Sarkopeni patofizyolojisi ve beslenme tedavisinde özel yaklaşımlar

Sarkopeni, yıllar içinde istemsiz olarak ilerleyen kas kitlesi ve işlev yitimidir. Sarkopeninin oluşumunda yaşlılık süreci, enflamasyon, oksidatif stres, hastalık, hormonal-nöral-endokrin değişiklikler, kas yapısındaki farklılaşma ve yetersiz beslenme gibi pek çok etken vardır. Tüm bu faktörlerde ortak olan temel sorun kas proteinlerindeki döngünün değişimi; yapım ve yıkımda oluşan dengesizliktir. Medikal tedavinin yanı sıra egzersiz ve beslenme konusunda özel yaklaşımlar vardır. Oluşmuş sarkopenide, günlük beslenmeye elzem amino asit içeriği zengin gıdaların eklenmesiyle kas protein sentezinin ve gücünün arttığı kanıtlanmıştır. Yaşlılıkta oluşan D vitamini eksikliği, insülin ve IGF-1 gibi anabolik hormonların yetersizliği, yıllar içinde biriken reaktif oksijen radikalleri, iştah kaybının artması gibi durumlar özel nutrientlerin desteğini gerektirmektedir. D Vitamini ve lif desteği, antioksidan miktarının artırılması, yara iyileşmesinde selenyum-çinko eklenmesi gibi özel destekler önerilmektedir. Sarkopenide farklı farmakonutrientlerin kullanımı, miktar ve süresi tam olarak açık değildir; ayrıca tanı açısından daha iyi yöntemlere gereksinim vardır. Ek olarak, sarkopeninin derecesi, enflamasyonun süreci ve reaktif oksijen türleriyle ilişkisi, antioksidan tedavisi, genetik yatkınlıkla olan bağıntı, beslenme tedavisi için açıklanmayı gerektirmektedir.

Sarcopenia pathophysiology and specific measures for nutritional treatment

Sarcopenia is the involuntary and progressive loss of muscle mass and function that occurs within years. There are numerous etiological factors for sarcopenia such as; the aging process, inflammation, oxidative stress, diseases, alterations in hormonal-neural- endocrine systems and muscle structure and malnutrition. The main basic pathopysiological factor in all these disorders is the change in muscle protein turnover; an imbalance in synthesis and demolition. In addition to medical treatment of sarcopenia, there are special approaches in exercise and nutrition. It has been proven that the addition of foods rich in essential amino acids to daily diet improves muscle protein syntesis and muscle strength in established sarcopenia. Vitamin D deficiency, insufficiency of anabolic hormones such as insulin and IGF-1, accumulation of reactive oxygen species within years, decreased appetite require specialized nutrient supplementation. Addition of vitamin D, supplementary fiber, rising the amount of antioxidants, selenium and zinc supplementation for wound healing have been recommended for sarcopenic patients. The use of different pharmaconutrients, the amount and length of supplementation is stil inconclusive. Better methods are required for diagnosis and for differential diagnosis. Besides, the degree of sarcopenia, the inflammatory process, anti- oxidant treatment, genetic predisposition and nutritional treatment still waits for further explanation Key words: Sarcopenia, Pathophysiology,Pharmaco-

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ISSN: 1300-0853
Yayın Aralığı: Yılda 6 Sayı
Başlangıç: 1992
Yayıncı: TÜRK TABİPLERİ BİRLİĞİ

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