筋内脂肪量の増大が予後に与える影響の解明：高齢入院患者での検討

阐明肌内脂肪量增加对预后的影响：老年住院患者的研究

• 批准号: 20K19661
• 负责人: 赤澤 直紀
• 金额: $ 2.75万
• 依托单位: Tokushima Bunri University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Early-Career Scientists
• 财政年份: 2020
• 资助国家: 日本
• 起止时间: 2020-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-20K19661/
• 关键词: 筋内脂肪量; 高齢入院患者; 大腿四頭筋; 嚥下; 低栄養; 予後; 日常生活動作能力

2018年に発表された世界規模の低栄養診断基準では，筋量の減少が，重要な現症の一つとして位置づけられている。一方，我々はこれまでに，高齢入院患者の骨格筋内における脂肪量（筋内脂肪量）の特徴を横断的に調査してきた。それら成果として，高齢入院患者の大腿四頭筋の筋内脂肪量の増大は，重度低栄養リスクと関連すること，さらにそれらは，筋量の減少よりも，嚥下機能と歩行自立度の低下に関連することを見出した。これら結果は，筋内脂肪量の増大は，筋量の減少よりも，高齢入院患者の予後に悪影響を与える可能性を示していた。本研究では，その可能性を検証するため，高齢入院患者における筋内脂肪量の増大と日常生活動作能力，在宅復帰率および生存率の低下との縦断的関連性を明らかとする。これら関連性を明らかとすることで，高齢入院患者の低栄養の議論において，筋量の減少よりも，筋内脂肪量の増大に着目する重要性を提示する。2022年度の研究成果として，高齢入院患者の入院時の大腿四頭筋の筋内脂肪量の増大が嚥下能力の回復に悪影響を与えることを明らかとした。これら知見は大腿四頭筋の筋内脂肪量を改善させる介入が嚥下能力の改善に繋がる可能性を示したものであり，嚥下能力が低下した高齢入院患者のマネジメントの発展に大きく寄与するものと考える。さらに，高齢入院患者の入院時の低栄養リスクは入院中の大腿四頭筋の筋内脂肪量の増大に関連することを明らかにした。これら知見についても高齢入院患者の大腿四頭筋の筋内脂肪量の改善には栄養介入が重要であることを示した点で非常に意義があると考える。

In 2018, the world-scale hypotrophic diagnostic benchmark was announced, and the reduction in muscle mass and the location of important symptoms were reduced. On the other hand, we investigated the characteristics of intramuscular fat mass (intramuscular fat mass) in patients with hypertension. The results showed that there was an increase in the amount of fat in the quadriceps of the thigh in patients admitted to the hospital with hypertension, and an increase in the amount of fat in the quadriceps of the thigh in patients admitted to the hospital with severe hypotension. The results showed that the increase in muscle fat and the decrease in muscle mass had a significant impact on the future of patients admitted to the hospital. This study examined the possibility that increased intramuscular fat mass in hospitalized patients with high obesity was associated with increased mobility in daily living, decreased home recovery rates, and decreased survival rates. This correlation indicates the importance of decreased muscle mass and increased intramuscular fat mass in the discussion of hypotrophy in patients admitted to hospital with hypertension. The results of the 2022 study showed that the increase in the amount of fat in the quadriceps muscles at admission affected the recovery of swallowing ability in patients with high obesity. This study showed that the incidence of obesity in patients admitted to the hospital was significantly higher than that in patients admitted to the hospital. In addition, there is a clear correlation between hypothyroidism at admission and increased fat mass in the quadriceps muscles at admission. The importance of nutritional intervention in improving the amount of fat in the quadriceps muscles of patients admitted to the hospital

项目成果

Higher malnutrition risk is related to increased intramuscular adipose tissue of the quadriceps in older inpatients: A cross-sectional study

• DOI: 10.1016/j.clnu.2019.11.028
• 发表时间: 2020-08-01
• 期刊: CLINICAL NUTRITION
• 影响因子: 6.3
• 作者: Akazawa, Naoki;Okawa, Naomi;Moriyama, Hideki
• 通讯作者: Moriyama, Hideki

Higher malnutrition risk in older inpatients who are referred to the department of rehabilitation is related to increase of intramuscular adipose tissue: A prospective study

转诊至康复科的老年住院患者营养不良风险较高与肌内脂肪组织的增加有关：一项前瞻性研究

• DOI: 10.1016/j.clnu.2022.08.010
• 发表时间: 2022
• 期刊: Clinical Nutrition
• 影响因子: 6.3
• 作者: Akazawa Naoki;Kishi Masaki;Hino Toshikazu;Tsuji Ryota;Tamura Kimiyuki;Hioka Akemi;Moriyama Hideki
• 通讯作者: Moriyama Hideki

Increased total body extracellular-to-intracellular water ratio in community-dwelling elderly women is associated with decreased handgrip strength and gait speed

• DOI: 10.1016/j.nut.2021.111175
• 发表时间: 2021-02-23
• 期刊: NUTRITION
• 影响因子: 4.4
• 作者: Hioka, Akemi;Akazawa, Naoki;Nagahiro, Shinji
• 通讯作者: Nagahiro, Shinji

Greater Quadriceps Muscle Mass at Post-Acute Care Admission is Associated with Better Swallowing Ability at Discharge among Adults with Stroke

成人中风患者在急性护理入院后的股四头肌质量与出院时更好的吞咽能力相关

• DOI: 10.1016/j.jamda.2021.04.019
• 发表时间: 2021
• 期刊: Journal of the American Medical Directors Association
• 影响因子: 7.6
• 作者: Akazawa Naoki;Kishi Masaki;Hino Toshikazu;Tsuji Ryota;Tamura Kimiyuki;Hioka Akemi;Moriyama Hideki
• 通讯作者: Moriyama Hideki

Using GLIM criteria, cutoff value for low BMI in Asian populations discriminates high or low muscle mass: A cross-sectional study

• DOI: 10.1016/j.nut.2020.110928
• 发表时间: 2021-01-01
• 期刊: NUTRITION
• 影响因子: 4.4
• 作者: Akazawa, Naoki;Kishi, Masaki;Moriyama, Hideki
• 通讯作者: Moriyama, Hideki