身体組成と乳がん：除脂肪体重の役割

身体組成と乳がん：除脂肪体重の役割に関するレビュー論文を紹介します。

Cameron McDonald, Judith D Bauer and Sandra Capra: Body composition and breast cancer – the role of lean body mass. CancerForum Volume 35 Number 2 July 2011

下記のHPで全文PDFで見ることができます。

http://www.cancerforum.org.au/file/2011/July/CF11July_102-106.pdf

乳がんにおける身体組成の変化については、まだ十分には解明されていません。しかし、診断後や治療後に除脂肪体重の減少やサルコペニアを認めることは、少なくありません。運動療法が除脂肪体重の減少を緩和するエビデンスはありますし、食事摂取量が減少することでサルコペニアが悪化することも示されています。

そのため、十分なエビデンスはありませんが、乳がんにおいても運動と食事の併用が重要だと考えられています。またn-3系脂肪酸（EPA）やBCAAが除脂肪体重を維持するために有用な可能性があります。

乳がんのリハというと、肩関節可動域制限やリンパ浮腫に対するものを考えがちですが、乳がんによるサルコペニアや悪液質は決して稀ではありませんし、これらの評価、介入も重要だと改めて実感しました。

Abstract
Breast cancer risk and outcomes for breast cancer survivors are known to be influenced by body composition. A wealth of literature surrounds the function and role of fat tissue, however considerably less is known regarding lean body mass and its functional role in immune, hormonal and metabolic regulation in breast cancer aetiology. This review outlines findings relevant to lean body mass before, and following breast cancer diagnosis. A paucity of research exists regarding lean body mass and breast cancer risk. However, post-diagnosis lean body mass losses are commonly reported and a concern for ongoing co-morbidity after treatment. A comprehensive mechanism for sarcopenic obesity in breast cancer survivors is currently unknown. However, findings from other disease states indicate that the effects of chronic inflammation and/or an increase in sedentary activity may partly explain the exaggerated losses of lean body mass.
Exercise has been a successful intervention for attenuating lean body mass losses after treatment, while weight loss through energy restriction may exacerbate breast cancer related sarcopenia. Combining exercise with dietary intervention to optimise lean body mass may be ideal; however there is insufficient evidence for this at present. Similarly, the role of functional food supplements, such as omega-3 fatty acids and essential amino acids, may aid lean body mass maintenance through anti-inflammatory action and increased muscle protein synthesis.