Wada Akira, Yamashita Hayato, Togashi Ayaka, Ogawa Shunsuke, Muroi Arashi, Kido Satoshi, Furuya Shigeki
Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc., Naruto 772-8601, Japan.
Department of Innovative Science and Technology for Bio-Industry, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka 819-0395, Japan.
Nutrients. 2024 Apr 19;16(8):1218. doi: 10.3390/nu16081218.
Postoperative sarcopenia is associated with poor outcomes in hospitalized patients. However, few studies have focused on short-term postoperative sarcopenia. Furthermore, the influence of nutritional management using amino acids (AAs) comprising a peripheral parenteral nutrition (PPN) solution and its combination with exercise (Exc) is unclear. Hence, we established a postoperative sarcopenic rat model to evaluate the effects of parenteral AA infusion combined with Exc on skeletal muscles and investigate the underlying mechanisms involved in the amelioration of muscle atrophy. Male F344 rats underwent surgery followed by hindlimb suspension (HS) for 5 days. The rats were divided into AA (-), AA (+), AA (-)-Exc, and AA (+)-Exc groups. They were continuously administered a PPN solution with or without AA at 98 kcal/kg/day. The Exc groups were subjected to intermittent loading for 1 h per day. Postoperative sarcopenic rats exhibited decreased muscle strength and mass and an upregulated ubiquitin-proteasome system, autophagy-lysosome system, and fast-twitch fiber-related genes, especially in the AA (-) group. The AA (+)-Exc group exhibited attenuated decreased muscle strength, increased gastrocnemius mass, and a suppressed upregulation of muscle atrophy- and fast-twitch fiber-related genes. Therefore, parenteral AA infusion combined with Exc may be effective in preventing postoperative sarcopenia in hospitalized patients.
术后肌肉减少症与住院患者的不良预后相关。然而，很少有研究关注术后短期肌肉减少症。此外，使用包含外周肠外营养（PPN）溶液的氨基酸（AA）进行营养管理及其与运动（Exc）相结合的影响尚不清楚。因此，我们建立了术后肌肉减少症大鼠模型，以评估肠外输注AA联合Exc对骨骼肌的影响，并研究参与改善肌肉萎缩的潜在机制。雄性F344大鼠接受手术，随后后肢悬吊（HS）5天。将大鼠分为AA（-）、AA（+）、AA（-）-Exc和AA（+）-Exc组。它们以98千卡/千克/天的剂量持续接受含或不含AA的PPN溶液。Exc组每天进行1小时的间歇性负荷训练。术后肌肉减少症大鼠表现出肌肉力量和质量下降，泛素-蛋白酶体系统、自噬-溶酶体系统和快肌纤维相关基因上调，尤其是在AA（-）组。AA（+）-Exc组表现出肌肉力量下降减轻、腓肠肌质量增加以及肌肉萎缩和快肌纤维相关基因上调受到抑制。因此，肠外输注AA联合Exc可能对预防住院患者术后肌肉减少症有效。
