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抗阻训练对肠衰竭患者肌肉减少症的影响:一项随机对照试验。

Effects of resistance training on sarcopenia in patients with intestinal failure: A randomized controlled trial.

机构信息

Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China; Department of General Surgery, Jinling Hospital, Nanjing Medical University, Nanjing, China.

Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China; Department of General Surgery, Jinling Hospital, Southern Medical University, Nanjing, China.

出版信息

Clin Nutr. 2023 Oct;42(10):1901-1909. doi: 10.1016/j.clnu.2023.07.013. Epub 2023 Jul 16.

Abstract

BACKGROUND

The potential effects of resistance training on sarcopenia in patients with intestinal failure (IF) are not fully elucidated. This study aimed to explore the efficacy of a resistance training program on appendicular skeletal muscle index (ASMI), physical performance, body composition, biochemical parameters, and health-related quality of life (HRQOL) in patients with IF exhibiting sarcopenia.

METHODS

A single-center randomized controlled trial was conducted in a Chinese tertiary teaching hospital. Patients with IF exhibiting sarcopenia were randomly assigned to the exercise group or control group. Participants in the exercise group incorporated four sets of resistance training involving the limbs and abdominal and lower back muscles, six times weekly for 4 weeks. The control group received no specific intervention. The primary outcome was the between-group difference in ASMI 4 weeks after intervention. Secondary outcomes included handgrip strength, 6-m gait speed, body composition, biochemical parameters, and HRQOL.

RESULTS

A total of 60 participants (control group 30, age 51.2 ± 12.9 years, women 43.3%; exercise group 30, age 53.9 ± 14.5 years, women 56.7%) completed the 4-week intervention trial. For the primary outcome, significant intervention effects were found in ASMI between the exercise group and the control group (mean difference 0.72, 95% CI, 0.56-0.89, P < 0.001). There were notable differences in handgrip strength (mean difference 2.7, 95% CI, 1.7-3.6, P < 0.001), 6-m gait speed (mean difference 0.08, 95% CI, 0.01-0.35, P = 0.034), body composition (including total cell mass, bone mineral content, skeletal muscle mass, lean mass, visceral fat area, total body water, intracellular water, extracellular water, and segmental water-legs), and biochemical parameters (including IGF-1, prealbumin, and hemoglobin) between the two groups (P < 0.05). No significant intervention benefits were observed for other secondary outcomes, including biochemical parameters (including albumin, total bilirubin, etc.) and HRQOL (P > 0.05).

CONCLUSIONS

In this randomized clinical trial, we observed that 4 weeks of resistance training was associated with improved ASMI, physical performance, biochemical parameters (including IGF-1, prealbumin, and hemoglobin), and body composition in IF patients with sarcopenia. Resistance training can be recommended as a simple and effective method to improve sarcopenia in patients with IF.

CLINICAL TRIAL REGISTRATION

www.chictr.org.cn, identifier: ChiCTR2100051727.

摘要

背景

抵抗训练对肠衰竭(IF)患者肌少症的潜在影响尚未完全阐明。本研究旨在探讨抵抗训练方案对 IF 合并肌少症患者四肢骨骼肌指数(ASMI)、身体机能、身体成分、生化参数和健康相关生活质量(HRQOL)的疗效。

方法

在中国一家三级教学医院进行了一项单中心随机对照试验。将 IF 合并肌少症的患者随机分为运动组和对照组。运动组参与者每周进行 6 次,每次进行 4 组涉及四肢和腹部及下背部肌肉的抵抗训练,共 4 周。对照组未接受任何特定干预。主要结局是干预 4 周后 ASMI 的组间差异。次要结局包括握力、6 米步行速度、身体成分、生化参数和 HRQOL。

结果

共有 60 名参与者(对照组 30 名,年龄 51.2±12.9 岁,女性 43.3%;运动组 30 名,年龄 53.9±14.5 岁,女性 56.7%)完成了 4 周的干预试验。对于主要结局,运动组与对照组之间的 ASMI 存在显著的干预效应(平均差异 0.72,95%置信区间,0.56-0.89,P<0.001)。握力(平均差异 2.7,95%置信区间,1.7-3.6,P<0.001)、6 米步行速度(平均差异 0.08,95%置信区间,0.01-0.35,P=0.034)、身体成分(包括总细胞质量、骨矿物质含量、骨骼肌质量、瘦体重、内脏脂肪面积、总体液、细胞内液、细胞外液和分段水-腿)和生化参数(包括 IGF-1、前白蛋白和血红蛋白)均存在显著差异(P<0.05)。两组之间其他次要结局(包括生化参数[包括白蛋白、总胆红素等]和 HRQOL)无显著干预获益(P>0.05)。

结论

在这项随机临床试验中,我们观察到 4 周的抵抗训练与 IF 合并肌少症患者的 ASMI、身体机能、生化参数(包括 IGF-1、前白蛋白和血红蛋白)和身体成分的改善相关。抵抗训练可作为改善 IF 患者肌少症的简单有效方法。

临床试验注册

www.chictr.org.cn,标识符:ChiCTR2100051727。

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