Inserm U558, University of Toulouse III, France.
Curr Opin Clin Nutr Metab Care. 2011 Jan;14(1):15-21. doi: 10.1097/MCO.0b013e328340c2c2.
The review summarizes and discusses the proposed new definitions for sarcopenia and cachexia. It also highlights the overlapping of both conditions and the fact that these conditions frequently occur in elderly patients.
Sarcopenia is now recognized as a multifactorial geriatric syndrome. Cachexia is defined as a metabolic syndrome in which inflammation is the key feature and so cachexia can be an underlying condition of sarcopenia. Recently, cachexia has been defined as 'a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle mass with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss in adults'. Different recommendations have been proposed for the diagnosis of sarcopenia. At present, all definitions combine an assessment of muscle mass and muscle function (strength or physical performances such as gait speed). However, the relevance and the validation of these evolving definitions need to be assessed in future studies.
Although the recent definitions of sarcopenia and cachexia boost research in the field and define distinct entities, the cause behind the loss of muscle mass (whether cachexia or sarcopenia) may, however, be indistinguishable in clinical practice. Therefore, new therapeutic approaches, alone or in combination, could be targeted on both conditions.
本文总结并讨论了目前提出的肌少症和恶病质的新定义。文中还强调了这两种情况的重叠性,以及这些情况在老年患者中经常同时出现的事实。
肌少症现在被认为是一种多因素的老年综合征。恶病质被定义为一种以炎症为关键特征的代谢综合征,因此恶病质可能是肌少症的潜在病因。最近,恶病质被定义为“一种与潜在疾病相关的复杂代谢综合征,其特征是肌肉质量下降,伴有或不伴有脂肪质量下降。恶病质的突出临床特征是成年人的体重减轻”。目前已经提出了不同的肌少症诊断建议。目前,所有的定义都将肌肉质量和肌肉功能(力量或步态速度等身体表现)的评估结合在一起。然而,这些不断发展的定义的相关性和验证仍需要在未来的研究中进行评估。
尽管肌少症和恶病质的最新定义推动了该领域的研究,并定义了不同的实体,但在临床实践中,导致肌肉质量下降的原因(无论是恶病质还是肌少症)可能难以区分。因此,新的治疗方法,无论是单独使用还是联合使用,都可以针对这两种情况。