老年心血管功能与营养课稿.ppt

The illness creates an environment that ay be characterized by inflammation, loss of appetite (anorexia), low anabolic horones and anemia. Decreased food intake and anorexia result in loss of body mass and muscle mass. IN addition anorexia inflammation, and insulin resistance and low levels of anabolic hormones result in muscle wasting Anker et al. difined cardiac cachexia as documented non-edematous weight loss of 6% of the previous normal weight observed over a period of 6?months. 1928 patients with Chronic Heart Failure, Functional classification of Class 2 using the New York Heart Association : Mild -Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, or dyspnea. Data showed that Weight loss of 6% or more at any time during follow-up was the strongest predictor of impaired survival (adjusted hazard ratio 2.10, 95% Confidence Interval 1.77-2.49; p0.0001), compared to the functional classification of CHF and Left ventricular Ejection Fraction Survival from Cardiac Cachexia over 1.5 Age-related decreases in muscle mass and muscle strength, in combination with reduced endurance, may determine reduced physical activity [14]. A reduction in muscle mass and physical activity reduces total energy expenditure in elderly people and may lead to weight gain, characterized mainly by the accumulation of abdominal fat [14]. On the other hand, increases in fat mass, particularly visceral fat, may lead to increased secretion of a number of pro- inflammatory cytokines [38]. Recruitment of macrophages by pro-inflammatory cytokines secreted by fat cells has recently been demonstrated [39]; however, it is possible to hypothesize a role for fat cells and macrophages in the pathogenesis of sarcopenia. Page 4 of 14 Sarcopenic obesity: A new category of obesity in the elderly 3/21/14 11:47 PM C-reactive protein (CRP) and interleukin 6 (IL-6) have been shown to be associated positivel