Buhl Sussi F, Andersen Aino L, Andersen Jens R, Andersen Ove, Jensen Jens-Erik B, Rasmussen Anne Mette L, Pedersen Mette M, Damkjær Lars, Gilkes Hanne, Petersen Janne
Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg C, Denmark.
Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg C, Denmark.
Clin Nutr. 2016 Feb;35(1):59-66. doi: 10.1016/j.clnu.2015.02.015. Epub 2015 Mar 5.
BACKGROUND & AIM: Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient. The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than standard care. Secondary outcomes were changes in muscle strength, functional ability and body weight.
29 acutely admitted old (>65 years) patients were randomly assigned to the intervention (n = 14) or to standard care (n = 15). The Intervention Group received 1.7 g protein/kg/day during admission and a daily protein supplement (18.8 g protein) and resistance training 3 times per week the 12 weeks following discharge. Muscle mass was assessed by Dual-energy X-ray Absorptiometry. Muscle strength was assessed by Hand Grip Strength and Chair Stand Test. Functional ability was assessed by the de Morton Mobility Index, the Functional Recovery Score and the New Mobility Score. Changes in outcomes from time of admission to three-months after discharge were analysed by linear regression analysis.
The intention-to-treat analysis showed no significant effect of the intervention on lean mass (unadjusted: β-coefficient = -1.28 P = 0.32, adjusted for gender: β-coefficient = -0.02 P = 0.99, adjusted for baseline lean mass: β-coefficient = -0.31 P = 0.80). The de Morton Mobility Index significantly increased in the Control Group (β-coefficient = -11.43 CI: 0.72-22.13, P = 0.04). No other differences were found.
No significant effect on muscle mass was observed in this group of acutely ill old medical patients. High compliance was achieved with the dietary intervention, but resistance training was challenging. Clinical trials identifier NCT02077491.
应激代谢与肌肉加速流失有关，这对老年内科患者有重大影响。本研究的目的是调查蛋白质与抗阻训练相结合的干预措施在对抗肌肉流失方面是否比标准护理更有效。次要结果是肌肉力量、功能能力和体重的变化。
29名急性入院的老年（>65岁）患者被随机分配到干预组（n = 14）或标准护理组（n = 15）。干预组在入院期间接受1.7 g/（kg·天）的蛋白质摄入，并在出院后的12周内每天补充蛋白质（18.8 g），每周进行3次抗阻训练。通过双能X线吸收法评估肌肉质量。通过握力和椅子站立试验评估肌肉力量。通过德莫顿运动指数、功能恢复评分和新运动评分评估功能能力。采用线性回归分析来分析从入院到出院后三个月的结果变化。
意向性分析显示，干预对瘦体重没有显著影响（未调整：β系数 = -1.28，P = 0.32；按性别调整：β系数 = -0.02，P = 0.99；按基线瘦体重调整：β系数 = -0.31，P = 0.80）。对照组的德莫顿运动指数显著增加（β系数 = -11.43，CI：0.72 - 22.13，P = 0.04）。未发现其他差异。
在这组急性病老年内科患者中，未观察到对肌肉质量的显著影响。饮食干预的依从性较高，但抗阻训练具有挑战性。临床试验标识符：NCT02077491。
