Harada H, Kai H, Niiyama H, Nishiyama Y, Katoh A, Yoshida N, Fukumoto Y, Ikeda H
Hisao Ikeda, MD, PhD, Department of Physical Therapy, Faculty of Fukuoka Medical Technology, Teikyo University, 6-22 Misaki-machi, Omuta, Fukuoka 836-8505, Japan, E-mail:
J Nutr Health Aging. 2017;21(4):449-456. doi: 10.1007/s12603-016-0743-9.
Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, with the risk of frailty and poor quality of life. This study aimed to clarify the clinical characteristics of sarcopenia and to investigate the effects of comprehensive cardiac rehabilitation (CCR), including nutrition, physical exercise and medication, in patients with cardiovascular disease (CVD).
We retrospectively studied 322 inpatients with CVD (age 72±12 years). Muscle mass, muscle strength and physical performance were assessed before and after exercise training in patients with and without sarcopenia, which was defined as either a gait speed of <0.8 m/s or reduced handgrip strength (<26 kg in males and <18 kg in females), together with lower skeletal muscle index (SMI) (<7.0 kg/m2 in males and <5.7 kg/m2 in females). The actual daily total calorie and nutrient intake was also calculated.
Sarcopenia was identified in 28% of patients with CVD, these patients having a higher prevalence of symptomatic chronic heart failure and chronic kidney disease. SMI was significantly associated with protein intake and statin treatment. The ratio of peak VO2 and SMI was significantly higher in the statin treatment group. Handgrip strength, gait speed, leg weight bearing index, and nutritional intake improved after exercise training in patients both with and without sarcopenia.
The present findings suggest that CCR is a promising strategy for prevention and treatment of sarcopenia in patients with CVD.
肌肉减少症是一种以骨骼肌质量和力量进行性、全身性丧失为特征的综合征，伴有虚弱风险和生活质量下降。本研究旨在阐明肌肉减少症的临床特征，并研究包括营养、体育锻炼和药物治疗在内的综合心脏康复（CCR）对心血管疾病（CVD）患者的影响。
我们回顾性研究了322例CVD住院患者（年龄72±12岁）。对有或无肌肉减少症的患者在运动训练前后评估肌肉质量、肌肉力量和身体功能，肌肉减少症定义为步态速度<0.8 m/s或握力降低（男性<26 kg，女性<18 kg），同时骨骼肌指数（SMI）较低（男性<7.0 kg/m²，女性<5.7 kg/m²）。还计算了实际每日总热量和营养摄入量。
在28%的CVD患者中发现了肌肉减少症，这些患者有症状性慢性心力衰竭和慢性肾病的患病率较高。SMI与蛋白质摄入量和他汀类药物治疗显著相关。他汀类药物治疗组的峰值VO₂与SMI之比显著更高。有或无肌肉减少症的患者在运动训练后握力、步态速度、腿部负重指数和营养摄入量均有所改善。
目前的研究结果表明，CCR是预防和治疗CVD患者肌肉减少症的一种有前景的策略。
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