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肌肉力量和相位角是肥胖型肌少症患者多学科减肥计划疗效的潜在标志物。

Muscle Strength and Phase Angle Are Potential Markers for the Efficacy of Multidisciplinary Weight-Loss Program in Patients with Sarcopenic Obesity.

作者信息

Brunani Amelia, Brenna Ettore, Zambon Antonella, Soranna Davide, Donini Lorenzo Maria, Busetto Luca, Bertoli Simona, Capodaglio Paolo, Cancello Raffaella

机构信息

Laboratory of Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, 28824 Piancavallo Verbania, Italy.

Biostatistic Unit, IRCCS, Istituto Auxologico Italiano, 20149 Milan, Italy.

出版信息

J Clin Med. 2024 Sep 4;13(17):5237. doi: 10.3390/jcm13175237.

Abstract

: Traditional weight-loss methods often result in the loss of both fat and muscle mass. For individuals with sarcopenic obesity (SO), additional muscle loss can exacerbate sarcopenia, leading to further declines in muscle strength and function, ultimately worsening quality of life. To mitigate this risk, weight-loss strategies should emphasize the preservation and building of muscle mass through adequate protein intake and tailored resistance training. This study aimed to evaluate changes in SO status following a 4-week multidisciplinary weight-loss intervention program in hospitalized patients with obesity. : This study included adult patients with obesity (BMI > 30 kg/m, aged 18-90 years). The SO diagnosis was performed using the handgrip strength (HGS) test and skeletal muscle mass (SMM) by bioelectrical impedance analysis (BIA) according to ESPEN/EASO-2022 guidelines. : A total of 2004 patients were enrolled, 64.8% female, with a mean age of 56 (±14) years and a BMI of 40.7 (±6.48) kg/m. SO was present in 9.38% (188 patients) at baseline. At discharge, 80 patients (42.55%) were no longer classified as sarcopenic and showed significant improvements in HGS. The likelihood of resolving SO was not modified in patients with only phase angle (PhA) improvement (-value = 0.141). Patients with HGS increment had a 65% probability to be No-SO at discharge and this probability, with the concomitant PhA increment, rose to 93% (-value < 0.0001), indicating that functional changes and good nutrition status are crucial in improvement of SO. Muscle mass (MM) and SMMI remained unchanged in the studied cohort. : Improvements in HGS and the PhA are potential markers for the efficacy of weight-loss programs tailored to patients with SO. These findings suggest that specific interventions focusing on these markers could be beneficial in managing SO patients.

摘要

传统的减肥方法往往会导致脂肪和肌肉量同时减少。对于患有肌少症肥胖(SO)的个体,额外的肌肉流失会加重肌少症,导致肌肉力量和功能进一步下降,最终使生活质量恶化。为了降低这种风险,减肥策略应通过充足的蛋白质摄入和量身定制的抗阻训练来强调肌肉量的保留和增加。本研究旨在评估肥胖住院患者在接受为期4周的多学科减肥干预项目后SO状态的变化。

本研究纳入了肥胖成年患者(BMI>30kg/m²,年龄18 - 90岁)。根据ESPEN/EASO - 2022指南,采用握力(HGS)测试和生物电阻抗分析(BIA)测量骨骼肌量(SMM)来进行SO诊断。

共纳入2004例患者,其中64.8%为女性,平均年龄56(±14)岁,BMI为40.7(±6.48)kg/m²。基线时9.38%(188例患者)存在SO。出院时,80例患者(42.55%)不再被归类为肌少症,且HGS有显著改善。仅相位角(PhA)改善的患者中,解决SO的可能性未改变(P值 = 0.141)。HGS增加的患者出院时无SO的概率为65%,伴随PhA增加时,该概率升至93%(P值<0.0001),表明功能变化和良好的营养状况对改善SO至关重要。研究队列中的肌肉量(MM)和骨骼肌质量指数(SMMI)保持不变。

HGS和PhA的改善是针对SO患者量身定制的减肥项目疗效的潜在标志物。这些发现表明,针对这些标志物的特定干预措施可能有助于管理SO患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b68d/11396015/3e116390125c/jcm-13-05237-g001.jpg

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