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Update zur Diagnose und Therapie der Sarkopenie

Diagnosis and therapy of sarcopenia—an update

  • Schwerpunkt: Stoffwechselerkrankungen
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Zusammenfassung

Sarkopenie, also der altersassoziierte, übermäßige Abbau von Muskelmasse, Muskelkraft und -funktion, hat seit 2016 mit M62.50 einen eigenen ICD-10-GM-Code (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification). Zur Diagnosestellung ist das kombinierte Vorliegen von verminderter Muskelkraft (z. B. Handkraft) und reduzierter Muskelmasse erforderlich. Plausible Ansätze zur Prävention und Behandlung von Sarkopenie sind individuell angepasste Trainingsprogramme – vor allem Kraft- und Ausdauertraining, aber auch Power-Training – sowie Ernährungsinterventionen, wenn möglich in Kombination. Dabei wird vor allem eine ausreichende Versorgung mit Proteinen als wichtig erachtet. Die Rolle anderer in den Muskelstoffwechsel involvierter Ernährungsfaktoren, beispielsweise Kreatin, Vitamin D, Antioxidanzien und Omega-3-Fettsäuren, wird aktuell noch kontrovers diskutiert. Der zukünftige Wert neuer pharmakologischer Ansätze kann derzeit noch nicht beurteilt werden. Prinzipiell gilt es festzustellen, dass zum heutigen Zeitpunkt nur wenige Interventionsstudien zu älteren Personen mit einer zuverlässigen Sarkopeniediagnose vorliegen. Daher werden weitere Studien zu dieser rasch wachsenden Population dringend benötigt.

Abstract

Since 2016 sarcopenia, the age-associated loss of muscle mass, strength and function, has the ICD-10-GM code M62.50 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification). The diagnosis of sarcopenia requires the combined presence of low muscle strength and low muscle mass. Well-established approaches for the prevention and therapy of sarcopenia are exercise programs—in particular strength, endurance and power training—and nutritional interventions, preferably a combination of both. Adequate protein intake is considered highly relevant, while the role of other nutrients involved in muscle metabolism (e. g. creatine, vitamin D, antioxidants, omega-3 fatty acids) is less clear, being still the subject of controversial discussions. Innovative pharmacological therapies are currently under investigation and their future relevance for this indication is unclear. In general, it has to be stated that there are still only few intervention studies available that focused specifically on sarcopenia in older individuals. More studies in this rapidly increasing population are urgently needed.

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Correspondence to S. Goisser.

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Interessenkonflikt

J.M. Bauer: Förderung wissenschaftlicher Projekte: Nestlé, Nutricia DANONE. Vortragshonorare: Nestlé, Nutricia DANONE, Fresenius, Pfizer, Novartis, Bayer. S. Goisser, R. Kob und C.C. Sieber geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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H. Lehnert, Lübeck

C.C. Sieber, Nürnberg

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Goisser, S., Kob, R., Sieber, C.C. et al. Update zur Diagnose und Therapie der Sarkopenie. Internist 60, 141–148 (2019). https://doi.org/10.1007/s00108-018-0551-x

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