Division of Geriatric Medicine, Center for Aging and Health, University of North Carolina, Chapel Hill, NC 27599, USA.
Division of Medicine and Pediatrics, University of North Carolina, Chapel Hill, NC 27599, USA.
Nutrients. 2022 Mar 26;14(7):1384. doi: 10.3390/nu14071384.
Sarcopenia, defined as the loss of muscle mass, strength, and function with aging, is a geriatric syndrome with important implications for patients and healthcare systems. Sarcopenia increases the risk of clinical decompensation when faced with physiological stressors and increases vulnerability, termed frailty. Sarcopenia develops due to inflammatory, hormonal, and myocellular changes in response to physiological and pathological aging, which promote progressive gains in fat mass and loss of lean mass and muscle strength. Progression of these pathophysiological changes can lead to sarcopenic obesity and physical frailty. These syndromes independently increase the risk of adverse patient outcomes including hospitalizations, long-term care placement, mortality, and decreased quality of life. This risk increases substantially when these syndromes co-exist. While there is evidence suggesting that the progression of sarcopenia, sarcopenic obesity, and frailty can be slowed or reversed, the adoption of broad-based screening or interventions has been slow to implement. Factors contributing to slow implementation include the lack of cost-effective, timely bedside diagnostics and interventions that target fundamental biological processes. This paper describes how clinical, radiographic, and biological data can be used to evaluate older adults with sarcopenia and sarcopenic obesity and to further the understanding of the mechanisms leading to declines in physical function and frailty.
肌肉减少症是一种以肌肉质量、力量和功能随年龄增长而下降为特征的老年综合征，对患者和医疗保健系统都有重要影响。肌肉减少症增加了患者在面对生理压力时临床失代偿的风险，并增加了脆弱性，即虚弱。肌肉减少症是由于生理和病理衰老引起的炎症、激素和肌细胞变化引起的，这些变化促进了脂肪量的增加和瘦体重和肌肉力量的损失。这些病理生理变化的进展可导致肌肉减少性肥胖和身体虚弱。这些综合征独立增加了不良患者结局的风险，包括住院、长期护理安置、死亡和生活质量下降。当这些综合征共存时，风险会大大增加。虽然有证据表明肌肉减少症、肌肉减少性肥胖和虚弱的进展可以减缓或逆转，但广泛筛查或干预措施的采用实施缓慢。导致实施缓慢的因素包括缺乏具有成本效益的、及时的床边诊断和针对基本生物学过程的干预措施。本文描述了如何使用临床、影像学和生物学数据来评估患有肌肉减少症和肌肉减少性肥胖的老年人，并进一步了解导致身体功能下降和虚弱的机制。
