Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Faculty of Medical and Life Science, University of Furtwangen, Schwenningen, Germany.
Clin Interv Aging. 2020 Jun 24;15:953-967. doi: 10.2147/CIA.S248868. eCollection 2020.
Whole-body electromyostimulation (WB-EMS) especially in combination with a high-protein supplementation has been established as an efficient treatment against sarcopenia. However, there are several case reports of rhabdomyolysis after WB-EMS application. Thus, we asked if this training could potentially lead to deteriorations of the cardiac as well as the renal function.
One hundred sarcopenic obese men aged 70 years and older were randomly balanced (1-1-1) and allocated to one of the three study arms. During 16 weeks of intervention, these groups either performed WB-EMS and took a protein supplement (WB-EMS&P), solely received the protein supplement (Protein) or served as control group (CG). WB-EMS consisted of 1.5×20 min (85 Hz, 350 μs, 4 s of strain to 4 s of rest) applied with moderate-to-high intensity while moving. We further generated a daily protein intake of 1.7-1.8 g/kg/body mass per day. At baseline and 8-10 days after completion of the intervention, blood was drawn and biomarkers of muscle, cardiac and renal health were assessed.
Hereby, we found slight but significant elevations of creatine kinase (CK) levels in the WB-EMS group pointing to minor damages of the skeletal muscle (140 U/l [81-210], p < 0.001). This was accompanied by a significant, low-grade increase of creatine kinase-muscle brain (CK-MB, 0.43 ng/mL [-0.29-0.96], p < 0.01) and high-sensitivity troponin T (hsTnT, 0.001 ng/mL. [0.000-0.003], p < 0.001) but without a higher risk of developing heart failure according to N-terminal prohormone of brain natriuretic peptide (NT-proBNP, -5.7 pg/mL [-38.8-24.6], p = 0.17). Estimated glomerular filtration rate (eGFR) was impaired neither by the high-protein supplementation alone nor in combination with WB-EMS (CG 76.0 mL/min/1.73 m [71.9-82.2] vs Protein 73.2 mL/min/1.73 m [63.0-78.9] vs WB-EMS&P 74.6 mL/min/1.73 m [62.8-84.1], p = 0.478).
In conclusion, even in the vulnerable group of sarcopenic obese seniors, the combination of WB-EMS with a high-protein intake revealed no short-term, negative impact on the eGFR, but potential consequences for the cardiovascular system need to be addressed in future studies.
全身肌电刺激（WB-EMS），特别是与高蛋白补充相结合，已被确立为治疗肌少症的有效方法。然而，有几例报道称，在接受 WB-EMS 治疗后出现横纹肌溶解症。因此，我们想知道这种训练是否会对心脏和肾脏功能产生潜在的恶化。
100 名 70 岁及以上的肌少症肥胖男性被随机平衡（1-1-1）并分配到三个研究组之一。在 16 周的干预期间，这些组要么进行 WB-EMS 并服用蛋白质补充剂（WB-EMS&P），要么单独接受蛋白质补充剂（Protein），要么作为对照组（CG）。WB-EMS 包括 1.5×20 分钟（85 Hz，350 μs，4 s 收缩至 4 s 休息），以中等至高强度运动时进行。我们进一步生成了每天 1.7-1.8 g/kg/体重的蛋白质摄入量。在基线和干预结束后 8-10 天，抽取血液并评估肌肉、心脏和肾脏健康的生物标志物。
在这里，我们发现 WB-EMS 组的肌酸激酶（CK）水平略有但显著升高，表明骨骼肌有轻微损伤（140 U/l [81-210]，p < 0.001）。这伴随着肌酸激酶同工酶-肌肉脑（CK-MB）的显著、低级别升高（0.43 ng/mL [-0.29-0.96]，p < 0.01）和高敏肌钙蛋白 T（hsTnT，0.001 ng/mL [0.000-0.003]，p < 0.001），但根据脑钠肽前体（NT-proBNP），心力衰竭的风险没有增加（-5.7 pg/mL [-38.8-24.6]，p = 0.17）。高蛋白质补充剂单独或与 WB-EMS 联合使用均未导致肾小球滤过率（eGFR）受损（CG 76.0 mL/min/1.73 m [71.9-82.2]，Protein 73.2 mL/min/1.73 m [63.0-78.9]，WB-EMS&P 74.6 mL/min/1.73 m [62.8-84.1]，p = 0.478）。
总之，即使在肌少症肥胖的老年脆弱人群中，WB-EMS 联合高蛋白摄入也不会对 eGFR 产生短期负面影响，但需要在未来的研究中探讨对心血管系统的潜在影响。
