. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007; 370 (9589): 765–773. DOI: 10.1016/S0140-6736(07)61380-4.Mannino D.M., Buist A.S. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007; 370 (9589): 765–773. DOI: 10.1016/S0140-6736(07)61380-4.Москаленко В.Д. Медицинские последствия наркомании и алкоголизма. Наркология. 2007. (7): 52–54.Moskalenko V.D. [Medical consequences of alcohol and drug abuse]. Narkologiya. 2007. (7): 52–54 (in Russian).Sisson J.H. Alcohol and airways function in health and disease. Alcohol. 2007; 41 (5): 293–307. DOI: 10.1016/j.alcohol.2007.06.003.Sisson J.H. Alcohol and airways function in health and disease. Alcohol. 2007; 41 (5): 293–307. DOI: 10.1016/j.alcohol.2007.06.003.Maurer D.R., Liebman J. Effects of ethanol on in vitro ciliary motility. J. Appl. Physiol. 1985; 65 (4): 1617–2000. DOI: 10.1152/jappl.1988.65.4.1617.Maurer D.R., Liebman J. Effects of ethanol on in vitro ciliary motility. J. Appl. Physiol. 1985; 65 (4): 1617–2000. DOI: 10.1152/jappl.1988.65.4.1617.Лесняк О.М., Евстигнеева Л.П., Кузьмина Л.И. и др. Эпидемиология переломов позвоночника и периферических костей в старших возрастных группах жителей г. Екатеринбурга. Остеопороз и остеопатии. 1999; (2): 2–4.Lesnyak O.M., Evstigneeva L.P., Kuz'mina L.I. et al. [Epidemiology of spine and bone fractures in elderly at Ekaterinburg]. Osteoporoz i osteopatii. 1999; (2): 2–4 (in Russian).Евстигнеева Л.П., Лесняк О.М., Пивень А.И. Эпидемиология остеопоротических переломов позвоночника по данным рентгеноморфометрического анализа среди популяционной выборки жителей г. Екатеринбурга 50 лет и старше. Остеопороз и остеопатии. 2001; (2): 2–6.Evstigneeva L.P., Lesnyak O.M., Piven' A.I. [Epidemiology of osteoporotic spine fractures according to radiomorphological analysis in subjects of > 50 years old at Ekaterinburg]. Osteoporoz i osteopatii. 2001; (2): 2–6 (in Russian).Торопцова Н.В., Баранова И.А. Глюкокортикоидный остеопороз: особенности терапии. Современная ревматология. 2013; 7 (4): 33–37. DOI: 10.14412/1996-7012-2013-2436.Toroptsova N.V., Baranova I.A. [Therapy of steroid-induced osteoporosis]. Sovremennaya revmatologiya. 2013; 7 (4): 33–37. DOI: 10.14412/1996-7012-2013-2436 (in Russian).Lukert B.P., Johnson B.E., Robinson R.G. Estrogen and progesterone replacement therapy reduces glucocorticoid-induced bone loss. J. Bone Miner. Res. 1992; 7 (9): 1063–1069. DOI: 10.1002/jbmr.5650070909.Lukert B.P., Johnson B.E., Robinson R.G. Estrogen and progesterone replacement therapy reduces glucocorticoid-induced bone loss. J. Bone Miner. Res. 1992; 7 (9): 1063–1069. DOI: 10.1002/jbmr.5650070909.Laan R.F., van Riel P.L., van de Putte L.B. et al. Low-dose prednisone induces rapid reversible axial bone loss in patients with rheumatoid arthritis. A randomized, controlled study. Ann. Intern. Med. 1993; 119 (10): 963–968.Laan R.F., van Riel P.L., van de Putte L.B. et al. Low-dose prednisone induces rapid reversible axial bone loss in patients with rheumatoid arthritis. A randomized, controlled study. Ann. Intern. Med. 1993; 119 (10): 963–968.Van Staa T.P., Leufkens H.G., Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int. 2002; 13 (10): 777–787. DOI: 10.1007/s001980200108.Van Staa T.P., Leufkens