肝疾患の治療歴のない高年齢層の一般住民における肝の線維化と骨格筋量の減少との関連
「I. 緒言」平成30年の総務省の統計では, 65歳以上の高齢者人口は3,529万人に達し, 総人口に占める割合 (高齢化率) は27.9%となっている. 人口の高齢化は今後さらに加速すると予想されており, 健康寿命の延伸や介護予防の視点から, 高齢者のフレイル (虚弱) またはサルコペニアの対策が公衆衛生上の課題になっている. フレイルは, 老化に伴って様々な機能の脆弱性が亢進した状態であり, 筋力の低下, 認知機能の低下, 精神活動の低下, 生活活動の低下などの広範な要素が含まれる. 一方, サルコペニアは, 骨格筋量の減少を基盤として筋力や身体機能の低下を伴う病態であり, 身体的フレイル...
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| Published in | 日本衛生学雑誌 Vol. 74; pp. 18031 - 0 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本衛生学会
2019
日本衛生学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5082 1882-6482 |
| DOI | 10.1265/jjh.18031 |
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| Abstract | 「I. 緒言」平成30年の総務省の統計では, 65歳以上の高齢者人口は3,529万人に達し, 総人口に占める割合 (高齢化率) は27.9%となっている. 人口の高齢化は今後さらに加速すると予想されており, 健康寿命の延伸や介護予防の視点から, 高齢者のフレイル (虚弱) またはサルコペニアの対策が公衆衛生上の課題になっている. フレイルは, 老化に伴って様々な機能の脆弱性が亢進した状態であり, 筋力の低下, 認知機能の低下, 精神活動の低下, 生活活動の低下などの広範な要素が含まれる. 一方, サルコペニアは, 骨格筋量の減少を基盤として筋力や身体機能の低下を伴う病態であり, 身体的フレイルの主たる要因を形成する. このような高齢者における骨格筋量の減少に対しては, 加齢のみならず, 身体活動性の低下 (廃用), 栄養不良 (摂取不足や吸収不良), 筋肉を司る神経の変性, 筋肉のタンパク合成・分解に関わる異常などが影響を及ぼすとされている. |
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| AbstractList | 「I. 緒言」平成30年の総務省の統計では, 65歳以上の高齢者人口は3,529万人に達し, 総人口に占める割合 (高齢化率) は27.9%となっている. 人口の高齢化は今後さらに加速すると予想されており, 健康寿命の延伸や介護予防の視点から, 高齢者のフレイル (虚弱) またはサルコペニアの対策が公衆衛生上の課題になっている. フレイルは, 老化に伴って様々な機能の脆弱性が亢進した状態であり, 筋力の低下, 認知機能の低下, 精神活動の低下, 生活活動の低下などの広範な要素が含まれる. 一方, サルコペニアは, 骨格筋量の減少を基盤として筋力や身体機能の低下を伴う病態であり, 身体的フレイルの主たる要因を形成する. このような高齢者における骨格筋量の減少に対しては, 加齢のみならず, 身体活動性の低下 (廃用), 栄養不良 (摂取不足や吸収不良), 筋肉を司る神経の変性, 筋肉のタンパク合成・分解に関わる異常などが影響を及ぼすとされている. |
| Author | 有田, 幹雄 宮井, 信行 志波, 充 竹下, 達也 大西, 修平 内海, みよ子 牟礼, 佳苗 |
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| References | (24) 岡上 武，水野雅之．肝機能検査，肝障害について―健診における問題点．総合健診2015;42:307–312 (27) Moriwaki H, Miwa Y, Tajika M, Kato M, Fukushima H, Shiraki M. Branched-chain amino acids as a protein- and energy-source in liver cirrhosis. Biochem Biophys Res Commun 2004;313:405–409. (33) Volpi E, Mittendorfer B, Rasmussen BB, Wolfe RR. The response of muscle protein anabolism to combined hyperaminoacidemia and glucose-induced hyperinsulinemia is impaired in the elderly. J Clin Endocrinol Metab 2000;85:4481–4490. (8) Hanai T, Shiraki M, Ohnishi S, Miyazakai T, Ideta T, Kochi T, et al. Rapid skeletal muscle wasting predicts worse survival in patients with liver cirrhosis. Hepatol Res 2016;46:743–751. (18) Janssen I, Baumgartner RN, Ross R, Rosenberg IH, Roubenoff R. Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 2004;159:413–421. (19) Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014;15:95–101. (29) Børsheim E, Bui QU, Tissier S, Kobayashi H, Ferrando AA, Wolfe RR. Effect of amino acid supplementation on muscle mass, strength and physical function in elderly. Clin Nutr 2008;27:189–195. (1) 総務省統計局．人口推計（平成30年7月報），2014．https://www.stat.go.jp/data/jinsui/pdf/201807.pdf（参照2018.7.25） (34) 駒井さつき，渡邊 裕，藤原佳典，金 憲経，枝広あや子，河合 恒，他．日本の地域在住高齢者における栄養状態とサルコペニア重症度の関連性の検討 BMI，Alb，体重減少の有無との関連．日本老年医学会雑誌 2016;53:387–395 (9) Harimoto N, Shirabe K, Yamashita YI, Ikegami T, Yoshizumi T, Soejima Y, et al. Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. Br J Surg 2013;100:1523–1530. (32) Dasarathy S. Consilience in sarcopenia of cirrhosis. J Cachexia Sarcopenia Muscle 2012;3:225–237. (23) Shah AG, Lydecker A, Murray K, Tetri BN, Contos MJ, Sanyal AJ; Nash Clinical Research Network. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2009;7:1104–1112. (22) Sumida Y, Yoneda M, Hyogo H, Itoh Y, Ono M, Fujii H, et al; Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD). Validation of the Fib4 index in a Japanese nonalcoholic fatty liver disease population. BMC Gastroenterol 2012;12:2. (36) Shih R, Wang Z, Heo M, Wang W, Heymsfield SB. Lower limb skeletal muscle mass: development of dual-energy X-ray absorptiometry prediction model. J Appl Physiol 2000;89:1380–1386. (2) 今井博久．2025問題とは何か：公衆衛生が直面する問題の諸相．保健医療科学2016;65:2–8 (5) Eguchi Y, Hyogo H, Ono M, Mizuta T, Ono N, Fujimoto K, et al. Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2009 to 2010 in Japan: a multicenter large retrospective study. J Gastroenterol 2012;47:586–595. (31) García PS, Cabbabe A, Kambadur R, Nicholas G, Csete M. Brief-reports: elevated myostatin levels in patients with liver disease: a potential contributor to skeletal muscle wasting. Anesth Analg 2010;111:707–709. (14) Tanaka N, Miyatani M, Masuo Y, Fukunaga T, Kanehisa H. Applicability of a segmental bioelectrical impedance analysis for predicting the whole body skeletal muscle volume. J Appl Physiol 2007;103:1688–1695. (25) Angulo P, Hui JM, Marchesini G, Bugianesi E, George J, Farrell GC, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 2007;45:846–854. (13) van der Ploeg HP, Chey T, Korda RJ, Banks E, Bauman A. Sitting time and all-cause mortality risk in 222 497 Australian adults. Arch Intern Med 2012;172:494–500. (35) Hara N, Iwasa M, Sugimoto R, Mifuji-Moroka R, Yoshikawa K, Terasaka E, et al. Sarcopenia and Sarcopenic Obesity Are Prognostic Factors for Overall Survival in Patients with Cirrhosis. Intern Med 2016;55:863–870. (12) 村瀬訓生，勝村俊仁，上田千穂子，井上 茂，下光輝一．身体活動量の国際標準化―IPAQ日本語版の信頼性，妥当性の評価―．厚生の指標2002;49:1–9 (15) Yonei Y, Miwa Y, Hibino S, Takahashi Y, Miyazaki R, Yoshikawa T, et al. Japanese Anthropometric reference data — special emphasis on bioelectrical on bioelectrical impedance analysis of muscle mass. Anti-Ageing Medicine 2008;5:63–72. (30) Grossmann M, Hoermann R, Gani L, Chan I, Cheung A, Gow PJ, et al. Low testosterone levels as an independent predictor of mortality in men with chronic liver disease. Clin Endocrinol (Oxf) 2012;77:323–328. (28) Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab 2006;291:E381–387. (26) Harrison SA, Oliver D, Arnold HL, Gogia S, Neuschwander-Tetri BA. Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease. Gut 2008;57:1441–1447. (6) Kikuchi M, Horie Y, Ebinuma H, Taniki N, Nakamoto N, Kanai T. Alcoholic liver cirrhosis and significant risk factors for the development of alcohol related hepatocellular carcinoma—Japan, 2012. Jpn J Alcohol & Drug Dependence 2015;50:222–234. (16) Miyatani M, Kanehisa H, Masuo Y, Ito M, Fukunaga T. Validity of estimating limb muscle volume by bioelectrical impedance. J Appl Physiol 2001;91:386–394. (4) 葛谷雅文．サルコペニアの診断・病態・治療．日本老年医学会雑誌2015;52:343–349 (20) Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology 2006;43:1317–1325. (7) 西口修平，日野啓輔，森屋恭爾，白木 亮，平松 憲，西川浩樹．日本肝臓学会サルコペニア判定基準作成ワーキンググループ．肝疾患におけるサルコペニアの判定基準（第1版）．肝臓2016;57:353–368 (3) 荒井秀典．