Institute of Women's Health Science, Showa Women's University, Tokyo, Japan.
Day Care SKY, Yokohama, Japan.
Am J Clin Nutr. 2019 Sep 1;110(3):652-665. doi: 10.1093/ajcn/nqz138.
The combined supplementation of medium-chain triglycerides (MCTs), l-leucine-rich amino acids, and cholecalciferol was previously shown to increase muscle strength and function in frail elderly individuals.
We examined whether treatment with MCTs alone is sufficient to increase muscle strength and function and activities of daily living (ADL) in such individuals.
We enrolled 64 elderly nursing home residents (85.5 ± 6.8 y) in a 3-mo randomized, controlled, single-blinded intervention trial. The participants were randomly assigned to 3 groups: the first group received supplemental l-leucine (1.2 g) and cholecalciferol (20 μg) enriched with 6 g/d of MCTs (LD + MCT group) as a positive control, the second group received 6 g/d of MCTs (MCT group) as a target, and the third group received 6 g/d of long-chain triglycerides (LCT group) as a negative control. Changes in muscle mass, strength, function, and ADL were monitored 4 times: at baseline, at 1.5 and 3 mo after initiation of the intervention (intervention), and 1.5 mo after termination of the intervention (washout).
The 64 participants randomly assigned to the 3 groups were included in an intention-to-treat analysis. Forty-eight participants completed the study and were included in a per-protocol analysis. At 3 mo, participants in the MCT group had a 48.1% increase in 10-s leg open and close test performance [intention-to-treat adjusted means: MCT 2.28 n/10 s (1.37, 3.19) compared with LCT -0.59 n/10 s (-1.52, 0.35), P < 0.05], a 27.8% increase in a 30-s repetitive saliva swallowing test [MCT 0.5 n/30 s (0.1, 1.0) compared with LCT -0.5 n/30 s (-0.9, 0.0), P < 0.05], and a 7.5% increase in Functional Independence Measure score, a questionnaire for assessing ADL [MCT 5.6 points (1.3, 9.9) compared with LCT -6.6 points (-11.3, -2.0), P < 0.05].
MCTs (6 g/d) could increase the muscle strength and function of frail elderly individuals and also improve their ADL. This trial was registered at the University Hospital Medical Information Network Clinical Trial Registry as UMIN000023302.
此前的研究表明，中链甘油三酯（MCTs）、富含亮氨酸的氨基酸和胆钙化醇的联合补充可增加虚弱老年人的肌肉力量和功能。
我们研究了单独使用 MCT 是否足以增加此类人群的肌肉力量和功能以及日常生活活动（ADL）。
我们招募了 64 名老年疗养院居民（85.5±6.8 岁）进行了为期 3 个月的随机、对照、单盲干预试验。参与者被随机分配到 3 组：第一组接受补充 1.2 g 亮氨酸和 20 μg 胆钙化醇，并富含 6 g/d 的 MCT（LD+MCT 组）作为阳性对照，第二组接受 6 g/d 的 MCT（MCT 组）作为目标，第三组接受 6 g/d 的长链甘油三酯（LCT 组）作为阴性对照。在 4 次监测肌肉质量、力量、功能和 ADL 的变化：基线、干预开始后 1.5 和 3 个月（干预）以及干预结束后 1.5 个月（洗脱）。
64 名随机分配到 3 组的参与者均纳入意向治疗分析。48 名参与者完成了研究并纳入了方案分析。在 3 个月时，MCT 组的 10 秒腿开和关测试表现提高了 48.1%[意向治疗调整均值：MCT 2.28 n/10 s（1.37，3.19）与 LCT -0.59 n/10 s（-1.52，0.35），P<0.05]，30 秒重复唾液吞咽测试提高了 27.8%[MCT 0.5 n/30 s（0.1，1.0）与 LCT -0.5 n/30 s（-0.9，0.0），P<0.05]，功能独立性测量评分（用于评估 ADL 的问卷）提高了 7.5%，MCT 提高了 5.6 分（1.3，9.9）与 LCT 相比降低了 6.6 分（-11.3，-2.0），P<0.05]。
MCT（6 g/d）可增加虚弱老年人的肌肉力量和功能，也可改善他们的 ADL。该试验在大学医院医学信息网络临床试验注册处注册，注册号为 UMIN000023302。
