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慢性阻塞性肺疾病中的肌肉减少症:机制、诊断及管理策略

Sarcopenia in chronic obstructive pulmonary disease: mechanisms, diagnosis, and management strategies.

作者信息

Khan Muhammad Hamza, Fatima Maham, Adnan Ahmad, Jawaid Alishba, Hassan Syed Muhammad, Talal Muhammad, Rahim Shazia, Mughal Zaib Un Nisa, Patel Aly Omer, Singh Achit Kumar

机构信息

Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan.

Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Ann Med Surg (Lond). 2025 Jul 16;87(8):5106-5121. doi: 10.1097/MS9.0000000000003584. eCollection 2025 Aug.

Abstract

Sarcopenia affects 20%-40% of chronic obstructive pulmonary disease (COPD) patients, significantly reducing muscle strength and functional capacity, leading to a decline in quality of life. This study reviews the impact of sarcopenia in COPD and evaluates effective therapeutic strategies. Findings suggest that pulmonary rehabilitation, combined with aerobic and resistance exercises, and supplemented with protein and vitamin D, enhances muscle function and reduces the prevalence of sarcopenia. Additionally, emerging interventions such as inspiratory muscle training, myostatin inhibitors, selective androgen receptor modulators, and hormonal therapies show promise in improving patient outcomes. A multidisciplinary approach, incorporating personalized exercise programs, targeted nutrition, and psychological support, is crucial for addressing the complex challenges of sarcopenia in COPD. Given its substantial burden, this research highlights critical strategies for optimizing care and improving functional outcomes in this high-risk population.

摘要

肌肉减少症影响20%-40%的慢性阻塞性肺疾病(COPD)患者,显著降低肌肉力量和功能能力,导致生活质量下降。本研究回顾了肌肉减少症对慢性阻塞性肺疾病的影响,并评估了有效的治疗策略。研究结果表明,肺康复结合有氧运动和抗阻运动,并补充蛋白质和维生素D,可增强肌肉功能并降低肌肉减少症的患病率。此外,诸如吸气肌训练、肌肉生长抑制素抑制剂、选择性雄激素受体调节剂和激素疗法等新兴干预措施在改善患者预后方面显示出前景。采用多学科方法,纳入个性化运动计划、针对性营养和心理支持,对于应对慢性阻塞性肺疾病中肌肉减少症的复杂挑战至关重要。鉴于其巨大负担,本研究强调了优化护理和改善这一高危人群功能结局的关键策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e301/12333762/72dc150772c0/ms9-87-5106-g001.jpg

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