H.G., Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int. 2002; 13 (10): 777–787. DOI: 10.1007/s001980200108.Kanis J.A., Johansson H., Oden A. et al. Meta-analysis of prior corticosteroid use and fracture risk. J. Bone Miner. Res. 2004; 19 (6): 893–899. DOI: 10.1359/JBMR.040134.Kanis J.A., Johansson H., Oden A. et al. Meta-analysis of prior corticosteroid use and fracture risk. J. Bone Miner. Res. 2004; 19 (6): 893–899. DOI: 10.1359/JBMR.040134.Holick M.F., Binkley N.C., Bischoff-Ferrari H.A. et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2011; 96 (7): 1911–1930. DOI: 10.1210/jc.2011-0385.Holick M.F., Binkley N.C., Bischoff-Ferrari H.A. et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2011; 96 (7): 1911–1930. DOI: 10.1210/jc.2011-0385.Lips P. Vitamin D physiology. Prog. Biophys. Mol. Biol. 2006; 92 (1): 4–8. DOI: 10.1016/j.pbiomolbio.2006.02.016.Lips P. Vitamin D physiology. Prog. Biophys. Mol. Biol. 2006; 92 (1): 4–8. DOI: 10.1016/j.pbiomolbio.2006.02.016.Janssens W., Lehouck A., Carremans C. et al. Vitamin D beyond bones in chronic obstructive pulmonary disease. Time to act. Am. J. Respir. Crit. Care Med. 2009; 179 (8): 630–636. DOI: 10.1164/rccm.200810-1576PP.Janssens W., Lehouck A., Carremans C. et al. Vitamin D beyond bones in chronic obstructive pulmonary disease. Time to act. Am. J. Respir. Crit. Care Med. 2009; 179 (8): 630–636. DOI: 10.1164/rccm.200810-1576PP.Hughes D.A., Norton R. Vitamin D and respiratory health. Clin. Exp. Immunol. 2009; 158 (1): 20–25. DOI: 10.1111/j.1365-2249.2009.04001.x.Hughes D.A., Norton R. Vitamin D and respiratory health. Clin. Exp. Immunol. 2009; 158 (1): 20–25. DOI: 10.1111/j.1365-2249.2009.04001.x.Quint J.K., Wedzicha J.A. Is vitamin D deficiency important in the natural history of COPD? Thorax. 2010; 65 (3): 192–194. DOI: 10.1136/thx.2009.129619.Quint J.K., Wedzicha J.A. Is vitamin D deficiency important in the natural history of COPD? Thorax. 2010; 65 (3): 192–194. DOI: 10.1136/thx.2009.129619.Ginde A.A., Mansbach J.M., Camargo C.A. Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the third national health and nutrition examination survey. Arch. Intern. Med. 2009; 169 (4): 384–390. DOI: 10.1001/archinternmed.2008.560.Ginde A.A., Mansbach J.M., Camargo C.A. Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the third national health and nutrition examination survey. Arch. Intern. Med. 2009; 169 (4): 384–390. DOI: 10.1001/archinternmed.2008.560.Geusens P., Goldring S.R., Briot K., Roux С. Chapter 11 – The role of the immune system in the development of osteoporosis and fracture risk. In: Lorenzo J., ed. Osteoimmunology: Interactions of the Immune and Skeletal Systems. The 2nd Edition. 2016: 187–214. DOI: 10.1016/B978-0-12-800571-2.00011-6.Geusens P., Goldring S.R., Briot K., Roux С. Chapter 11 - The role of the immune system in the development of osteoporosis and fracture risk. In: Lorenzo J., ed. Osteoimmunology: Interactions of the Immune and Skeletal Systems. The 2nd Edition. 2016: 187–214. DOI: 10.1016/B978-0-12-800571-2.00011-6.Баранова И.А., Торопцова Н.В. Новые аспекты в диагностике и лечении глюкокортикоидного остеопороза. Остеопороз и остеопании. 