Loss of skeletal muscle mass in aging: Examining the relationship of starvation, sarcopenia and cachexia

被引:337
作者
Thomas, David R. [1 ]
机构
[1] St Louis Univ, Med Ctr, Div Geriatr Med, St Louis, MO 63104 USA
关键词
starvation; sarcopenia; cachexia; nutrition; malnutrition; undernutrition; weight loss;
D O I
10.1016/j.clnu.2007.03.008
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
A loss of body weight or skeletal Muscle mass is common in older persons and is a harbinger of poor outcome. Involuntary weight loss can be categorized into three primary etiologies of starvation, sarcopenia, and cachexia. Starvation results in a toss of body fat and non-fat mass due to inadequate intake of protein and energy. Sarcopenia is associated with a reduction in muscle mass and strength occurring with normal aging, associated with a reduction in motor unit number and atrophy of muscle fibers, especially the type IIa fibers. The loss of muscle mass with aging is clinically important because it leads to diminished strength and exercise capacity. Cachexia is widely recognized as severe wasting accompanying disease states such as cancer or immunodeficiency disease, but does not have a universally accepted definition. The key clinical question is whether these changes in body composition are distinct entities or represent an interdependent continuum. The importance of defining the distinction ties in developing a targeted therapeutic approach to skeletal muscle loss and muscle strength in older persons. Failure to distinguish among these causes of skeletal muscle toss often results in frustration over the clinical response to therapeutic interventions. (C) 2007 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
引用
收藏
页码:389 / 399
页数:11
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