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中国社区老年人群膳食蛋白质摄入量与四年间肌肉量及身体功能下降的关联

Associations of dietary protein intake on subsequent decline in muscle mass and physical functions over four years in ambulant older Chinese people.

作者信息

Chan R, Leung J, Woo J, Kwok T

机构信息

Dr Ruth Chan, Department of Medicine and Therapeutics, Rm 124021, 10/F Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, Telephone number: (852) 2632 2190, Fax number: (852) 2637 9215, Email:

出版信息

J Nutr Health Aging. 2014;18(2):171-7. doi: 10.1007/s12603-013-0379-y.

Abstract

OBJECTIVE

To examine the association of dietary protein intake with 4-year change in physical performance measures and muscle mass in Chinese community-dwelling older people aged 65 and older in Hong Kong.

DESIGN

Prospective cohort study design.

SETTING

Hong Kong, People's of Republic of China.

PARTICIPANTS

There were 2,726 (1411 male, 1315 female) community-dwelling older people aged 65 and older.

MEASUREMENTS

Baseline total, animal and vegetable protein intakes were collected using a validated food frequency questionnaire. Relative protein intake expressed as g/kg body weight was calculated and divided into quartiles for data analysis. Baseline and 4-year physical performance measures (normal and narrow 6-meters walking speed and step length in a 6-meters walk) were measured and 4-year change in appendicular skeletal muscle mass (ASM) from baseline was assessed by dual-energy X-ray absorptiometry. Univariate analysis identified age and sex as significant factors associated with change in physical performance measures or ASM, thus adjustments for these factors were made for subsequent analysis of covariance.

RESULTS

Median relative total protein intake was 1.3 g/kg body weight in men and 1.1 g/kg body weight in women. After adjustment for age and sex, relative total protein intake and animal protein intake were not associated with change in physical performance measures and ASM. In contrast, participants in the highest quartile (>0.72 g/kg body weight) of relative vegetable protein intake lost significantly less ASM over 4-year than those in the lowest quartile of relative vegetable protein intake (<=0.40 g/kg body weight) (adjusted mean ± SE: 0.270 ± 0.029 vs. 0.349 ± 0.030 kg, ptrend=0.025). There was no association between relative vegetable protein intake and change in physical performance measures.

CONCLUSIONS

Higher protein intake from vegetable source was associated with reduced muscle loss in Chinese community-dwelling older people in Hong Kong whereas no association between total and animal protein intake and subsequent decline in muscle mass or physical performance measures was observed in this sample.

摘要

目的

研究香港65岁及以上社区居住的中国老年人膳食蛋白质摄入量与体能指标和肌肉量4年变化之间的关联。

设计

前瞻性队列研究设计。

地点

中华人民共和国香港。

参与者

2726名(1411名男性,1315名女性)65岁及以上社区居住的老年人。

测量

使用经过验证的食物频率问卷收集基线时的总蛋白质、动物蛋白和植物蛋白摄入量。计算以克/千克体重表示的相对蛋白质摄入量,并分为四分位数进行数据分析。测量基线和4年时的体能指标(正常和狭窄6米步行速度以及6米步行中的步长),并通过双能X线吸收法评估从基线开始的4年中四肢骨骼肌量(ASM)的变化。单因素分析确定年龄和性别是与体能指标或ASM变化相关的重要因素,因此在后续的协方差分析中对这些因素进行了调整。

结果

男性相对总蛋白质摄入量中位数为1.3克/千克体重,女性为1.1克/千克体重。在调整年龄和性别后,相对总蛋白质摄入量和动物蛋白摄入量与体能指标和ASM的变化无关。相比之下,相对植物蛋白摄入量最高四分位数(>0.72克/千克体重)的参与者在4年中ASM的损失明显少于相对植物蛋白摄入量最低四分位数(<=0.40克/千克体重)的参与者(调整后均值±标准误:0.270±0.029 vs. 0.349±0.030千克,ptrend=0.025)。相对植物蛋白摄入量与体能指标变化之间无关联。

结论

在香港社区居住的中国老年人中,较高的植物源蛋白质摄入量与肌肉损失减少有关,而在该样本中未观察到总蛋白质和动物蛋白摄入量与随后的肌肉量或体能指标下降之间存在关联。

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