2013; 16 (3): 36–40.Baranova I.A., Toroptsova N.V. [New aspects in diagnosis and treatment of steroid-induced osteoporosis]. Osteoporoz i osteopanii. 2013; 16 (3): 36–40 (in Russian).Maltais F., Decramer M., Casaburi R. et al. An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2014; 189 (9): е15–62. DOI: 10.1164/rccm.201402-0373ST.Maltais F., Decramer M., Casaburi R. et al. An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2014; 189 (9): е15–62. DOI: 10.1164/rccm.201402-0373ST.Seymour J.M., Spruit M.A., Hopkinson N.S. et al. The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur. Respir. J. 2010; 36 (1): 81–88. DOI: 10.1183/09031936.00104909.Seymour J.M., Spruit M.A., Hopkinson N.S. et al. The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur. Respir. J. 2010; 36 (1): 81–88. DOI: 10.1183/09031936.00104909.Spruit M.A., Gosselink R., Troosters T. et al. Muscle force during an acute exacerbation in hospitalised patients with COPD and its relationship with CXCL8 and IGF-I. Thorax. 2003; 58 (9): 752–756.Spruit M.A., Gosselink R., Troosters T. et al. Muscle force during an acute exacerbation in hospitalised patients with COPD and its relationship with CXCL8 and IGF-I. Thorax. 2003; 58 (9): 752–756.Vilaro´ J., Ramirez-Sarmiento A., Mart´ınez-Llorens J.M. et al. Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations. Respir. Med. 2010; 104 (12): 1896–1902. DOI: 10.1016/j.rmed.2010.05.001.Vilaro´ J., Ramirez-Sarmiento A., Mart´ınez-Llorens J.M. et al. Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations. Respir. Med. 2010; 104 (12): 1896–1902. DOI: 10.1016/j.rmed.2010.05.001.Yun Z., Lin Q., Giaccia A.J. Adaptive myogenesis under hypoxia. Mol. Cell. Biol. 2005; 25 (8): 3040–3055. DOI: 10.1128/MCB.25.8.3040-3055.2005.Yun Z., Lin Q., Giaccia A.J. Adaptive myogenesis under hypoxia. Mol. Cell. Biol. 2005; 25 (8): 3040–3055. DOI: 10.1128/MCB.25.8.3040-3055.2005.England B.K., Chastain J.L., Mitch W.E. Abnormalities in protein synthesis and degradation induced by extracellular pH in BC3H1 myocytes. Am. J. Physiol. 1991; 260 (2): 277–282. DOI: 10.1152/ajpcell.1991.260.2.C277.England B.K., Chastain J.L., Mitch W.E. Abnormalities in protein synthesis and degradation induced by extracellular pH in BC3H1 myocytes. Am. J. Physiol. 1991; 260 (2): 277–282. DOI: 10.1152/ajpcell.1991.260.2.C277.Decramer M., de Bock V., Dom R. Functional and histologic picture of steroid-induced myopathy in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 1996; 153 (6, Pt 1): 1958–1964. DOI: 10.1164/ajrccm.153.6.8665061.Decramer M., de Bock V., Dom R. Functional and histologic picture of steroid-induced myopathy in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 1996; 153 (6, Pt 1): 1958–1964. DOI: 10.1164/ajrccm.153.6.8665061.Schakman O., Gilson H., Kalista S., Thissen J.P. Mechanisms of muscle atrophy induced by glucocorticoids. Horm. Res. 2009; 72 (Suppl. 1): 36–41. DOI: 10.1159/000229762.Schakman O., Gilson H., Kalista S., Thissen J.P. Mechanisms of muscle atrophy induced by glucocorticoids. Horm. Res. 2009; 72 (Suppl. 1): 36–41. DOI: 10.1159/000229762.Sohl E., van Schoor N.M., de Jongh R.T. et al. Vitamin D status is associated with functional limitations and functional decline in older individuals. J. Clin. Endocrinol. Metab. 