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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">diaendo</journal-id><journal-title-group><journal-title xml:lang="ru">Сахарный диабет</journal-title><trans-title-group xml:lang="en"><trans-title>Diabetes mellitus</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-0351</issn><issn pub-type="epub">2072-0378</issn><publisher><publisher-name>Endocrinology research centre</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14341/DM13462</article-id><article-id custom-type="elpub" pub-id-type="custom">diaendo-13462</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Саркопения у пациенток с сахарным диабетом 1 типа в постменопаузе: характеристика функциональных, лабораторных и инструментальных показателей</article-title><trans-title-group xml:lang="en"><trans-title>Sarcopenia in postmenopausal patients with type 1 diabetes mellitus: characteristics of functional, laboratory, and instrumental indicators</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2948-5019</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жданова</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhdanova</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Жданова Анастасия Станиславовна, аспирант</p><p>117036, г. Москва, ул. Дмитрия Ульянова, д. 11 </p></bio><bio xml:lang="en"><p>Anastasiia S. Zhdanova, PhD student</p><p>11 Dmitria Uljanova street, 117292 Moscow</p></bio><email xlink:type="simple">zhdanova.a.doc@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6674-6441</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белая</surname><given-names>Ж. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Belaya</surname><given-names>Z. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Белая Жанна Евгеньевна, д.м.н., профессор</p><p>Москва</p></bio><bio xml:lang="en"><p>Zhanna E. Belaya, MD, PhD, Professor</p><p>Moscow</p></bio><email xlink:type="simple">jannabelaya@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3433-0142</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шамхалова</surname><given-names>М. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Shamkhalova</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шамхалова Минара Шамхаловна, д.м.н. </p><p>Москва</p></bio><bio xml:lang="en"><p>Minara S. Shamkhalova, MD, PhD</p><p>Moscow</p></bio><email xlink:type="simple">shamkhalova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3628-2102</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Русяева</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rusyaeva</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Русяева Надежда Владимировна, к.м.н. </p><p>Researcher ID: AAY-6365-2021</p><p>Scopus Author ID: 57220024968</p><p>Москва</p></bio><bio xml:lang="en"><p>Nadezhda V. Rusyaeva, MD, PhD</p><p>Moscow</p></bio><email xlink:type="simple">nadshul@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-6670-5671</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жданова</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhdanova</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Жданова Анастасия Андреевна</p><p>Москва</p></bio><bio xml:lang="en"><p>Anastasia A. Zhdanova, MD</p><p>Moscow</p></bio><email xlink:type="simple">anastasia.zhdanova@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3838-8285</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Трубицына</surname><given-names>Н. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Trubitsyna</surname><given-names>N. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Трубицына Наталья Петровна, к.м.н., в.н.с. </p><p>Москва</p><p> </p></bio><bio xml:lang="en"><p>Natalia P. Trubitsyna, MD, PhD, leading research associate</p><p>Moscow</p></bio><email xlink:type="simple">trubicina@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3443-7206</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сухарева</surname><given-names>О. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Sukhareva</surname><given-names>O. Y.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сухарева Ольга Юрьевна, к.м.н., доцент </p><p>Москва</p></bio><bio xml:lang="en"><p>Olga Y. Sukhareva, MD, PhD, Associate Professor</p><p>Moscow</p></bio><email xlink:type="simple">olgasukhareva@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-8284-9072</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мироненков</surname><given-names>Д. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Mironenkov</surname><given-names>D. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мироненков Дмитрий Евгеньевич </p><p>Москва</p></bio><bio xml:lang="en"><p>Dmitrii E. Mironenkov, MD</p><p>Moscow</p></bio><email xlink:type="simple">dmitrii.mironenkov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3535-520X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ибрагимова</surname><given-names>Л. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Ibragimova</surname><given-names>L. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ибрагимова Людмила Ибрагимовна, к.м.