Luo Dan, Lin Zheng, Li Sha, Liu Shen-Jia
School of Nursing, Nanjing Medical University, Nanjing, 210029, China.
Administrative Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Int J Nurs Sci. 2017 Oct 16;4(4):389-401. doi: 10.1016/j.ijnss.2017.09.004. eCollection 2017 Oct 10.
This systematic review was conducted to explore whether nutritional supplement can improve the benefits of exercise intervention on sarcopenia in the elderly.
Databases, including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, WANFANG, and VIP, were searched. All related papers with randomized controlled trials (RCT) methodology that were included in the databases from inception to 19 July 2016 were selected for the study. The tool "assessing risk of bias" from Cochrane Handbook 5.10 was used to evaluate the quality of included papers. A meta-analysis of eligible studies was performed using Stata12.0. Data that we were unable to convene or merge were subjected to descriptive analysis.
Six trials were included in our study, which included 429 elderly patients with sarcopenia. The overall methodological quality of the trials was moderate. Compared with the exercise group, patients who were given nutritional supplements gained a bigger boost in fat-free mass (standard mean difference (SMD) = 5.78, 95% CI: 5.17 to 6.40, = 0.000) and muscle mass (SMD = 2.048, 95% CI: 0.907 to 3.189, = 0.000), as well as showed enhancement of keen extension strength (SMD = 1.08, 95% CI: 0.71 to 1.45, = 0.000) and usual walk speed (SMD = 0.570, 95% CI: 0.19 to 0.95, = 0.003).
Nutritional supplementation may magnify the effect of exercise intervention on sarcopenia elderly in terms of muscle mass, muscle strength, and physical performance. Inconsistencies were present among research studies. More robust studies are needed to determine the most suitable type of nutrient and target population and to explore the actual role of combined intervention in managing sarcopenia in the elderly.
进行此项系统评价,以探究营养补充剂能否增强运动干预对老年人肌肉减少症的益处。
检索了多个数据库,包括PubMed、Embase、Cochrane图书馆、科学网、护理学与健康领域数据库、中国生物医学文献数据库、中国知网、万方数据库和维普资讯。选取数据库中从建库至2016年7月19日收录的所有采用随机对照试验(RCT)方法的相关论文进行研究。使用Cochrane手册5.10中的“偏倚风险评估”工具评估纳入论文的质量。使用Stata12.0对符合条件的研究进行荟萃分析。对于无法汇总或合并的数据进行描述性分析。
本研究纳入了6项试验,共429例老年肌肉减少症患者。试验的总体方法学质量中等。与运动组相比,接受营养补充剂的患者去脂体重增加更为显著(标准均差(SMD)=5.78,95%置信区间:5.17至6.40,P=0.000),肌肉量增加(SMD=2.048,95%置信区间:0.907至3.189,P=0.000),同时伸膝力量增强(SMD=1.08,95%置信区间:0.71至1.45,P=0.000),日常步行速度加快(SMD=0.570,95%置信区间:0.19至0.95,P=0.003)。
营养补充可能在肌肉量、肌肉力量和身体机能方面增强运动干预对老年肌肉减少症患者的效果。研究之间存在不一致性。需要更有力的研究来确定最合适的营养素类型和目标人群,并探索联合干预在管理老年肌肉减少症中的实际作用。