摘要肌肉减少性肥胖(SO)是一种肌肉减少症和肥胖共存的综合征。 SO 在老年人群中发病率高,且常与某些慢性疾病
如糖尿病、肿瘤、非酒精性脂肪性肝病同时发生,SO 能显著增加临床不良结局的风险,如生活质量下降,跌倒、骨折和死亡率上
升等,准确诊断和有效管理 SO 对于改善患者预后至关重要。 基于当前的研究和临床经验,本文使用 GRADE 系统(Grading of
Recommendations Assessment, Development, and Evaluation)对 SO 临床筛查、诊断、评估和治疗相关推荐意见的证据质量和推荐
强度进行分级评估,形成共识。 该共识强调 SO 的诊断应遵循结构化的三步法:筛查、诊断和分期。 评估应包括肌肉功能、肌
肉质量以及脂肪含量等,同时应使用针对中国人群的特异性诊断阈值,以确保诊断的准确性。 而 SO 的治疗需要个体化的综
合干预策略,包括药物治疗、营养治疗和运动干预等,且这些干预措施应根据患者的具体需求和病情进行个性化调整。 该共
识旨在为临床医师提供一个管理 SO 和改善患者护理的标准化框架。
Abstract：Sarcopenic obesity SO is a complex condition characterized by the coexistence of sarcopenia and obesity commonly
seen in older adults and individuals with chronic diseases including malignancies. SO is associated with a markedly increased risk of
poor clinical outcomes including diminished quality of life reduced physical function and elevated mortality. Accurate diagnosis and
effective management are essential to mitigating these risks and improving patient outcomes. Based on current research and clinical
experience this paper uses the GRADE system Grading of Recommendations Assessment Development and Evaluation to grade the
evidence quality and recommendation strength of recommendations related to SO clinical screening diagnosis evaluation and
treatment to form a consensus. The guidelines advocate for a stepwise diagnostic approach integrating assessments of skeletal muscle
function and body composition and the specific diagnostic thresholds for the China population should be used to ensure the accuracy of
diagnosis. Treatment recommendations encompass pharmacological therapies nutritional interventions and exercise programs and
these interventions should be individually adjusted according to the patient's specific needs and condition. These guidelines aim to
equip clinicians with a standardized framework to optimize the management of SO and enhance patient care.
中国抗癌协会肿瘤营养专业委员会,中国抗癌协会肿瘤整合支持治疗委员会. 肌肉减少性肥胖临床诊疗专家共识[J]. 肿瘤代谢与营养电子杂志, 2025, 12(2): 168-180.
Chinese Society of Nutritional Oncology, Chinese Society for Holistic Integrative Supportive Care. Clinical expert consensus on the diagnosis and treatment of sarcopenic obesity. Electron J Metab Nutr Cancer, 2025, 12(2): 168-180.
