6th Cachexia Conference抄録

12月8-10日にミラノで開催される6th Cachexia Conferenceの抄録集がJ Cachexia Sarcopenia Muscleに掲載されています。

Abstracts of the 6th Cachexia Conference, Milan, Italy, December 8–10, 2011. J Cachexia Sarcopenia Muscle DOI 10.1007/s13539-011-0045-3

下記のHPで抄録集をPDFで見ることができます。

http://www.springerlink.com/content/ku5q46173458q124/fulltext.pdf

日本からの発表も抄録集を見る限り、6-7題程度あるようです。面白そうな抄録を順番に紹介していきます。まずは「同種造血幹細胞移植前患者におけるサルコペニアの発生割合と、身体組成、生理機能、栄養、疲労への影響」を紹介します。

サルコペニアの診断基準には骨格筋量が男性8.87kg未満、女性6.42kg未満を使用しています。生理機能は握力、膝伸展筋力、6分間歩行距離で評価しています。

結果ですが、164人の患者（年齢中央値50歳）のうち、83人（50.6％）にサルコペニアを認めました。除脂肪体重（LBM）は握力、膝伸展筋力と強い相関を、6分間歩行距離と弱い相関をそれぞれ認めました。サルコペニアの患者ではサルコペニアではない患者と比較して、握力、膝伸展筋力が低く、疲労が多かったです。

同種造血幹細胞移植前患者の2人に1人がサルコペニアという事実は、かなりインパクトがあると思います。原因としては悪液質によるものが最も疑われますが、飢餓や廃用を合併している可能性もあります。原因検索の追及とその対策、サルコペニアの患者は予後が悪いかなども今後知りたいですね。

Shinichiro Morishita, et al: The incidence of sarcopenia and its effects on body composition, physiological function, nutrition, and fatigue in patients before allogeneic hematopoietic stem cell transplantation
Background and aims: Cachexia in patients with haematological
malignancies is often related to sarcopenia. We believe that allogeneic
hematopoietic stem cell transplant (allo-hematopoietic stem cell
transplantation (HSCT)) patients are often stricken by sarcopenia prior
to transplantation. The aim of this study is to investigate the incidence
of sarcopenia and the relationship of sarcopenia with body composition
and physiological function, nutrition, and fatigue in patients
before allo-HSCT.

Methods: Study participants included patients who had undergone
allo-HSCT from May 2007 to July 2011. One hundred and sixty-four
patients were included in this study (median 50 years). Body
composition was evaluated using bioelectrical impedance analysis.
Evidence of sarcopenia was calculated using the male (<8.87 kg of
skeletal muscle mass/m2) and female (<6.42 kg of skeletal muscle mass/
m2). Physiological functions were evaluated by handgrip, knee extensor
strength, and 6-min walk test (6MWT).
Results: Eighty-three patients (50.6%) enrolled in our study had sarcopenia
prior to allo-HSCT. Lean body mass (LBM) strongly correlated with handgrip
and knee extensor strength (r=0.72∼0.75, p<0.01) and weakly correlated
with 6MWT (r=0.34, p<0.01). Body weight and fat body mass correlated
with fatigue (r=−0.15 and r=−0.2, respectively, p<0.05). Patients with
sarcopenia experienced decreased muscular strength and increased fatigue
compared with patients without sarcopenia (handgrip=−12%, knee extensor
strength=−12%, fatigue=+22%, p<0.05).

Conclusion: Sarcopenia has been reported to occur at a rate of 5% (2 SD)
in the elderly. In this study, roughly half of the patients had sarcopenia
before allo-HSCT. Therefore, patients may have decreased muscle mass
prior to allo-HSCT. In the evaluation of body composition, we discovered
that muscle strength and LBM showed a high correlation. Patients with
sarcopenia also have decreased muscle strength due to muscle atrophy and
we believe that this causes increased fatigue in these patients.