н. </p><p>Москва</p></bio><bio xml:lang="en"><p>Liudmila I. Ibragimova, MD, PhD</p><p>Moscow</p></bio><email xlink:type="simple">ibragimovaliudmila@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0394-6913</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мельникова</surname><given-names>О. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Melnikova</surname><given-names>O. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мельникова Ольга Георгиевна, к.м.н., в.н.с.</p><p>Москва</p></bio><bio xml:lang="en"><p>Olga G. Melnikova, MD, PhD, leading research associate</p><p>Moscow</p></bio><email xlink:type="simple">melnikova.olga@endocrincentr.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5033-2412</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шмидт</surname><given-names>О. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Schmidt</surname><given-names>O. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шмидт Ольга Марковна</p><p>Москва</p></bio><bio xml:lang="en"><p>Olga M. Schmidt, MD</p><p>Moscow</p></bio><email xlink:type="simple">olga_shm@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1120-8240</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Никанкина</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Nikankina</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Никанкина Лариса Вячеславовна, к.м.н. </p><p>Москва</p></bio><bio xml:lang="en"><p>Larisa V. Nikankina, MD, PhD</p><p>Moscow</p></bio><email xlink:type="simple">larisa.nikankina@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-3273-6930</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Слепцова</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Sleptsova</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Слепцова Арина Игоревна</p><p>Москва</p></bio><bio xml:lang="en"><p>Arina I. Sleptsova</p><p>Moscow</p></bio><email xlink:type="simple">sleptsova.arina@endocrincentr.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-5158-7149</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гунькина</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Gunkina</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гунькина Виктория Викторовна</p><p>Москва</p></bio><bio xml:lang="en"><p>Victoria V. Gunkina, MD</p><p>Moscow</p></bio><email xlink:type="simple">vikou@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5634-7877</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мельниченко</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Melnichenko</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мельниченко Галина Афанасьевна, д.м.н., профессор, академик РАН</p><p>Москва</p></bio><bio xml:lang="en"><p>Galina A. Melnichenko, MD, PhD, Academician of the RAS</p><p>Moscow</p></bio><email xlink:type="simple">teofrast2000@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГНЦ РФ ФГБУ «Национальный медицинский исследовательский центр эндокринологии им. академика И.И. Дедова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Endocrinology Research Centre</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>26</day><month>07</month><year>2026</year></pub-date><volume>29</volume><issue>3</issue><fpage>245</fpage><lpage>255</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Жданова А.С., Белая Ж.Е., Шамхалова М.Ш., Русяева Н.В., Жданова А.А., Трубицына Н.П., Сухарева О.Ю., Мироненков Д.Е., Ибрагимова Л.И., Мельникова О.Г., Шмидт О.М., Никанкина Л.В., Слепцова А.И., Гунькина В.В., Мельниченко Г.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Жданова А.С., Белая Ж.Е., Шамхалова М.Ш., Русяева Н.В., Жданова А.А., Трубицына Н.П., Сухарева О.Ю., Мироненков Д.Е., Ибрагимова Л.И., Мельникова О.Г., Шмидт О.М., Никанкина Л.В., Слепцова А.И., Гунькина В.В., Мельниченко Г.А.</copyright-holder><copyright-holder xml:lang="en">Zhdanova A.S., Belaya Z.E., Shamkhalova M.S., Rusyaeva N.V., Zhdanova A.A., Trubitsyna N.P., Sukhareva O.Y., Mironenkov D.E., Ibragimova L.I., Melnikova O.G., Schmidt O.M., Nikankina L.V., Sleptsova A.I., Gunkina V.V., Melnichenko G.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.dia-endojournals.ru/jour/article/view/13462">https://www.dia-endojournals.ru/jour/article/view/13462</self-uri><abstract><sec><title>ОБОСНОВАНИЕ</title><p>ОБОСНОВАНИЕ. Пациенты с сахарным диабетом 1 типа (СД1) подвержены более раннему развитию саркопении под влиянием дефицита инсулина, гипергликемии, оксидативного стресса и митохондриальной дисфункции. Актуальной задачей в ведении таких пациентов является поиск стандартизированных диагностических инструментов для своевременного выявления и мониторинга саркопении.</p></sec><sec><title>ЦЕЛЬ</title><p>ЦЕЛЬ. Сравнительная оценка лабораторных уровней миокинов сыворотки крови в сопоставлении с показателями мышечной массы, силы и функции у пациенток с СД1 и лиц контрольной группы без СД в постменопаузе.</p></sec><sec><title>МАТЕРИАЛЫ И МЕТОДЫ</title><p>МАТЕРИАЛЫ И МЕТОДЫ. Проведено одноцентровое одномоментное сравнительное исследование женщин с СД1 (n=40) и группы контроля (n=40) в возрасте 50–75 лет. Оценивались результаты анкетирования по SARC-F, лабораторные показатели (миостатин, фоллистатин, цистатин С, липокалин 2, ИФР-1, гликированный гемоглобин (HbA1c)), мышечная масса (денситометрия iDXA), сила (кистевая динамометрия) и функция (краткая физическая батарея). Статистическая обработка выполнена в программах Statistica 14.0.0.15, IBM SPSS Statistics 23 с использованием критериев Манна-Уитни, Фишера, корреляции Спирмена.