2013年1月16日水曜日

サルコペニアの病態・診断・管理

サルコペニアの病態・診断・管理のレビュー論文を紹介します。

Sayer AA, Robinson SM, Patel HP, Shavlakadze T, Cooper C, Grounds MD. New horizons in the pathogenesis, diagnosis and management of sarcopenia. Age Ageing. 2013 Jan 11. [Epub ahead of print]

下記HPで全文PDFで見ることができます。

http://ageing.oxfordjournals.org/content/early/2013/01/10/ageing.afs191.full.pdf+html

サルコペニアの診断は、European Working Group on Sarcopenia in Older People (EWGSOP)のものとInternational Working Group on Sarcopeniaのものを取り上げています。

サルコペニアの治療は、運動、栄養、運動+栄養、薬物、ライフコースアプローチ(若年時のピークの筋肉量を高める)が紹介されています。運動+栄養が最も効果的と思われますが、運動+栄養のエビデンスはまだ不十分なようです。

最近の重要なサルコペニア論文が紹介されていますし全文読めますので、興味のある方はぜひ全文読んでみてください。

Abstract
Sarcopenia is the age-related loss of skeletal muscle mass and function. It is now recognised as a major clinical problem for older people and research in the area is expanding exponentially. One of the most important recent developments has been convergence in the operational definition of sarcopenia combining measures of muscle mass and strength or physical performance. This has been accompanied by considerable progress in understanding of pathogenesis from animal models of sarcopenia. Well-described risk factors include age, gender and levels of physical activity and this knowledge is now being translated into effective management strategies including resistance exercise with recent interest in the additional role of nutritional intervention. Sarcopenia is currently a major focus for drug discovery and development although there remains debate about the best primary outcome measure for trials, and various promising avenues to date have proved unsatisfactory. The concept of 'new tricks for old drugs' is, however, promising, for example, there is some evidence that the angiotensin-converting enzyme inhibitors may improve physical performance. Future directions will include a deeper understanding of the molecular and cellular mechanisms of sarcopenia and the application of a lifecourse approach to understanding aetiology as well as to informing the optimal timing of interventions.

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