Nishikawa Hiroki, Fukunishi Shinya, Asai Akira, Nishiguchi Shuhei, Higuchi Kazuhide
The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka 569-8686, Japan.
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Life (Basel). 2021 Apr 27;11(5):399. doi: 10.3390/life11050399.
Skeletal muscle is the largest organ in the body, and skeletal muscle atrophy results from a shift in the balance of protein synthesis and degradation toward protein breakdown. Primary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to aging, and secondary sarcopenia is defined as a loss of skeletal muscle mass and strength or physical function due to underlying diseases. Liver cirrhosis (LC) is one of the representative diseases which can be complicated with secondary sarcopenia. Muscle mass loss becomes more pronounced with worsening liver reserve in LC patients. While frailty encompasses a state of increased vulnerability to environmental factors, there is also the reversibility of returning to a healthy state with appropriate intervention. Several assessment criteria for sarcopenia and frailty were proposed in recent years. In 2016, the Japan Society of Hepatology created assessment criteria for sarcopenia in liver disease. In Japan, health checkups for frailty in the elderly aged 75 years or more started in April 2020. Both sarcopenia and frailty can be adverse predictors for cirrhotic patients. In this review article, we will summarize the current knowledge of sarcopenia and frailty in LC patients.
骨骼肌是人体最大的器官，骨骼肌萎缩是由于蛋白质合成与降解的平衡向蛋白质分解方向转变所致。原发性肌肉减少症被定义为由于衰老导致的骨骼肌质量、力量或身体功能丧失，继发性肌肉减少症被定义为由于潜在疾病导致的骨骼肌质量、力量或身体功能丧失。肝硬化（LC）是可并发继发性肌肉减少症的代表性疾病之一。在LC患者中，随着肝脏储备功能的恶化，肌肉质量损失会更加明显。虽然衰弱包括对环境因素易感性增加的状态，但通过适当干预也有恢复到健康状态的可逆性。近年来提出了几种肌肉减少症和衰弱的评估标准。2016年，日本肝脏病学会制定了肝病中肌肉减少症的评估标准。在日本，针对75岁及以上老年人的衰弱健康检查于2020年4月开始。肌肉减少症和衰弱都是肝硬化患者的不良预测指标。在这篇综述文章中，我们将总结目前关于LC患者肌肉减少症和衰弱的知识。