</p></sec><sec><title>РЕЗУЛЬТАТЫ</title><p>РЕЗУЛЬТАТЫ. Возраст пациенток составил 60 [56; 64] лет в группе СД1 и 64 [60; 66] года в группе контроля (р=0,029). HbA1c в группе СД1 составил 8,0% [7,6; 9,3] при длительности диабета 26 [13; 42] лет. Уровень миостатина был значимо выше при СД1 52,73 [46,45; 58,26] мг/мл против 21,46 [19,07; 24,74] в контроле (р&lt;0,001) и положительно коррелировал с HbA1c (r=0,544, р&lt;0,001), но не с показателями мышечной силы и массы. HbA1c отрицательно коррелировал со временем 5-кратного вставания со стула. По уровню фоллистатина, липокалина 2, цистатина С различий не выявлено. Сила кистевой динамометрии и скорость ходьбы с тенденцией к статистической значимости были ниже в группе СД1. Медиана ИФР-1 была ниже при СД1 (92,7 vs 114,1 нг/мл, р=0,014) и положительно коррелировала с мышечной силой (r=0,472, р&lt;0,001). Индекс саркопении отрицательно коррелировал с мышечной силой (r=-0,402, р=0,021) и положительно с HbA1c (r=0,514, р=0,035). Тяжелая саркопения (по EWGSOP2) диагностирована только у одной пациентки с СД1, уровень миостатина у которой не отличался от диапазона пациентов без саркопении.</p></sec><sec><title>ЗАКЛЮЧЕНИЕ</title><p>ЗАКЛЮЧЕНИЕ. Пациенты с СД1 имеют более высокие значения миостатина, что коррелирует с уровнем HbA1c,. Низкие функциональные возможности пациентов с СД1 связаны с показателем HbA1c, но не имеют прямой связи с уровнем миостатина.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>BACKGROUND</title><p>BACKGROUND. Patients with type 1 diabetes mellitus (T1DM) are prone to earlier development of sarcopenia due to insulin deficiency, hyperglycemia, oxidative stress, and mitochondrial dysfunction. A pressing challenge in the  management of these patients is the search for standardized diagnostic tools for the timely detection and monitoring of sarcopenia.</p></sec><sec><title>OBJECTIVE</title><p>OBJECTIVE. Comparative assessment of laboratory serum myokine levels in relation to muscle mass, strength, and function in postmenopausal women with type 1 diabetes and controls without diabetes.</p></sec><sec><title>MATERIALS AND METHODS</title><p>MATERIALS AND METHODS. A single-center, cross-sectional comparative study was conducted in women with type 1 diabetes (n=40) and a control group (n=40) aged 50–75 years. The SARC-F questionnaire, laboratory parameters (myostatin, follistatin, cystatin C, lipocalin 2, IGF-1), muscle mass (iDXA densitometry), strength (wrist dynamometry), and function (short-form exercise battery) were assessed. Statistical processing was performed in Statistica 14.0.0.15, IBM SPSS Statistics 23 using the Mann-Whitney, Fisher, and Spearman correlation tests.</p></sec><sec><title>RESULTS</title><p>RESULTS. The age of the patients was 60 [56;64] years in the T1DM group and 64 [60;66] years in the control group (p=0.029). Glycated hemoglobin (HbA1c) in the T1DM group was 8.0% [7.6;9.3] with a diabetes duration of 26 [13;42] years. The myostatin level was significantly higher in T1DM 52.73 [46.45;58.26] mg/ml versus 21.46 [19.07;24.74] in the control (p &lt; 0.001) and positively correlated with HbA1c (r=0.544, p &lt; 0.001), but not with muscle strength and mass. HbA1c negatively correlated with the time it took to get up from a chair 5 times. No differences were found in the levels of follistatin, lipocalin 2, cystatin C. Wrist dynamometry strength and walking speed were lower in the T1DM group with a tendency to statistical significance. The median IGF-1 was lower in diabetes (92.7 vs. 114.1 ng/ml, p=0.014) and positively correlated with muscle strength (r=0.472, p &lt; 0.001). The sarcopenia index negatively correlated with muscle strength (r=-0.402, p=0.021) and positively with HbA1c (r=0.514, p=0.035). Severe sarcopenia (according to EWGSOP2) was diagnosed in only one patient with T1DM, whose myostatin level did not differ from the range of patients without sarcopenia.</p></sec><sec><title>CONCLUSION</title><p>CONCLUSION. Thus, patients with type 1 diabetes have higher myostatin levels, which correlates with with the level of HbA1c. Low functional capacity in patients with type 1 diabetes is associated with HbA1c levels, but is not directly related to myostatin levels.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>саркопения</kwd><kwd>мышечная сила</kwd><kwd>сахарный диабет 1 типа</kwd><kwd>миостатин</kwd><kwd>фоллистатин</kwd><kwd>липокалин 2</kwd></kwd-group><kwd-group xml:lang="en"><kwd>sarcopenia</kwd><kwd>muscle strength</kwd><kwd>type 1 diabetes mellitus</kwd><kwd>myostatin</kwd><kwd>follistatin</kwd><kwd>lipocalin 2</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена в рамках государственного задания №124020700097-8. Работа выполнена с использованием материалов Уникальной научной установки «Коллекция биологического материала пациентов с эндокринными патологиями» ГНЦ РФ ФГБУ «НМИЦ эндокринологии им. академика И.И. 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