| 特集名 | 透析患者の栄養障害とNSTの可能性 | |
|---|---|---|
| 題名 | 透析患者のサルコペニアとは？ | |
| 発刊年月 | 2013年 07月 | |
| 著者 | 小田巻 眞理 | 常葉大学健康プロデュース学部健康栄養学科・管理栄養士 |
| 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 】 | サルコペニアは筋肉量の減少および筋力の低下を特徴とし，ADL（日常生活動作）の悪化やQOL（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） では，サルコペニアを加齢による一次的なものと廃用や疾患による二次的なものに大別している． 筋肉量は，筋肉合成と筋肉異化のバランスによって調節されているが，慢性腎臓病（CKD）患者では筋肉合成が低下し異化が亢進している．さらに骨格筋萎縮と関連する筋肉内のミオスタチン遺伝子発現が増加していることが報告されている．また，大腿部を含む四肢の筋肉量の低下は患者の生命予後にも悪影響を及ぼすことも報告されている． |
|
| Theme | Protein-energy wasting and potentiality of NST in dialysis patients | |
|---|---|---|
| Title | Sarcopenia in hemodialysis patients | |
| Author | Mari Odamaki | Faculty of Health Promortional Sciences, Deapartment of Health and Nutritional Sciences, Tokoha University |
| Author | Akihiko Kato | Blood Purification Unit, Hamamatsu University School of Medicine |
| [ Summary ] | Sarcopenia is a syndrome characterized by decreased muscle mass and declines in muscle strength with a risk of poor quality of life or reduced activity levels and eventual death. The European Working Group on Sarcopenia in Older People (EWGSOP) classified primary sarcopenia as being caused by aging and secondary sarcopenia due to disuse syndrome or diseases such as organ failure, inflammation, malignancy, endocrine disorders and malnutrition. Muscle mass is regulated by a balance between muscle synthesis and muscle catabolism. Reduction of muscle synthesis and increased muscle catabolism are observed in CKD patients. Activation of the cellular ubiquitin-proteasome system, which plays important roles in muscle catabolism, is due to declines in insulin and IGF-1, cortisol, as well as myostatin. It is reported that the myostatin gene associated with skeletal muscle atrophy expression, is observed in increased numbers in intramuscular cells. Furthermore, we found that follistatin, which is an antagonist for myostatin, is correlated with inflammation markers and nutritional indexes, suggesting that folllistatin may rise with skeletal muscle atrophy in relation to mystatin. In addition, we reported that declines in muscle mass in the femoral muscle, including thigh muscles, affect long-term prognoses for hemodialysis patients. |
|