フレイルの意義．日本老年医学会雑誌2014;51:497–501 (11) Hayashi F, Matsumoto Y, Momoki C, Yuikawa M, Okada G, Hamakawa E, et al. Physical inactivity and insufficient dietary intake are associated with the frequency of sarcopenia in patients with compensated viral liver cirrhosis. Hepatol Res 2013;43:1264–1275. (10) Kamachi S, Mizuta T, Otsuka T, Nakashita S, Ide Y, Miyoshi A, et al. Sarcopenia is a risk factor for the recurrence of hepatocellular carcinoma after curative treatment. Hepatol Res 2016;46:201–208. (17) Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998;147:755–763. (21) Yang HR, Kim HR, Kim MJ, Ko JS, Seo JK. Noninvasive parameters and hepatic fibrosis scores in children with nonalcoholic fatty liver disease. World J Gastroenterol 2012;18:1525–1530. |
| References_xml | – reference: (27) Moriwaki H, Miwa Y, Tajika M, Kato M, Fukushima H, Shiraki M. Branched-chain amino acids as a protein- and energy-source in liver cirrhosis. Biochem Biophys Res Commun 2004;313:405–409. – reference: (9) Harimoto N, Shirabe K, Yamashita YI, Ikegami T, Yoshizumi T, Soejima Y, et al. Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. Br J Surg 2013;100:1523–1530. – reference: (21) Yang HR, Kim HR, Kim MJ, Ko JS, Seo JK. Noninvasive parameters and hepatic fibrosis scores in children with nonalcoholic fatty liver disease. World J Gastroenterol 2012;18:1525–1530. – reference: (28) Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab 2006;291:E381–387. – reference: (20) Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology 2006;43:1317–1325. – reference: (5) Eguchi Y, Hyogo H, Ono M, Mizuta T, Ono N, Fujimoto K, et al. Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2009 to 2010 in Japan: a multicenter large retrospective study. J Gastroenterol 2012;47:586–595. – reference: (23) Shah AG, Lydecker A, Murray K, Tetri BN, Contos MJ, Sanyal AJ; Nash Clinical Research Network. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2009;7:1104–1112. – reference: (31) García PS, Cabbabe A, Kambadur R, Nicholas G, Csete M. Brief-reports: elevated myostatin levels in patients with liver disease: a potential contributor to skeletal muscle wasting. Anesth Analg 2010;111:707–709. – reference: (3) 荒井秀典．フレイルの意義．日本老年医学会雑誌2014;51:497–501． – reference: (6) Kikuchi M, Horie Y, Ebinuma H, Taniki N, Nakamoto N, Kanai T. Alcoholic liver cirrhosis and significant risk factors for the development of alcohol related hepatocellular carcinoma—Japan, 2012. Jpn J Alcohol & Drug Dependence 2015;50:222–234. – reference: (19) Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014;15:95–101. – reference: (22) Sumida Y, Yoneda M, Hyogo H, Itoh Y, Ono M, Fujii H, et al; Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD). Validation of the Fib4 index in a Japanese nonalcoholic fatty liver disease population. BMC Gastroenterol 2012;12:2. – reference: (7) 西口修平，日野啓輔，森屋恭爾，白木 亮，平松 憲，西川浩樹．日本肝臓学会サルコペニア判定基準作成ワーキンググループ．肝疾患におけるサルコペニアの判定基準（第1版）．