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Arthritis und Rheuma 2018; 38(02): 87-92
DOI: 10.1055/s-0038-1649286
Geronto-Orthopädie
Schattauer GmbH

Sarkopenie

Pathophysiologie und TherapieSarcopeniaPathophysiology and therapy
W. Kemmler
1   Institut für Medizinische Physik, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Erlangen
,
F. Jakob
2   Orthopädisches Zentrum für Muskuloskeletale Forschung, Experimentelle und Klinische Osteologie, Orthopädische Klinik König-Ludwig-Haus Würzburg, Universität Würzburg
,
C. Sieber
3   Institut für Biomedizin des Alterns, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Nürnberg
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Publikationsverlauf



Publikationsdatum:
27. April 2018 (online)

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Zusammenfassung

Sarkopenie ist eine altersassoziierte Erkrankung, deren Prävalenz mit der zunehmenden Lebenserwartung ansteigt. Der Verlust an Muskelmasse und Funktion geht mit einer erhöhten Mortalität und mit einem hohen Risiko der Behinderung und der Hospitalisierung einher. Die Angaben über die Häufigkeit in selbstständig lebenden Populationen sind sehr inkonsistent. Wichtige Risikofaktoren sind genetische/epigenetische Faktoren, Immobilisation, Fehlund Mangelernährung, Hormonmangelzustände, chronische Entzündung und ein Anstieg der inhibitorischen Faktoren der Geweberegeneration. Trotz hoher Forschungsintensität und intensiver Diskussion in Konsensus-Konferenzen über die diagnostischen Kriterien besteht noch keine einheitliche Definition der Sarkopenie. Eine ganze Reihe von Interventionsstrategien werden klinisch getestet. Trainings-Regimes, Ernährungsprogramme, Hormonersatztherapien und pharmakologische Ansätze mit anabolen Prinzipien wie SARMs, Ghrelin/Wachstumshormon und Myostatin-Antagonisten sind in der klinischen Evaluationsphase. Aus den wenigen bereits publizierten Studienergebnissen wird deutlich, dass Trainingsprogramme und Medikamente ein hohes Potenzial haben. Nicht wenige Studien zeigen aber über die Verbesserungen der Surrogatparameter hinaus keine eindrucksvollen Funktionsverbesserungen. Zukünftige Strategien müssen multimodale Interventionen zum Inhalt haben und im Design verbessert werden.

Summary

Sarcopenia is an aging-associated syndrome with increasing prevalence in aging societies. Loss of muscle mass and function is associated with enhanced mortality, and conveys a high risk of disability and hospitalization. Data about its prevalence in free living populations are inconsistent. There are important risk factors such as genetics/epigenetics, immobilisation, malnutrition and anorexia, hormone deficiencies, chronic inflammation and raising levels of inhibitors of tissue regeneration. In spite of intensive research activities and discussions in consensus conferences we do not yet have a generally accepted definition of sarcopenia. Many intervention strategies are being evaluated in clinical trials, including exercise regimens, nutrition programs, hormone replacement and pharmacological strategies involving anabolic principles such as SARMs, Ghrelin/growth hormone and myostatin antagonists. Available data suggest that exercise strategies and pharmacological approaches have a high potential. However a relevant number of studies also does not demonstrate impressive functional outcomes beyond significant improvement of surrogate parameters. Future strategies will have to involve multimodal interventions and improved study designs.

Schlüsselwörter

Sarkopenie - Sarcopenic Obesity - Definition - Diagnostik - Intervention

Keywords

Sarcopenia - sarcopenic obesity - definition - diagnostics - interventions
 

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