| 特集名 | 透析患者における運動・リハビリ療法 | |
|---|---|---|
| 題名 | ［各論］サルコペニアの評価法と臨床的アウトカム | |
| 発刊年月 | 2011年 09月 | |
| 著者 | 加藤 明彦 | 浜松医科大学附属病院血液浄化療法部 |
| 【 要旨 】 | サルコペニアは進行性で全身の筋力量および筋力低下を特徴とし，身体能力や生活の質の低下，死亡リスクを伴う症候群である．the European Working Group on Sarcopenia in Older People（EWGSOP）のコンセンサス・カンファレンスでは，筋肉の量的低下と機能的低下（筋力，身体能力）の両者が存在する場合にサルコペニアと診断するよう定義している． 透析患者では，サルコペニアの評価はこれまでは筋肉量で行われており，筋力や身体能力を併せた評価は行われてこなかった．しかし，透析患者において，筋肉量の減少や握力の低下は動脈硬化などの合併症や生命予後と関連することが報告されている．今後，サルコペニアの考えがより普及するためには，健常人と透析患者における筋肉量，筋力，身体能力を評価する疫学調査が不可欠であり，日本人におけるサルコペニアの定義が作られる必要がある．さらに，サルコペニアの発症・進展を予防するため，簡便なスクリーニング法の開発が望まれる． |
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| Theme | Exercise Therapy and Rehabilitation for Dialysis Patients | |
|---|---|---|
| Title | Assessment of sarcopenia and its adverse outcomes in dialysis patients | |
| Author | Akihiko Kato | Blood Purification Unit, Hamamatsu University School of Medicine |
| [ Summary ] | Sarcopenia is a syndrome characterized by progressive, generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and eventually death. The European Working Group on Sarcopenia in Older People (EWGSOP) recommends assessment of both low muscle mass and low muscle function (strength and performance) for the diagnosis of sarcopenia. In dialysis patients, sarcopenia is diagnosed entirely by the measurement of muscle mass. Muscle strength and physical performance are not evaluated in conjunction with muscle mass. However, decreased muscle volume and handgrip strength are demonstrated to be closely associated with adverse outcomes such as arteriosclerosis and mortality in dialysis patients. Therefore, to more greatly understand the concept of sarcopenia in the field of dialysis therapy, a large epidemiological cohort is needed to assess muscle mass, muscle strength and physical performance. It will be necessary to define cut-off points developed in relation to the measurement techniques chosen and on the availability of reference studies on the Japanese population. In addition, tools for screening and assessment of sarcopenia in medical practice are needed to identify strategies which can prevent or delay the progression of sarcopenia. |
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