支链氨基酸和维生素 D 补充对住院康复的肌少症老年人身体功能、肌肉质量和力量及营养状况的影响：一项多中心随机对照试验。

Effects of branched-chain amino acids and vitamin D supplementation on physical function, muscle mass and strength, and nutritional status in sarcopenic older adults undergoing hospital-based rehabilitation: A multicenter randomized controlled trial.

机构信息

Department of Rehabilitation, Heisei Tohya Hospital, Kumamoto, Japan.

Department of Rehabilitation, Suizenji Tohya Hospital, Kumamoto, Japan.

出版信息

Geriatr Gerontol Int. 2019 Jan;19(1):12-17. doi: 10.1111/ggi.13547. Epub 2018 Oct 24.

DOI:10.1111/ggi.13547

PMID:30358032

Abstract

AIM

To investigate the effects of branched-chain amino acids and vitamin D supplementation on physical function, muscle strength, muscle mass, and nutritional status in sarcopenic older adults undergoing hospital-based rehabilitation.

METHODS

We carried out an 8-week, multicenter, randomized, controlled, blinded outcome, two-cohort parallel group intervention trial of sarcopenic older adults undergoing in-hospital rehabilitation. The eligibility criteria included older adults (aged ≥65 years) with low muscle strength (handgrip strength) and low muscle mass (calf circumference) according to the cut-off values for older Asians. The intervention group received branched-chain amino acids and vitamin D supplementation, whereas the control group did not. Both groups underwent low-intensity resistance training in addition to the post-acute rehabilitation program. The primary outcome of physical function (Functional Independence Measure-motor scores), and the secondary outcomes of muscle strength (handgrip strength), muscle mass (calf circumference) and nutritional status (body mass index) were measured at baseline and at the end of the intervention.

RESULTS

Finally, a total of 68 patients were analyzed (intention-to-treat analysis): 35 in the intervention group and 33 in the control group. Functional Independence Measure-motor scores increased significantly in both groups over time (P < 0.05). However, no treatment-by-time effects were observed (median estimated difference 2.4, 95% confidence interval -1.2 to 7.1). Handgrip strength, calf circumference and body mass index increased significantly in both groups over time (P < 0.05), with significantly greater improvements in the intervention group (P = 0.041, 0.033 and 0.035, respectively).

CONCLUSIONS

We showed that an 8-week intervention of branched-chain amino acids and vitamin D supplementation with low-intensity resistance training improves muscle-related outcomes in sarcopenic older adults undergoing hospital-based rehabilitation (UMIN000006238). Geriatr Gerontol Int 2019; 19: 12-17.

摘要

目的

研究支链氨基酸和维生素 D 补充对住院康复的老年肌少症患者身体功能、肌肉力量、肌肉质量和营养状况的影响。

方法

我们进行了一项为期 8 周、多中心、随机、对照、盲法结局、两队列平行组干预试验，纳入了符合以下标准的住院康复的老年肌少症患者：根据亚洲老年人的截断值，肌肉力量（握力）低和肌肉质量（小腿围）低。干预组接受支链氨基酸和维生素 D 补充，而对照组不接受。两组均在接受急性后康复方案的同时接受低强度抗阻训练。主要结局为身体功能（功能性独立测量运动评分），次要结局为肌肉力量（握力）、肌肉质量（小腿围）和营养状况（体重指数），在基线和干预结束时进行测量。

结果

最终，共有 68 例患者进行了分析（意向治疗分析）：干预组 35 例，对照组 33 例。两组患者的功能性独立测量运动评分均随时间显著增加（P < 0.05）。然而，未观察到治疗与时间的交互作用（中位数估计差值 2.4，95%置信区间 -1.2 至 7.1）。握力、小腿围和体重指数均随时间显著增加（P < 0.05），干预组的改善更为显著（P = 0.041、0.033 和 0.035）。