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白藜芦醇对周围动脉疾病老年人行走能力的影响:RESTORE 随机临床试验。

Effect of Resveratrol on Walking Performance in Older People With Peripheral Artery Disease: The RESTORE Randomized Clinical Trial.

机构信息

Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

出版信息

JAMA Cardiol. 2017 Aug 1;2(8):902-907. doi: 10.1001/jamacardio.2017.0538.

Abstract

IMPORTANCE

Research shows that resveratrol, a sirtuin activator in red wine, improves exercise endurance and skeletal-muscle oxidative metabolism in animals and may enhance vascular function in humans. Resveratrol supplement sales exceed $30 million annually in the United States, but few data are available regarding its efficacy in humans.

OBJECTIVE

To determine whether resveratrol, 125 mg/d or 500 mg/d, improves the 6-minute walk performance in patients with peripheral artery disease (PAD).

DESIGN, SETTING, AND PARTICIPANTS: This parallel-design, double-blind, randomized clinical trial, called Resveratrol to Improve Outcomes in Older People With PAD (RESTORE), was conducted at Northwestern University. Sixty-six participants 65 years or older with PAD were randomized to receive a daily capsule of resveratrol, 125 mg or 500 mg, or placebo for 6 months. Participants were randomized using a randomly permuted block method stratified by baseline 6-minute walk test performance. This trial was conducted between January 1, 2015, and August 5, 2016, and data analyses were performed according to the intention-to-treat concept.

INTERVENTIONS

Administration of resveratrol, 125 or 500 mg/d, or placebo once daily.

MAIN OUTCOMES AND MEASURES

The primary outcome measure was the change in 6-minute walk distance at the 6-month follow-up. One of the secondary outcomes was change in maximal treadmill walking time. Because of the preliminary nature of the trial, the a priori power calculation used a 1-sided test with a significance level of P < .10.

RESULTS

The 66 participants were predominantly men (45 [68%]), had a mean (SD) age of 74.4 (6.6) years, and had a mean (SD) ankle brachial index of 0.67 (0.18). Sixty-four (97%) completed follow-up. Six-month mean (SE) changes in 6-minute walk distance were 4.6 (8.1) m for the 125-mg resveratrol group, -12.8 (7.5) m for the 500-mg resveratrol group, and -12.3 (7.9) m for the placebo group (P = .07 for the 125-mg resveratrol group vs placebo; P = .96 for the 500-mg resveratrol group vs placebo). Six-month mean (SE) changes in maximal treadmill walking time were 0.5 (2.3) minutes for the 125-mg resveratrol group, -0.6 (2.1) minutes for the 500-mg resveratrol group, and 0.4 (2.1) minutes for the placebo group (P = .18 for the 125-mg resveratrol group vs placebo; P = .12 for the 500-mg resveratrol group vs placebo).

CONCLUSIONS AND RELEVANCE

The RESTORE trial found no consistent evidence that resveratrol improves walking performance in patients 65 years or older with PAD.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT02246660.

摘要

目的:研究表明,红酒中的白藜芦醇作为一种组蛋白去乙酰化酶激活剂,可改善动物的运动耐力和骨骼肌氧化代谢,并且可能增强人类的血管功能。白藜芦醇补充剂在美国的年销售额超过 3000 万美元,但关于其在人体中的疗效的数据却很少。

方法和地点:这是一项在西北大学进行的平行设计、双盲、随机临床试验,称为白藜芦醇改善外周动脉疾病老年人的结局(RESTORE)。共纳入 66 名年龄在 65 岁及以上的外周动脉疾病患者,随机接受白藜芦醇 125mg/d 或 500mg/d 或安慰剂治疗 6 个月。使用随机区组方法按基线 6 分钟步行试验结果分层进行随机分组。该试验于 2015 年 1 月 1 日至 2016 年 8 月 5 日进行,根据意向治疗原则进行数据分析。

参与者:参与者 66 人,均为男性(45 人[68%]),平均(SD)年龄为 74.4(6.6)岁,平均(SD)踝肱指数为 0.67(0.18)。64 人(97%)完成了随访。6 个月时的主要结局是 6 分钟步行距离的变化。次要结局之一是最大跑步机步行时间的变化。由于试验的初步性质,事先的功效计算使用单侧检验,显著性水平为 P<0.10。

干预:每天服用白藜芦醇 125 或 500mg/d 或安慰剂一次。

结果:66 名参与者主要为男性(45[68%]),平均(SD)年龄为 74.4(6.6)岁,平均(SD)踝肱指数为 0.67(0.18)。64 名(97%)完成了随访。服用白藜芦醇 125mg/d 组 6 个月时 6 分钟步行距离的平均(SE)变化为 4.6(8.1)m,500mg/d 组为-12.8(7.5)m,安慰剂组为-12.3(7.9)m(白藜芦醇 125mg/d 组与安慰剂组相比,P=0.07;白藜芦醇 500mg/d 组与安慰剂组相比,P=0.96)。服用白藜芦醇 125mg/d 组 6 个月时最大跑步机步行时间的平均(SE)变化为 0.5(2.3)分钟,500mg/d 组为-0.6(2.1)分钟,安慰剂组为 0.4(2.1)分钟(白藜芦醇 125mg/d 组与安慰剂组相比,P=0.18;白藜芦醇 500mg/d 组与安慰剂组相比,P=0.12)。

结论:RESTORE 试验没有一致的证据表明白藜芦醇能改善 65 岁及以上外周动脉疾病患者的步行能力。

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