2013; 98 (9): 1483–1490. DOI: 10.1210/jc.2013-1698.Sohl E., van Schoor N.M., de Jongh R.T. et al. Vitamin D status is associated with functional limitations and functional decline in older individuals. J. Clin. Endocrinol. Metab. 2013; 98 (9): 1483–1490. DOI: 10.1210/jc.2013-1698.Evans W.J., Morley J.E., Argilés J. et al. Cachexia: a new definition. Clin. Nutr. 2008; 27 (6): 793–799. DOI: 10.1016/j.clnu.2008.06.013.Evans W.J., Morley J.E., Argilés J. et al. Cachexia: a new definition. Clin. Nutr. 2008; 27 (6): 793–799. DOI: 10.1016/j.clnu.2008.06.013.Fried L.P., Tangen C.M., Walston J. et al. Frailty in older adults: Evidence for a phenotype. J. Gerontol. 2001; 56A (3): M146–M156.Fried L.P., Tangen C.M., Walston J. et al. Frailty in older adults: Evidence for a phenotype. J. Gerontol. 2001; 56A (3): M146–M156.Cruz-Jentoft A.J., Bahat G., Bauer J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019; 48 (1): 16–31. DOI: 10.1093/ageing/afy169.Cruz-Jentoft A.J., Bahat G., Bauer J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019; 48 (1): 16–31. DOI: 10.1093/ageing/afy169.Jones S.E., Maddocks M., Kon S.S.C. et al. Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax. 2015; 70 (3): 213–218. DOI: 10.1136/thoraxjnl-2014-206440.Jones S.E., Maddocks M., Kon S.S.C. et al. Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax. 2015; 70 (3): 213–218. DOI: 10.1136/thoraxjnl-2014-206440.Maddocks M., Kon S.S.С., Canavan J.L. et al. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study. Thorax. 2016; 71 (11): 988–995. DOI: 10.1136/thoraxjnl-2016-208460.Maddocks M., Kon S.S.С., Canavan J.L. et al. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study. Thorax. 2016; 71 (11): 988–995. DOI: 10.1136/thoraxjnl-2016-208460.Walsh M.C., Hunter G.R., Livingstone M.B. Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density. Osteoporosis Int. 2006; 17 (1): 61–67. DOI: 10.1007/s00198-005-1900-x.Walsh M.C., Hunter G.R., Livingstone M.B. Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density. Osteoporosis Int. 2006; 17 (1): 61–67. DOI: 10.1007/s00198-005-1900-x.Demontiero O., Boersma D., Suriyaarachchi P., DuqueG. Clinical outcomes of impaired muscle and bone interactions. Clin. Rev. Bone Miner. Metab. 2014; 12 (2): 86–92. DOI: 10.1007/s12018-014-9164-7.Demontiero O., Boersma D., Suriyaarachchi P., DuqueG. Clinical outcomes of impaired muscle and bone interactions. Clin. Rev. Bone Miner. Metab. 2014; 12 (2): 86–92. DOI: 10.1007/s12018-014-9164-7.Mera P., Laue K., Ferron M. et al. Osteocalcin signaling in myofibers is necessary and sufficient for optimum adaptation to exercise. Cell Metab. 2016; 23 (6): 1078–1092. DOI: 10.1016/j.cmet.2016.05.004.Mera P., Laue K., Ferron M. et al. Osteocalcin signaling in myofibers is necessary and sufficient for optimum adaptation to exercise. Cell Metab. 2016; 23 (6): 1078–1092. DOI: 10.1016/j.cmet.2016.05.004.Tagliaferri C., Wittrant Y., Davicco M.J. et al. Muscle and bone, two interconnected tissues. Ageing Res. Rev. 2015; 21: 55–70. DOI: 10.1016/j.arr.2015.03.002.Tagliaferri C., Wittrant Y., Davicco M.J. et al. Muscle and bone, two interconnected tissues. Ageing Res. Rev. 2015; 21: 55–70. DOI: 10.1016/j.arr.2015.03.002.

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