Cruz-Jentoft Alfonso J, Landi Francesco, Schneider Stéphane M, Zúñiga Clemente, Arai Hidenori, Boirie Yves, Chen Liang-Kung, Fielding Roger A, Martin Finbarr C, Michel Jean-Pierre, Sieber Cornel, Stout Jeffrey R, Studenski Stephanie A, Vellas Bruno, Woo Jean, Zamboni Mauro, Cederholm Tommy
Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Ctra. Colmenar km 9, 1, 28034 Madrid, Spain.
Istituto di Medicina Interna e Geriatria, Università Cattolica del Sacro Cuore, Rome, Italy.
Age Ageing. 2014 Nov;43(6):748-59. doi: 10.1093/ageing/afu115. Epub 2014 Sep 21.
to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP).
PubMed and Dialog databases were searched (January 2000-October 2013) using pre-defined search terms. Prevalence studies and intervention studies investigating muscle mass plus strength or function outcome measures using the EWGSOP definition of sarcopenia, in well-defined populations of adults aged ≥50 years were selected.
prevalence of sarcopenia was, with regional and age-related variations, 1-29% in community-dwelling populations, 14-33% in long-term care populations and 10% in the only acute hospital-care population examined. Moderate quality evidence suggests that exercise interventions improve muscle strength and physical performance. The results of nutrition interventions are equivocal due to the low number of studies and heterogeneous study design. Essential amino acid (EAA) supplements, including ∼2.5 g of leucine, and β-hydroxy β-methylbutyric acid (HMB) supplements, show some effects in improving muscle mass and function parameters. Protein supplements have not shown consistent benefits on muscle mass and function.
prevalence of sarcopenia is substantial in most geriatric settings. Well-designed, standardised studies evaluating exercise or nutrition interventions are needed before treatment guidelines can be developed. Physicians should screen for sarcopenia in both community and geriatric settings, with diagnosis based on muscle mass and function. Supervised resistance exercise is recommended for individuals with sarcopenia. EAA (with leucine) and HMB may improve muscle outcomes.
通过使用老年人肌少症欧洲工作组(EWGSOP)提出的肌少症共识定义的研究,来审视报告肌少症患病率以及营养和运动干预效果的临床证据。
使用预定义的搜索词检索PubMed和Dialog数据库(2000年1月至2013年10月)。选择在明确界定的≥50岁成年人群体中,采用EWGSOP肌少症定义调查肌肉量加力量或功能结局指标的患病率研究和干预研究。
肌少症的患病率因地区和年龄而异,在社区居住人群中为1% - 29%,在长期护理人群中为14% - 33%,在所研究的唯一急性医院护理人群中为10%。中等质量的证据表明运动干预可改善肌肉力量和身体表现。由于研究数量少且研究设计各异,营养干预的结果不明确。必需氨基酸(EAA)补充剂(包括约2.5克亮氨酸)和β - 羟基 - β - 甲基丁酸(HMB)补充剂在改善肌肉量和功能参数方面显示出一些效果。蛋白质补充剂在肌肉量和功能方面未显示出一致的益处。
在大多数老年环境中,肌少症的患病率很高。在制定治疗指南之前,需要设计良好、标准化的研究来评估运动或营养干预。医生应在社区和老年环境中筛查肌少症,诊断基于肌肉量和功能。建议对肌少症患者进行有监督的抗阻运动。EAA(含亮氨酸)和HMB可能改善肌肉结局。