老年人少肌性肥胖预防和治疗策略

Prevention and treatment strategies for sarcopenic obesity in the elderly

少肌性肥胖(SO)已成为老年医学领域关注的热点问题。老年人SO可导致跌倒、失能、骨折、心血管代谢疾病、癌症甚至死亡。SO的发病机制尚不明确,主要包括与年龄相关的身体成分改变、慢性低度炎症、胰岛素抵抗、激素水平改变等。生活方式的干预是治疗SO的主要措施,包括合理营养膳食和体力锻炼(有氧运动和抗阻训练),达到增加肌肉和减少脂肪的目的。新型的治疗方式包括睾酮补充、选择性雄激素受体调节剂、肌抑素抑制剂、全身振动疗法、维生素K、间充质干细胞疗法等。深入了解SO的发病机制,进行有效的预防和治疗是研究者和临床医生的当务之急。

Sarcopenic obesity(SO)has been a hot issue in the field of geriatrics.SO is associated with major adverse health consequences such as falls,disability,fractures,cardiometabolic diseases,cancer and death.The pathogenesis of SO is still unclear,mainly involving age-related changes in body composition,chronic low-grade inflammation,insulin resistance and sex-specific hormonal changes.Lifestyle interventions,including rational nutrition,physical activity,and especially aerobic exercise and resistance training,are the cornerstones of SO treatment.Emerging therapies include testosterone supplements,selective androgen receptor modulators,myostatin inhibitors,whole body vibration therapy,vitamin K and mesenchymal stem cell therapy.There is an urgent need for researchers and clinicians to have an in-depth understanding of the pathogenesis of SO and carry out effective prevention and treatment.