营养及运动干预对肌肉衰减综合征社区老年人肌肉和体脂状况影响的随机对照研究

Impact of nutrition intervention and physical exercise on muscle mass and body fat among community elderly with sarcopenia:a randomized controlled study

目的探讨营养补充(乳清蛋白、鱼油及维生素D)及体育锻炼(抗阻及有氧运动)对肌肉衰减综合征社区老年人肌肉和体脂肪量的影响。方法符合纳入及排除标准的102例肌肉衰减综合征社区老年人(年龄≥60岁)被随机分入营养补充组(接受营养干预,34例)、营养和运动联合组(同时接受营养干预和体育锻炼34例)或对照组(常规营养咨询,34例)。干预12周后,比较干预前后肌肉和体脂相关指标的变化。结果协方差分析结果显示,与对照组相比,干预后不同组间各指标差异均有统计学意义(均为P<0.05)。进一步成对比较统计结果显示,与对照组相比,营养补充组的四肢骨骼肌质量(appendicular skeletal muscle mass,ASM)增加0.837 kg(P=0.003,95%CI:0.301~1.372),脂肪质量减少2.876 kg(P<0.01,95%CI:-3.941~-1.812);营养及运动联合组的ASM增加0.745 kg(P=0.010,95%CI:0.180~1.311),脂肪质量减少2.928 kg(P<0.01,95%CI:-4.408~-1.808)。营养补充组和营养及运动联合组的其他肌肉质量相关指标,如ASM/身高、ASM/体重等均显著增加,其他体脂相关指标均显著减少。而营养补充组与营养及运动联合组相比,各指标差异均无统计学意义。结论营养补充或营养及运动联合干预有助于改善肌肉衰减综合征老年人肌肉和体脂状况。以营养干预为基础的生活方式调整对于社区肌肉衰减综合征老年人具有重要意义。

Objective To investigate the impact of nutrition supplementation(whey protein,fish oil and vitamin D)and physical exercise(resistance and aerobic exercise)on muscle mass and body fat metrics among community elderly with sarcopenia.Method 102 eligible sarcopenic participants per inclusion and exclusion criteria were randomized into the control group(routine consultation,n=34)or the groups receiving nutrition supplementation(Nutr,n=34)or nutrition supplementation combined with exercise(Nutr+Ex,n=34)for 12 weeks.Muscle and body fat related indicators were compared across groups pre-and post-intervention.Results Analysis of covariance showed that all indicators were significantly different between groups(all P<0.05).Further pairwise comparisons showed that compared with controls,patients in Nutr group showed increased appendicular muscle mass(ASM)by 0.837 kg(P=0.003,95%CI:0.301 to 1.372)and decreased fat mass by 2.876 kg(P<0.01,95%CI:-3.941 to-1.812),while patients in Nutr+Ex group showed increased ASM by 0.745 kg(P=0.010,95%CI:0.180 to 1.311)and decreased fat mass by 2.928kg(P<0.01,95%CI:-4.408 to-1.808).Other muscle-related indicators also increased while fat-related indicators decreased in both Nutr and Nutr+Ex groups.However,there is no significant difference between Nutr and Nutr+Ex groups.Conclusions Nutrition supplementation and physical exercise contribute to muscle mass and body fat improvement among sarcopenic elderly.Lifestyle intervention based on nutrition intervention is important for the community elderly with sarcopenia.