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抗阻运动联合营养干预治疗老年肌少症患者的临床效果。

Clinical effect of anti-resistance exercise combined with nutritional intervention in the treatment of elderly patients with sarcopenia.

机构信息

Department of Orthopedics, Xiantao First People's Hospital, Xiantao, China.

Department of Orthopedics, Qianjiang Central Hospital, Qianjiang, China.

出版信息

Medicine (Baltimore). 2024 Sep 13;103(37):e39472. doi: 10.1097/MD.0000000000039472.

Abstract

This study aims to evaluate the efficacy of a combined intervention involving resistance exercise and nutritional support in improving grip strength, walking speed, and skeletal muscle density among elderly individuals suffering from sarcopenia. Data from a cohort of 500 elderly sarcopenic patients were segregated into observation and control cohorts based on distinct treatment modalities. Baseline evaluations included weight, grip strength, walking speed, and skeletal muscle density. Changes in these parameters and oxidative stress markers were monitored and compared at 1-, 3-, and 6-month intervals. Baseline grip strength for the observation and control groups stood at (20.25 ± 2.34) and (21.06 ± 2.97) kg, respectively. Walking speed was measured at (0.99 ± 0.12) and (0.98 ± 0.20) m/s, respectively. Skeletal muscle density registered (42.98 ± 4.17) and (42.77 ± 5.02) Hu for the observation and control groups, respectively, while muscle mass index was recorded as (6.19 ± 1.46) and (6.20 ± 1.68) kg/m2, respectively. Limb skeletal muscle mass for both cohorts was (16.83 ± 3.57) and (16.77 ± 3.89) kg. No significant disparities were discerned in baseline characteristics between the groups. Following 1, 3, and 6 months, the observation group exhibited marked enhancements in grip strength and walking speed (P < .05), with substantially superior grip strength compared to the control cohort (P < .05). Notably, skeletal muscle density, muscle mass index, and limb skeletal muscle mass exhibited significant augmentation in the observation group (P < .05), while no significant alterations were observed in the control cohort. Oxidative stress-related parameters displayed no notable differences between groups pretreatment (P > .05). Post-treatment, levels of Hcy, IFN-γ, and MDA markedly decreased in both groups, with considerably lower levels evident in the observation cohort (P < .05). Moreover, SOD levels exhibited significant post-treatment increments in both groups, with markedly higher levels observed in the observation group (P < .05). An integrated approach of resistance exercise and nutritional support significantly enhances grip strength, walking speed, and skeletal muscle density in elderly patients with sarcopenia, contributing to better prognoses and improved quality of life.

摘要

本研究旨在评估一项包含阻力运动和营养支持的综合干预措施在改善患有肌少症的老年人握力、步行速度和骨骼肌密度方面的疗效。将 500 名老年肌少症患者的数据根据不同的治疗方式分为观察组和对照组。基线评估包括体重、握力、步行速度和骨骼肌密度。在 1、3 和 6 个月的时间间隔内监测和比较这些参数和氧化应激标志物的变化。观察组和对照组的基线握力分别为(20.25±2.34)kg 和(21.06±2.97)kg。步行速度分别为(0.99±0.12)m/s 和(0.98±0.20)m/s。观察组和对照组的骨骼肌密度分别为(42.98±4.17)Hu 和(42.77±5.02)Hu,肌肉质量指数分别为(6.19±1.46)kg/m2 和(6.20±1.68)kg/m2。两组的四肢骨骼肌质量分别为(16.83±3.57)kg 和(16.77±3.89)kg。两组间基线特征无显著差异。经过 1、3 和 6 个月后,观察组的握力和步行速度明显提高(P<.05),握力明显优于对照组(P<.05)。值得注意的是,观察组的骨骼肌密度、肌肉质量指数和四肢骨骼肌质量均显著增加(P<.05),而对照组无明显变化。治疗前两组氧化应激相关参数无明显差异(P>.05)。治疗后,两组的 Hcy、IFN-γ和 MDA 水平均显著降低,观察组水平明显更低(P<.05)。此外,两组的 SOD 水平均显著升高,观察组水平明显更高(P<.05)。阻力运动和营养支持的综合方法可显著提高老年肌少症患者的握力、步行速度和骨骼肌密度,改善预后,提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312b/11404919/fdd2dd36501e/medi-103-e39472-g001.jpg

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