Ergänzende bilanzierte Diät mit essenziellen Aminosäuren bei chronischen Krankheiten und im fortgeschrittenen Alter

Zusammenfassung

Die Entstehung von Sarkopenie und Kachexie sind wesentlich durch den Proteinmetabolismus der Muskulatur determiniert. Hierbei ist eine Vielzahl pathophysiologischer Mechanismen mit einer Dysbalance zwischen anabolen und katabolen Faktoren involviert. Im Gegensatz zur Kachexie ist die Sarkopenie im Regelfall nicht mit einem Gewichtsverlust assoziiert, wohl aber mit funktioneller Einbuße und deren klinischen Konsequenzen. In den vergangenen Jahren wurde eine große Zahl von Studien vorgelegt, die den Wert einer ergänzenden bilanzierten Diät mit essenziellen Aminosäuren bei Sarkopenie und bei Erkrankungen, die häufig mit der Entwicklung einer Kachexie assoziiert sind, belegen. Hierzu gehören Diabetes mellitus, chronische Herz- und Niereninsuffizienz, chronisch-obstruktive Lungenerkrankung und Tumorerkrankungen. Nach einem Überblick über die pathophysiologischen Hintergründe des Muskelproteinstoffwechsels und der klinischen Diskussion der Sarkopenie und Kachexie beschreibt dieser Artikel die Studienlage zur ergänzenden bilanzierten Diät mit essenziellen Aminosäuren bei diesen Erkrankungen.

Abstract

Muscle protein metabolism is the main determinant in the development of both sarcopenia and cachexia. A vast array of pathophysiological mechanisms is involved in the dysbalance between anabolic and catabolic factors. Unlike cachexia, sarcopenia is not usually associated with weight loss. However, one of the prominent features of sarcopenia is the development of functional impairment and its clinical consequences. Over the last several years, a large number of studies has been published that buttress the value of essential amino acids as a nutritional supplement in sarcopenia and in chronic illnesses that are frequently associated with the development of cachexia. Such illnesses include diabetes mellitus, chronic heart and chronic renal failure, chronic obstructive pulmonary disease and malignant diseases. This article reviews the pathophysiological background of muscle protein metabolism as well as sarcopenia and cachexia as clinical entities. Moreover, this article provides an overview of studies that used essential amino acids as a nutritional supplement in the aforementioned illnesses.

Schlüsselwörter

Sarkopenie - Kachexie - essenzielle Aminosäuren - Proteinstoffwechsel - Muskel - chronische Krankheit

Keywords

sarcopenia - cachexia - essentiell amino acids - protein metabolism - muscle - chronic illness

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