肌肉减少症:与年龄相关的肌量流失和功能下降

Sarcopenia: age-related muscle mass loss and functional declines

背景:肌肉减少症定义为与年龄增长有关的进行性骨骼肌量减少、伴有肌肉力量和/或肌肉功能减退,并能引起意外骨折等一系列不良后果的综合征。目的:从肌肉减少症的定义、测量方法、与骨折的相关性及防治等方面的进展进行综述。方法:检索PubMed、知网等数据库,查阅与肌肉减少症相关的文献,中文检索词为"肌肉减少症/肌肉减少/肌肉/骨折/治疗/预防";英文检索词为"sarcopenia/muscular atrophy/muscle/fracture/treatment/prevention",对所有检索词进行单独及组合检索,阅读全文。结果与结论:EWGSOP、IWGS、AWGS等工作组已经制定了肌肉减少症的标准化定义及诊断,但在PubMed上搜索出的文章中,各个研究中定义肌肉减少症的标准略有不同。患有肌肉减少症的老年人发生骨折风险增加,而对于骨质疏松症的患者来说,肌肉减少症将会造成更坏的影响;动物实验验证在肌肉减少症和骨质疏松性骨折共存的动物模型中,肌肉减少症可导致骨折愈合延迟。运动及营养干预是肌肉减少症目前普遍采用的防治方案,骨钙素、omega-3多不饱和脂肪酸、可溶性激活素ⅡB受体抗体及干细胞移植对肌肉减少症的治疗具有非常大的潜力。

BACKGROUND: Sarcopenia is defined as a syndrome of progressive reduction in age-related skeletal muscle mass, accompanied by declines in muscle strength and/or function, triggering a series of undesirable consequences such as accidental fractures. OBJECTIVE: To review the progress in the definition, measurement methods, correlation with fractures, prevention and treatment of sarcopenia.METHODS: PubMed and CNKI were searched for literatures related to sarcopenia using the keywords of "sarcopenia/muscular atrophy/muscle/fracture/treatment/prevention." Keywords were searched alone and in combination, followed by full-text reading.RESULTS AND CONCLUSION: EWGSOP, IWGS, AWGS and other working groups have developed a standardized definition and diagnosis of sarcopenia. However, the criteria for defining sarcopenia vary slightly in literatures included in Pub Med. Risk of fractures is increased in older adults with sarcopenia, and sarcopenia will have a worse effect in patients with osteoporosis. Animal experiments have verified that sarcopenia and osteoporotic fractures coexist in animal models, and sarcopenia can lead to delayed fracture healing. Exercise and nutrition intervention are currently used prevention and treatment programs. Osteocalcin, omega-3 polyunsaturated fatty acids, soluble activin IIB receptor and stem cell transplantation have great potential in the treatment of sarcopenia.