Lennmarken C, Sandstedt S, Schenck H V, Larsson J
Department of Anaesthesiology, University Hospital, S-581 85 Linköping, Sweden.
Clin Nutr. 1986 May;5(2):99-103. doi: 10.1016/0261-5614(86)90015-4.
Measuring skeletal muscle function may be a diagnostic aid to detect malnutrition. To evaluate this hypothesis 11 lean women were studied before and after 5 days of total starvation. Skeletal muscle function was assessed as hand grip strength and as adductor pollicis muscle function after electrical stimulation of the ulnar nerve. The muscle function variables were force of contraction at 5, 10, 20 and 50 Hz stimulation, relaxation rate and endurance. In addition some currently used anthropometric and biochemical nutritional indices were serially determined. Hand grip strength was decreased (p < 0.05) and the function of the adductor pollicis muscle was altered with a higher contraction force at 10 Hz (p < 0.01), a slower relaxation rate (p < 0.05) and a reduced endurance (p < 0.05). These changes were all within the normal ranges. Triceps skin fold and arm muscle circumference were not changed after a mean weight loss of 3.3 kg (p < 0.05). However blood glucose, insulin and triiodothyronine all decreased (p < 0.01) indicating a metabolic adaptation to starvation. Prealbumin (p < 0.05) and fibronectin (p < 0.01) were also lowered. In conclusion, skeletal muscle function was significantly altered after five days of total starvation. However, to identify short term nutritional depletion in clinical practice the changes in muscle function were too small to be diagnostically useful.
测量骨骼肌功能可能有助于诊断营养不良。为了评估这一假设，对11名体型偏瘦的女性在完全饥饿5天前后进行了研究。骨骼肌功能通过握力以及尺神经电刺激后拇收肌的功能来评估。肌肉功能变量包括5、10、20和50赫兹刺激下的收缩力、松弛率和耐力。此外，还连续测定了一些目前使用的人体测量和生化营养指标。握力下降（p<0.05），拇收肌功能发生改变，在10赫兹时收缩力增强（p<0.01），松弛率减慢（p<0.05），耐力降低（p<0.05）。这些变化均在正常范围内。平均体重减轻3.3千克后，三头肌皮褶厚度和上臂肌肉周长未发生变化（p<0.05）。然而，血糖、胰岛素和三碘甲状腺原氨酸均下降（p<0.01），表明对饥饿产生了代谢适应。前白蛋白（p<0.05）和纤连蛋白（p<0.01）也降低了。总之，完全饥饿5天后骨骼肌功能发生了显著改变。然而，在临床实践中，为了识别短期营养消耗，肌肉功能的变化太小，无法用于诊断。
