The problem of sarcopenia in postmenopausal women. Prevention opportunities


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Abstract

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.

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About the authors

Elena A. Sandakova

Academician E.A. Vagner Perm State Medical University, Ministry of Health of Russia

Email: selena11perm@yandex.ru
Dr. Med. Sci., Professor, Head of Obstetrics and Gynaecology Department №2

Inna G. Zhukovskaya

Izhevsk State Medical Academy, Ministry of Health of Russia

Email: zhoukovskaya@mail.ru
Dr. Med. Sci., Associate Professor of Obstetrics and Gynaecology Department

Ekaterina P. Timofeeva

Academician E.A. Vagner Perm State Medical University, Ministry of Health of Russia

Email: kate77tim@mail.ru
5th year student

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