Hollingworth Thomas William, Oke Siddhartha M, Patel Harnish, Smith Trevor R
Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
Department of Gastroenterology, Saint Mark's Hospital, Harrow, London, UK.
Frontline Gastroenterol. 2020 Jan 20;12(1):53-61. doi: 10.1136/flgastro-2019-101348. eCollection 2021.
Sarcopenia is a progressive and generalised disorder of skeletal muscle strength, function and mass, that is most commonly associated with the normal ageing process. It is increasingly recognised that sarcopenia can also develop as a consequence of malabsorptive and inflammatory conditions, such as those seen by gastroenterologists and hepatologists. It affects 1%-30% of the general population, but is seen in approximately 40% of patients with gastrointestinal conditions including inflammatory bowel disease and cirrhosis. Within this group of patients, it is associated with increased complications and mortality. The pathogenesis of sarcopenia is multifactorial with several risk factors implicated in its development including undernutrition, physical inactivity and coexistent multimorbidity. The SARC-F questionnaire has been developed to screen for patients at risk of sarcopenia, however, this focuses on the functional consequences and will therefore not identify those patients who are early in the progression of sarcopenia. There are several different non-invasive techniques available to assess muscle quantity and quality including; grip strength, dual energy X-ray absorptiometry, CT which can be used together to diagnose sarcopenia. Assessment and correction of malnutrition, particularly protein intake, in those at risk of sarcopenia is important in preventing the development and progression of sarcopenia. There are no specific drugs that are available for the treatment of sarcopenia, however, resistance exercise programmes combined with nutritional interventions show promise. It is important that this common condition is screened for and recognised, with any contributing factors addressed to reduce the risk of its progression.
肌肉减少症是一种骨骼肌力量、功能和质量的进行性全身性疾病，最常与正常衰老过程相关。人们越来越认识到，肌肉减少症也可能由于吸收不良和炎症性疾病而发生，例如胃肠病学家和肝病学家所见到的那些疾病。它影响1%至30%的普通人群，但在包括炎症性肠病和肝硬化在内的胃肠道疾病患者中约有40%会出现。在这组患者中，它与并发症和死亡率增加有关。肌肉减少症的发病机制是多因素的，其发展涉及多种风险因素，包括营养不良、身体活动不足和并存的多种疾病。SARC-F问卷已被开发用于筛查有肌肉减少症风险的患者，然而，这侧重于功能后果，因此无法识别那些处于肌肉减少症进展早期的患者。有几种不同的非侵入性技术可用于评估肌肉数量和质量，包括握力、双能X线吸收法、CT，这些方法可共同用于诊断肌肉减少症。对有肌肉减少症风险的人进行营养不良评估和纠正，特别是蛋白质摄入，对于预防肌肉减少症的发生和进展很重要。目前没有用于治疗肌肉减少症的特定药物，然而，抗阻运动计划与营养干预相结合显示出前景。对这种常见疾病进行筛查和识别很重要，应对任何促成因素加以解决，以降低其进展风险。
