Department of Nutrition and Specialized Centre for Obesity, Rouen University Hospital, CHU Rouen, 76031 Rouen, France.
Université de Rouen Normandie, Inserm UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", 76183 Rouen, France.
Nutrients. 2022 Sep 8;14(18):3708. doi: 10.3390/nu14183708.
Background: In patients with obesity and metabolic syndrome (MetS), lifestyle interventions combining diet, in particular, and physical exercise are recommended as the first line treatment. Previous studies have suggested that leucine or arginine supplementation may have beneficial effects on the body composition or insulin sensitivity and endothelial function, respectively. We thus conducted a randomized controlled study to evaluate the effects of a supervised adapted physical activity program associated or not with oral supplementation with leucine and arginine in MetS-complicated patients with obesity. Methods: Seventy-nine patients with obesity and MetS were randomized in four groups: patients receiving arginine and leucine supplementation (ALs group, n = 20), patients on a supervised adapted physical activity program (APA group, n = 20), patients combining ALs and APA (ALs+APA group, n = 20), and a control group (n = 19). After the baseline evaluation (m0), patients received ALs and/or followed the APA program for 6 months (m6). Body composition, MetS parameters, lipid and glucose metabolism markers, inflammatory markers, and a cardiopulmonary exercise test (CPET) were assessed at m0, m6, and after a 3-month wash-out period (m9). Results: After 6 months of intervention, we did not observe variable changes in body weight, body composition, lipid and glucose metabolism markers, inflammatory parameters, or quality of life scores between the four groups. However, during the CPET, the maximal power (Pmax and Ppeak), power, and O2 consumption at the ventilatory threshold (P(VT) and O2(VT)) were improved in the APA and ALs+APA groups (p < 0.05), as well as the forced vital capacity (FVC). Between m6 and m9, a gain in fat mass was only observed in patients in the APA and ALs+APA groups. Conclusion: In our randomized controlled trial, arginine and leucine supplementation failed to improve MetS in patients with obesity, as did the supervised adapted physical activity program and the combination of both. Only the cardiorespiratory parameters were improved by exercise training.
在肥胖和代谢综合征（MetS）患者中，推荐将饮食等生活方式干预作为一线治疗方法。既往研究提示亮氨酸或精氨酸补充可能分别对机体成分或胰岛素敏感性和内皮功能具有有益作用。因此，我们开展了一项随机对照研究，以评估在伴有肥胖的 MetS 患者中，监督下适应性体力活动方案联合或不联合亮氨酸和精氨酸口服补充对机体成分的影响。
将 79 例肥胖伴 MetS 患者随机分为 4 组：精氨酸和亮氨酸补充组（ALs 组，n=20）、监督下适应性体力活动组（APA 组，n=20）、联合 ALs 和 APA 组（ALs+APA 组，n=20）和对照组（n=19）。在基线评估（m0）后，患者接受 ALs 和/或在 6 个月内进行适应性体力活动方案（m6）。在 m0、m6 和 3 个月洗脱期（m9）时评估机体成分、MetS 参数、血脂和糖代谢标志物、炎症标志物和心肺运动试验（CPET）。
干预 6 个月后，4 组患者的体重、机体成分、血脂和糖代谢标志物、炎症参数或生活质量评分均未发生变化。然而，在 CPET 中，APA 和 ALs+APA 组的最大功率（Pmax 和 Ppeak）、功率和通气阈时的 O2 消耗（P(VT)和 O2(VT)）以及用力肺活量（FVC）得到改善（p＜0.05）。在 m6 到 m9 期间，仅 APA 和 ALs+APA 组患者的脂肪量增加。
在我们的随机对照试验中，精氨酸和亮氨酸补充以及监督下适应性体力活动方案均不能改善肥胖 MetS 患者的代谢情况，仅运动训练能改善心肺参数。
