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补充维生素 D 和富含亮氨酸的乳清蛋白营养补充剂 13 周可减轻肌少症老年人的慢性低度炎症:PROVIDE 研究。

Thirteen weeks of supplementation of vitamin D and leucine-enriched whey protein nutritional supplement attenuates chronic low-grade inflammation in sarcopenic older adults: the PROVIDE study.

机构信息

Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090, Brussels, Belgium.

Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands.

出版信息

Aging Clin Exp Res. 2019 Jun;31(6):845-854. doi: 10.1007/s40520-019-01208-4. Epub 2019 May 2.

Abstract

BACKGROUND

A chronic low-grade inflammatory profile (CLIP) is associated with sarcopenia in older adults. Protein and Vitamin (Vit)D have immune-modulatory potential, but evidence for effects of nutritional supplementation on CLIP is limited.

AIM

To investigate whether 13 weeks of nutritional supplementation of VitD and leucine-enriched whey protein affected CLIP in subjects enrolled in the PROVIDE-study, as a secondary analysis.

METHODS

Sarcopenic adults (low skeletal muscle mass) aged ≥ 65 years with mobility limitations (Short Physical Performance Battery 4-9) and a body mass index of 20-30 kg/m were randomly allocated to two daily servings of active (n = 137, including 20 g of whey protein, 3 g of leucine and 800 IU VitD) or isocaloric control product (n = 151) for a double-blind period of 13 weeks. At baseline and after 13 weeks, circulating interleukin (IL)-8, IL-1 receptor antagonist (RA), soluble tumor-necrosis-factor receptor (sTNFR)1, IL-6, high-sensitivity C-reactive protein, pre-albumin and 25-hydroxyvitamin(OH)D were measured. Data-analysis included repeated measures analysis of covariance (corrected for dietary VitD intake) and linear regression.

RESULTS

IL-6 and IL-1Ra serum levels showed overall increases after 13 weeks (p = 0.006 and p < 0.001, respectively). For IL-6 a significant time × treatment interaction (p = 0.046) was observed, with no significant change over time in the active group (p = 0.155) compared to control (significant increase p = 0.012). IL-8 showed an overall significant decrease (p = 0.03). The change in pre-albumin was a significant predictor for changes in IL-6 after 13 weeks.

CONCLUSIONS

We conclude that 13 weeks of nutritional supplementation with VitD and leucine-enriched whey protein may attenuate the progression of CLIP in older sarcopenic persons with mobility limitations.

摘要

背景

慢性低度炎症特征(CLIP)与老年人的肌肉减少症有关。蛋白质和维生素 D(VitD)具有免疫调节作用,但关于营养补充对 CLIP 影响的证据有限。

目的

作为 PROVIDE 研究的二次分析,探究 13 周补充 VitD 和富含亮氨酸的乳清蛋白是否会影响纳入研究的对象的 CLIP。

方法

选择年龄≥65 岁、有活动能力受限(短体适能表现测试 4-9 分)、身体质量指数为 20-30kg/m²的低骨骼肌量的肌少症成年人,随机分配到每天 2 份活性(n=137,含 20 克乳清蛋白、3 克亮氨酸和 800IU VitD)或等热量对照产品(n=151)组,进行为期 13 周的双盲治疗。在基线和 13 周后,检测循环白细胞介素(IL)-8、IL-1 受体拮抗剂(IL-1Ra)、可溶性肿瘤坏死因子受体(sTNFR)1、IL-6、高敏 C 反应蛋白、前白蛋白和 25-羟维生素 D(25-OHD)。数据分析包括重复测量方差分析(校正膳食 VitD 摄入量)和线性回归。

结果

IL-6 和 IL-1Ra 血清水平在 13 周后均呈总体升高(p=0.006 和 p<0.001)。IL-6 出现显著的时间×治疗交互作用(p=0.046),活性组的时间变化无显著差异(p=0.155),而对照组有显著变化(p=0.012)。IL-8 总体呈显著下降(p=0.03)。13 周后,前白蛋白的变化是 IL-6 变化的显著预测因子。

结论

我们得出结论,13 周补充 VitD 和富含亮氨酸的乳清蛋白可能会减缓有活动能力受限的肌少症老年人 CLIP 的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ad/6583678/e86aeec32ab6/40520_2019_1208_Fig1_HTML.jpg

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