Division of Endocrinology, Diabetes, and Metabolism, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):412-9. doi: 10.1097/01.med.0000433071.11466.7f.
The increasing prevalence of sarcopenic obesity in older adults has heightened interest in identifying the most effective treatment. This review highlights recent progress in the management, with an emphasis on lifestyle interventions and pharmacologic therapy aimed at reversing sarcopenic obesity.
Whereas weight loss and exercise independently reverse sarcopenic obesity, they act synergistically in combination to improve body composition and physical function, beyond which is observed with either intervention alone. Optimizing protein intake appears to have beneficial effects on net muscle protein accretion in older adults. Myostatin inhibition is associated with favorable changes in body composition in animal studies, although experience in humans is relatively limited. Testosterone and growth hormone offer improvements in body composition, but the benefits must be weighed against potential risks of therapy. GHRH-analog therapy shows promise, but further studies are needed in older adults.
At present, lifestyle interventions incorporating both diet-induced weight loss and regular exercise appear to be the optimal treatment for sarcopenic obesity. Maintenance of adequate protein intake is also advisable. Ongoing studies will determine whether pharmacologic therapy such as myostatin inhibitors or GHRH analogs have a role in the treatment of sarcopenic obesity.
老年人中肌少症性肥胖的患病率不断增加，这使得人们对寻找最有效的治疗方法产生了浓厚的兴趣。本综述重点介绍了肌少症性肥胖治疗方面的最新进展，强调了生活方式干预和旨在逆转肌少症性肥胖的药物治疗。
虽然体重减轻和运动均可独立逆转肌少症性肥胖，但两者联合应用具有协同作用，可改善身体成分和身体功能，优于单独应用任何一种干预措施的效果。优化蛋白质摄入似乎对老年人的净肌肉蛋白合成有有益影响。肌肉生长抑制素抑制在动物研究中与身体成分的有利变化有关，但在人类中的经验相对有限。睾酮和生长激素可改善身体成分，但必须权衡治疗的潜在风险。生长激素释放激素类似物治疗显示出前景，但仍需要在老年人中进行更多的研究。
目前，包括饮食诱导的体重减轻和定期运动在内的生活方式干预似乎是肌少症性肥胖的最佳治疗方法。摄入足够的蛋白质也是明智的。正在进行的研究将确定肌肉生长抑制素抑制剂或生长激素释放激素类似物等药物治疗在肌少症性肥胖治疗中的作用。
