Section for Health and Exercise Physiology, Inland Norway University of Applied Sciences, P.O. Box 422, 2604, Lillehammer, Norway.
Department of Medicine, Innlandet Hospital Trust, Lillehammer, Norway.
J Transl Med. 2021 Jul 6;19(1):292. doi: 10.1186/s12967-021-02969-1.
Subjects with chronic obstructive pulmonary disease (COPD) are prone to accelerated decay of muscle strength and mass with advancing age. This is believed to be driven by disease-inherent systemic pathophysiologies, which are also assumed to drive muscle cells into a state of anabolic resistance, leading to impaired abilities to adapt to resistance exercise training. Currently, this phenomenon remains largely unstudied. In this study, we aimed to investigate the assumed negative effects of COPD for health- and muscle-related responsiveness to resistance training using a healthy control-based translational approach.
Subjects with COPD (n = 20, GOLD II-III, FEV 57 ± 11%, age 69 ± 5) and healthy controls (Healthy, n = 58, FEV 112 ± 16%, age 67 ± 4) conducted identical whole-body resistance training interventions for 13 weeks, consisting of two weekly supervised training sessions. Leg exercises were performed unilaterally, with one leg conducting high-load training (10RM) and the contralateral leg conducting low-load training (30RM). Measurements included muscle strength (n = 7), endurance performance (n = 6), muscle mass (n = 3), muscle quality, muscle biology (m. vastus lateralis; muscle fiber characteristics, RNA content including transcriptome) and health variables (body composition, blood). For core outcome domains, weighted combined factors were calculated from the range of singular assessments.
COPD displayed well-known pathophysiologies at baseline, including elevated levels of systemic low-grade inflammation ([c-reactive protein]), reduced muscle mass and functionality, and muscle biological aberrancies. Despite this, resistance training led to improved lower-limb muscle strength (15 ± 8%), muscle mass (7 ± 5%), muscle quality (8 ± 8%) and lower-limb/whole-body endurance performance (26 ± 12%/8 ± 9%) in COPD, resembling or exceeding responses in Healthy, measured in both relative and numeric change terms. Within the COPD cluster, lower FEV was associated with larger numeric and relative increases in muscle mass and superior relative improvements in maximal muscle strength. This was accompanied by similar changes in hallmarks of muscle biology such as rRNA-content↑, muscle fiber cross-sectional area↑, type IIX proportions↓, and changes in mRNA transcriptomics. Neither of the core outcome domains were differentially affected by resistance training load.
COPD showed hitherto largely unrecognized responsiveness to resistance training, rejecting the notion of disease-related impairments and rather advocating such training as a potent measure to relieve pathophysiologies.
ClinicalTrials.gov ID: NCT02598830. Registered November 6th 2015, https://clinicaltrials.gov/ct2/show/NCT02598830.
患有慢性阻塞性肺疾病（COPD）的患者随着年龄的增长，肌肉力量和质量的衰减速度会加快。据信，这是由疾病固有的全身病理生理学驱动的，这也被认为会导致肌肉细胞进入合成代谢抵抗状态，从而削弱对抵抗运动训练的适应能力。目前，这一现象在很大程度上仍未得到研究。在这项研究中，我们旨在通过基于健康对照的转化方法，研究 COPD 对健康和肌肉相关的抵抗训练反应的假设负面影响。
20 名 COPD 患者（GOLD II-III，FEV 57±11%，年龄 69±5）和 58 名健康对照者（Healthy，FEV 112±16%，年龄 67±4）进行了为期 13 周的相同全身抵抗训练干预，包括每周两次监督训练。腿部运动进行单侧运动，一条腿进行高负荷训练（10RM），另一条腿进行低负荷训练（30RM）。测量包括肌肉力量（n=7）、耐力表现（n=6）、肌肉质量（n=3）、肌肉质量、肌肉生物学（股外侧肌；肌肉纤维特征、RNA 含量，包括转录组）和健康变量（身体成分、血液）。对于核心结果领域，从单一评估的范围计算加权综合因素。
COPD 在基线时表现出众所周知的病理生理学，包括全身低度炎症水平升高（c-反应蛋白）、肌肉质量和功能降低以及肌肉生物学异常。尽管如此，抵抗训练导致 COPD 患者的下肢肌肉力量（15±8%）、肌肉质量（7±5%）、肌肉质量（8±8%）和下肢/全身耐力表现（26±12%/8±9%）得到改善，在相对和数值变化方面与健康对照者的反应相似或超过。在 COPD 组中，较低的 FEV 与肌肉质量的更大数值和相对增加以及最大肌肉力量的更好相对改善相关。这伴随着肌肉生物学标志物的类似变化，如 rRNA 含量↑、肌肉纤维横截面积↑、IIX 型比例↓以及 mRNA 转录组学的变化。核心结果领域均不受抵抗训练负荷的影响。
COPD 对抵抗训练表现出迄今为止尚未被广泛认识的反应性，拒绝了与疾病相关的损伤的概念，而是提倡这种训练作为缓解病理生理学的有效措施。
ClinicalTrials.gov ID：NCT02598830。于 2015 年 11 月 6 日注册，https://clinicaltrials.gov/ct2/show/NCT02598830。
