Dodds Richard, Sayer Avan Aihie
Academic Geriatric Medicine, School of Medicine, University of Southampton, Southampton, UK.
Arq Bras Endocrinol Metabol. 2014 Jul;58(5):464-9. doi: 10.1590/0004-273000000.
Sarcopenia, the loss of muscle mass and function with age, is highly relevant to clinical practice as it has been associated with a wide range of ageing outcomes including disability and shorter survival times. As such it is now a major focus for research and drug discovery. There has been recent progress in the development of consensus definitions for the diagnosis of sarcopenia, taking the form of measurements of muscle mass and strength or physical performance. These definitions form potential inclusion criteria for use in trials, although the optimum choice of outcome measures is less clear. Prevalence estimates using these new definitions vary, although they suggest that sarcopenia is a common (approximately 13% from one study) clinical problem in older people. A range of lifestyle factors have been investigated in regard to the development of this condition, and progressive resistance training is the most well-established intervention so far. There is also marked research interest in the role of diet, although so far the value of supplementation is less clear. Other potential treatments for sarcopenia include the angiotensin-converting enzyme inhibitors, with some evidence that they can improve physical performance in older people. Future research directions include an increased understanding of the molecular and cellular mechanisms of sarcopenia and the use of a life course approach to explore the possibility of earlier intervention and prevention.
肌肉减少症是指随着年龄增长肌肉质量和功能的丧失,它与临床实践高度相关,因为它与包括残疾和较短生存时间在内的一系列衰老后果有关。因此,它现在是研究和药物研发的主要重点。最近在肌肉减少症诊断的共识定义制定方面取得了进展,形式为肌肉质量、力量或身体表现的测量。这些定义构成了试验中潜在的纳入标准,尽管最佳结局指标的选择尚不清楚。使用这些新定义的患病率估计各不相同,不过它们表明肌肉减少症在老年人中是一个常见的(一项研究显示约为13%)临床问题。关于这种病症的发展,已经对一系列生活方式因素进行了研究,渐进性抗阻训练是迄今为止最成熟的干预措施。对饮食的作用也有显著的研究兴趣,尽管到目前为止补充剂的价值尚不清楚。肌肉减少症的其他潜在治疗方法包括血管紧张素转换酶抑制剂,有一些证据表明它们可以改善老年人的身体表现。未来的研究方向包括更深入地了解肌肉减少症的分子和细胞机制,以及采用生命历程方法来探索早期干预和预防的可能性。