筋トレで骨格筋の悪液質改善：症例報告

関節リウマチに対するレジスタンストレーニングは骨格筋の悪液質と筋肉の機能を改善させるという症例報告を紹介します。

Salaheddin Sharif, et al: Resistance Exercise Reduces Skeletal Muscle Cachexia and Improves Muscle Function in Rheumatoid Arthritis. Case Reports in MedicineVolume 2011 (2011), Article ID 205691, 7 pages doi:10.1155/2011/205691

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http://www.hindawi.com/journals/crim/2011/205691/

関節リウマチで悪液質の患者を対象に、16週間のレジスタンストレーニングを行い、筋トレの前後で外側広筋の筋生検を行いました。その結果、筋肉の核がわずかに増加し、アポトーシスをおこした筋肉の核がわずかに減少しました。これより筋トレが関節リウマチの悪液質に有効な可能性があるとしています。

有酸素運動やレジスタンストレーニングには、悪液質への抗炎症作用があると考えていますが、今回の症例ではCRPは筋トレ前後とも正常範囲内でした。抗炎症作用以外にも悪液質患者に運動が有効なメカニズムがあるのかもしれません。

Abstract
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune, inflammatory disease associated with cachexia (reduced muscle and increased fat). Although strength-training exercise has been used in persons with RA, it is not clear if it is effective for reducing cachexia. A 46-year-old woman was studied to determine: (i) if resistance exercise could reverse cachexia by improving muscle mass, fiber cross-sectional area, and muscle function; and (2) if elevated apoptotic signaling was involved in cachexia with RA and could be reduced by resistance training. A needle biopsy was obtained from the vastus lateralis muscle of the RA subject before and after 16 weeks of resistance training. Knee extensor strength increased by 13.6% and fatigue decreased by 2.8% Muscle mass increased by 2.1%. Average muscle fiber cross-sectional area increased by 49.7%, and muscle nuclei increased slightly after strength training from 0.08 to 0.12 nuclei/μm2. In addition, there was a slight decrease (1.6%) in the number of apoptotic muscle nuclei after resistance training. This case study suggests that resistance training may be a good tool for increasing the number of nuclei per fiber area, decreasing apoptotic nuclei, and inducing fiber hypertrophy in persons with RA, thereby slowing or reversing rheumatoid cachexia.