Ali Sumbul, Garcia Jose M
Division of Diabetes, Endocrinology and Metabolism, MCL, Center for Translational Research in Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Tex., USA.
Gerontology. 2014;60(4):294-305. doi: 10.1159/000356760. Epub 2014 Apr 8.
By the year 2050, individuals over the age of 65 years will comprise 20% of the US population. Loss of muscle mass and strength is common in this age group and it is associated with increased dependence, frailty and mortality. Sarcopenia, defined as the loss of muscle mass and function associated with aging, and cachexia, defined as weight loss due to an underlying illness, are muscle wasting disorders of particular relevance in the aging population, but they go largely unrecognized. In this review we highlight the common pathophysiological mechanisms underlying muscle loss in sarcopenia and cachexia, the factors unique to each condition and means of diagnosing and differentiating them clinically. Therapeutic options including exercise, nutritional therapy, androgens and growth hormone as well as their practical limitations are discussed. We also shed light on newer agents being developed as potential therapeutic options for wasting diseases.
到2050年,65岁以上的人群将占美国人口的20%。肌肉质量和力量的丧失在这个年龄组中很常见,并且与依赖性增加、身体虚弱和死亡率上升有关。肌肉减少症,定义为与衰老相关的肌肉质量和功能丧失,以及恶病质,定义为由于潜在疾病导致的体重减轻,是老年人群中特别相关的肌肉萎缩性疾病,但它们在很大程度上未被认识到。在这篇综述中,我们强调了肌肉减少症和恶病质中肌肉丢失的常见病理生理机制、每种情况特有的因素以及临床诊断和区分它们的方法。讨论了包括运动、营养治疗、雄激素和生长激素在内的治疗选择及其实际局限性。我们还介绍了正在开发的作为消瘦性疾病潜在治疗选择的新型药物。