Sarcopenia의 최신지견: 근감소증
Clinical and Physiopathological Mechanism of Sarcopenia
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초록
근감소증은 나이가 증가함에 따라 동반 되는 근육의 양과 동시에 근력의 감소로 정의되고, 그 결과로 다양한 동반 질환과 사망을 유발하는 질환이다. 근감소증은 운동량의 감소와 단백질 섭취 감소가 원인이 될 수 있으며 테스토스테론과 성장호르몬, 염증 유발 사이토카인의 변화가 원인이 된다. 조직학적으로는 근섬유 중 type II 근섬유에서 특이적으로 감소한다고 알려져 있고 분자 생물학적으로도 다양한 경로가 연관되어 있으나 아직 그 병태 생리는 명확하지 않다. 또한 European Working Group에서는 근육량의 감소가 있고 근력 또는 신체기능의 저하 둘 중 하나 더 있으면 근감소증으로 진단한다고 제시되는 등, 여러 연구에서 다양한 진단 기준이 제시되고 있지만 아직은 세계적으로 표준화된 근감소증의 진단 기준은 없다. 이렇게 근감소증에 대하여 명확하지 않은 부분이 많지만 우리나라는 물론 미국과 유럽의 여러 역학 연구를 통해 근감소증이 노인에 미치는 건강상의 영향은 매우 명확하다. 따라서 향후 및 현재 매우 빠르게 노령화가 진행되고 있는 우리사회에서 근감소증에 대한 기준 및 평가는 물론이며, 사회적 경제적 비용을 줄일수 있는 근감소증의 예방을 위한 프로그램 및 치료에 대한 관심이 시급한 상황이고 근감소증의 치료에 대한 우리 의료인들의 컨센서스 또한 매우 필요한 시점이라 사료된다.
Abstract
Sarcopenia is defined the loss of muscle mass and strength with aging. Although the etiology and the pathogenesis, the diagnosis of sarcopenia are obscure, the sequel of sarcopenia, i.e. morbidity and mortality, metabolic complications, are a major public health problem. Particularly, aged people in Korea are increasing rapidly more than expected; therefore the interest of sarcopenia is also increasing rapidly. This article provides an overview of the pathogenesis, and diagnosis, epidemiology, clinical results. (Korean J Med 2012;83:444-454)
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