肝臓2016;57:353–368． – reference: (25) Angulo P, Hui JM, Marchesini G, Bugianesi E, George J, Farrell GC, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 2007;45:846–854. – reference: (16) Miyatani M, Kanehisa H, Masuo Y, Ito M, Fukunaga T. Validity of estimating limb muscle volume by bioelectrical impedance. J Appl Physiol 2001;91:386–394. – reference: (17) Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998;147:755–763. – reference: (33) Volpi E, Mittendorfer B, Rasmussen BB, Wolfe RR. The response of muscle protein anabolism to combined hyperaminoacidemia and glucose-induced hyperinsulinemia is impaired in the elderly. J Clin Endocrinol Metab 2000;85:4481–4490. – reference: (35) Hara N, Iwasa M, Sugimoto R, Mifuji-Moroka R, Yoshikawa K, Terasaka E, et al. Sarcopenia and Sarcopenic Obesity Are Prognostic Factors for Overall Survival in Patients with Cirrhosis. Intern Med 2016;55:863–870. – reference: (12) 村瀬訓生，勝村俊仁，上田千穂子，井上 茂，下光輝一．身体活動量の国際標準化―IPAQ日本語版の信頼性，妥当性の評価―．厚生の指標2002;49:1–9． – reference: (32) Dasarathy S. Consilience in sarcopenia of cirrhosis. J Cachexia Sarcopenia Muscle 2012;3:225–237. – reference: (26) Harrison SA, Oliver D, Arnold HL, Gogia S, Neuschwander-Tetri BA. Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease. Gut 2008;57:1441–1447. – reference: (29) Børsheim E, Bui QU, Tissier S, Kobayashi H, Ferrando AA, Wolfe RR. Effect of amino acid supplementation on muscle mass, strength and physical function in elderly. Clin Nutr 2008;27:189–195. – reference: (36) Shih R, Wang Z, Heo M, Wang W, Heymsfield SB. Lower limb skeletal muscle mass: development of dual-energy X-ray absorptiometry prediction model. J Appl Physiol 2000;89:1380–1386. – reference: (14) Tanaka N, Miyatani M, Masuo Y, Fukunaga T, Kanehisa H. Applicability of a segmental bioelectrical impedance analysis for predicting the whole body skeletal muscle volume. J Appl Physiol 2007;103:1688–1695. – reference: (30) Grossmann M, Hoermann R, Gani L, Chan I, Cheung A, Gow PJ, et al. Low testosterone levels as an independent predictor of mortality in men with chronic liver disease. Clin Endocrinol (Oxf) 2012;77:323–328. – reference: (13) van der Ploeg HP, Chey T, Korda RJ, Banks E, Bauman A. Sitting time and all-cause mortality risk in 222 497 Australian adults. Arch Intern Med 2012;172:494–500. – reference: (24) 岡上 武，水野雅之．肝機能検査，肝障害について―健診における問題点．総合健診2015;42:307–312． – reference: (34) 駒井さつき，渡邊 裕，藤原佳典，金 憲経，枝広あや子，河合 恒，他．日本の地域在住高齢者における栄養状態とサルコペニア重症度の関連性の検討 BMI，Alb，体重減少の有無との関連．日本老年医学会雑誌 2016;53:387–395． – reference: (18) Janssen I, Baumgartner RN, Ross R, Rosenberg IH, Roubenoff R. Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 2004;159:413–421. – reference: (8) Hanai T, Shiraki M, Ohnishi S, Miyazakai T, Ideta T, Kochi T, et al. Rapid skeletal muscle wasting predicts worse survival in patients with liver cirrhosis. Hepatol Res 2016;46:743–751. – reference: (10) Kamachi S, Mizuta T, Otsuka T, Nakashita S, Ide Y, Miyoshi A, et al. Sarcopenia is a risk factor for the recurrence of hepatocellular carcinoma after curative treatment. Hepatol Res 2016;46:201–208. – reference: (11) Hayashi F, Matsumoto Y, Momoki C, Yuikawa M, Okada G, Hamakawa E, et al. 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| Snippet | 「I. 緒言」平成30年の総務省の統計では, 65歳以上の高齢者人口は3,529万人に達し, 総人口に占める割合 (高齢化率) は27.9%となっている. 人口の高齢化は今後さらに加... |
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| SubjectTerms | Fib4インデックス 一般住民 肝線維化 骨格筋量 高齢者 |
| Title | 肝疾患の治療歴のない高年齢層の一般住民における肝の線維化と骨格筋量の減少との関連 |
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