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肝硬化中的肌肉减少症:从病理生理学到介入治疗

Sarcopenia in cirrhosis: From pathophysiology to interventional therapy.

作者信息

Chen Huiling, Yang Chenyun, Yan Shijie, Liu Xintao, Zhou Ligang, Yuan Xinlu

机构信息

Department of Endocrinology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai 201399, China; Fudan University, Shanghai, China.

Department of Endocrinology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai 201399, China.

出版信息

Exp Gerontol. 2024 Oct 15;196:112571. doi: 10.1016/j.exger.2024.112571. Epub 2024 Sep 9.

Abstract

Sarcopenia, characterized by the loss of skeletal muscle mass and function, is a significant complication in patients with cirrhosis. This condition not only exacerbates the overall morbidity and mortality associated with liver disease but also complicates patient management, increasing the risk of hospitalization, infections, and hepatic encephalopathy. Despite its clinical significance, sarcopenia in cirrhotic patients remains underdiagnosed and undertreated. This review aims to summarize current knowledge on the pathophysiology of sarcopenia in cirrhosis, including mechanisms such as altered metabolism, hormonal imbalances, and inflammation. Additionally, we explore diagnostic challenges and discuss emerging therapeutic strategies, including nutritional support, exercise, and pharmacological interventions. By highlighting the gaps in existing research and proposing directions for future studies, this review seeks to improve the management and outcomes of cirrhotic patients affected by sarcopenia.

摘要

肌肉减少症以骨骼肌质量和功能丧失为特征,是肝硬化患者的一种重要并发症。这种情况不仅会加剧与肝脏疾病相关的总体发病率和死亡率,还会使患者管理变得复杂,增加住院、感染和肝性脑病的风险。尽管肌肉减少症具有临床重要性,但肝硬化患者中的肌肉减少症仍未得到充分诊断和治疗。本综述旨在总结目前关于肝硬化中肌肉减少症病理生理学的知识,包括代谢改变、激素失衡和炎症等机制。此外,我们探讨诊断挑战并讨论新兴的治疗策略,包括营养支持、运动和药物干预。通过强调现有研究中的差距并为未来研究提出方向,本综述旨在改善受肌肉减少症影响的肝硬化患者的管理和治疗效果。

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