Paulin Fernanda Viana, Zagatto Alessandro Moura, Chiappa Gaspar R, Müller Paulo de Tarso
Laboratory of Respiratory Pathophysiology (LAFIR), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, MS, Brazil.
Laboratory of Respiratory Pathophysiology (LAFIR), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, MS, Brazil; Department of Physical Education, UNESP - Universidade Estadual Paulista, Bauru, São Paulo, Brazil.
Respir Med. 2017 Jan;122:23-29. doi: 10.1016/j.rmed.2016.11.015. Epub 2016 Nov 22.
Vitamin B12 is essential in the homocysteine, mitochondrial, muscle and hematopoietic metabolisms, and its effects on exercise tolerance and kinetics adjustments of oxygen consumption (V'O) in rest-to-exercise transition in COPD patients are unknown. This randomized, double-blind, controlled study aimed to verify a possible interaction between vitamin B12 supplementation and these outcomes. After recruiting 69 patients, 35 subjects with moderate-to-severe COPD were eligible and 32 patients concluded the study, divided into four groups (n = 8 for each group): 1. rehabilitation group; 2. rehabilitation plus B12 group; 3. B12 group; and 4. placebo group. The primary endpoint was cycle ergometry endurance before and after 8 weeks and the secondary endpoints were oxygen uptake kinetics parameters (time constant). The prevalence of vitamin B12 deficiency was high (34.4%) and there was a statistically significant interaction (p < 0.05), favoring a global effect of supplementation on exercise tolerance in the supplemented groups compared to the non-supplemented groups, even after adjusting for confounding variables (p < 0.05). The same was not found for the kinetics adjustment variables (τV'O and V'O, p > 0.05 for both). Supplementation with vitamin B12 appears to lead to discrete positive effects on exercise tolerance in groups of subjects with more advanced COPD and further studies are needed to establish indications for long-term supplementation.
维生素B12在同型半胱氨酸、线粒体、肌肉和造血代谢中至关重要，但其对慢性阻塞性肺疾病（COPD）患者从静息到运动转换过程中的运动耐力及耗氧量（V'O）动力学调整的影响尚不清楚。这项随机、双盲、对照研究旨在验证补充维生素B12与这些结果之间可能存在的相互作用。招募69例患者后，35例中重度COPD患者符合条件，32例患者完成研究，分为四组（每组n = 8）：1. 康复组；2. 康复加B12组；3. B12组；4. 安慰剂组。主要终点是8周前后的蹬车耐力，次要终点是摄氧动力学参数（时间常数）。维生素B12缺乏的患病率很高（34.4%），且存在统计学显著的相互作用（p < 0.05），与未补充组相比，补充组补充剂对运动耐力具有整体效应，即使在调整混杂变量后也是如此（p < 0.05）。动力学调整变量（τV'O和V'O）未发现同样情况（两者p > 0.05）。补充维生素B12似乎对病情更严重的COPD患者组的运动耐力产生了明显的积极影响，需要进一步研究以确定长期补充的指征。
