Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Department of Rehabilitation Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Endocr J. 2021 Mar 28;68(3):291-298. doi: 10.1507/endocrj.EJ20-0550. Epub 2020 Oct 17.
Type 2 diabetes is associated with sarcopenia. Resistance training and appropriate nutritional therapy are reported to be effective for muscle strength and mass. This study aimed to evaluate the effect of resistance training using elastic bands at home combined with a leucine-rich amino acid supplement on muscle strength, physical function, and muscle mass in elderly type 2 diabetes. We conducted a 48-week prospective single-center randomized controlled trial in 60 patients who were randomly allocated to one of three groups: control (C), resistance exercise (R), and resistance exercise plus supplement (RL). R and RL groups performed daily bodyweight resistance training with elastic bands exercises at home, and the RL group also took 6 g of a leucine-rich amino acid supplement daily. Knee extension strength (muscle strength), grip strength, usual gait speed (physical function), muscle mass, and cognitive function were assessed at 0 and 48 weeks. Although the change in knee extension strength from baseline was significantly increased by 6.4 Nm (95% CI 1.0, 11.7) in the RL group (p = 0.036), no significant difference was observed among the three groups (p = 0.090). Physical function, muscle mass, and cognitive function also had no changes during the study period among the three groups. No additive effect of a leucine-rich amino acid supplement on muscle strength or mass was observed. Although a post hoc analysis comparing with or without resistance training (C group vs. R + RL group) found that knee extension strength was significantly increased (p = 0.028), and cognitive decline was less (p = 0.046) than in the C group.
2 型糖尿病与肌肉减少症有关。有报道称，抗阻力训练和适当的营养疗法对肌肉力量和质量有效。本研究旨在评估在家中使用弹性带进行抗阻力训练与补充富含亮氨酸的氨基酸联合对老年 2 型糖尿病患者肌肉力量、身体机能和肌肉质量的影响。我们在 60 例患者中进行了一项为期 48 周的前瞻性单中心随机对照试验，这些患者被随机分配到以下三组之一：对照组（C）、抗阻力运动组（R）和抗阻力运动加补充剂组（RL）。R 和 RL 组在家中每天进行体重抗阻力训练，使用弹性带进行锻炼，RL 组还每天服用 6 克富含亮氨酸的氨基酸补充剂。在 0 周和 48 周时评估膝关节伸展力量（肌肉力量）、握力、通常的步行速度（身体机能）、肌肉质量和认知功能。虽然 RL 组的膝关节伸展力量从基线开始的变化显著增加了 6.4 Nm（95%CI 1.0，11.7）（p = 0.036），但三组之间没有观察到显著差异（p = 0.090）。三组在研究期间的身体机能、肌肉质量和认知功能也没有变化。没有观察到富含亮氨酸的氨基酸补充剂对肌肉力量或质量的附加作用。尽管事后分析比较了有或没有抗阻力训练（C 组与 R + RL 组），发现膝关节伸展力量显著增加（p = 0.028），认知能力下降较少（p = 0.046），优于 C 组。
