Sheehy Robert, McCormack Samuel, Fermoyle Caitlin, Corte Tamera
Faculty of Medicine and Health, University of Sydney, Sydney, Australia
Department of Respiratory Medicine, Princess Alexandra Hospital, Brisbane, Australia.
Eur Respir Rev. 2024 Dec 4;33(174). doi: 10.1183/16000617.0126-2024. Print 2024 Oct.
Interstitial lung disease (ILD) encompasses a heterogeneous group of chronic lung conditions with considerable variability in prognosis and response to treatment. People with reduced muscle mass and function, known as sarcopenia, have a higher risk of mortality and adverse clinical outcomes both in the general population and in other chronic disease states. The importance of sarcopenia across the spectrum of patients with ILD is not well established.
In this narrative review, we explore the prevalence and clinical implications of sarcopenia in patients with ILD, evaluate the optimal methods to diagnose sarcopenia in this patient population and review treatment interventions.
Almost one third of patients with chronic forms of ILD have evidence of sarcopenia. Sarcopenia is associated with adverse clinical outcomes and increased risk of mortality in select populations with ILD. Screening tests such as the SARC-F (strength, assistance walking, rise from a chair, climb stairs, falls) questionnaire and clinical assessment tools (including grip strength dynamometry) are well validated. Medical imaging modalities, including computed tomography, are hampered by lack of a gold standard and normative values, but have been used in patients with ILD in acute care and research settings. If sarcopenia is identified, multidimensional interventions such as pulmonary rehabilitation are beneficial.
Sarcopenia is common in patients with ILD and is associated with poorer outcomes. Accordingly, if identified, targeted interventions should be considered. Validated diagnostic criteria exist, but the optimal use of medical imaging techniques in this patient cohort remains an area of uncertainty.
间质性肺疾病（ILD）涵盖了一组异质性的慢性肺部疾病，其预后和对治疗的反应差异很大。肌肉量和功能减少的人群，即肌少症患者，在普通人群和其他慢性疾病状态下都有较高的死亡风险和不良临床结局。肌少症在整个ILD患者群体中的重要性尚未明确。
在本叙述性综述中，我们探讨了ILD患者中肌少症的患病率和临床意义，评估了诊断该患者群体肌少症的最佳方法，并回顾了治疗干预措施。
几乎三分之一的慢性ILD患者有肌少症的证据。在特定的ILD患者群体中，肌少症与不良临床结局和死亡风险增加相关。诸如SARC-F（力量、辅助行走、从椅子上起身、爬楼梯、跌倒）问卷等筛查测试和临床评估工具（包括握力测量）已得到充分验证。包括计算机断层扫描在内的医学成像方式因缺乏金标准和正常值而受到阻碍，但已在急性护理和研究环境中的ILD患者中使用。如果识别出肌少症，多维干预措施如肺康复是有益的。
肌少症在ILD患者中很常见，且与较差的结局相关。因此，如果识别出肌少症，应考虑针对性干预措施。存在经过验证的诊断标准，但医学成像技术在该患者队列中的最佳应用仍是一个不确定的领域。
