蛋白质摄入量和抗阻训练对急症老年内科患者肌肉量影响的随机对照试验

Clin Nutr. 2016 Feb;35(1):59-66.

The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients - A randomized controlled trial.

Buhl SF, Andersen AL, Andersen JR, Andersen O, Jensen JE, Rasmussen AM, Pedersen MM, Damkjær L, Gilkes H, Petersen J.

Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark.

Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg C, Denmark.

Nutrition Unit 5711, Rigshospitalet, DK-2100 Copenhagen Oe, Denmark.

Department of Endocrinology (541), Amager Hvidovre Hospital, DK-2650 Hvidovre, Denmark.

Department of Rehabilitation, Municipality of Copenhagen, DK-2200 Copenhagen N, Denmark.

BACKGROUND & AIM: Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient. The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than standard care. Secondary outcomes were changes in muscle strength, functional ability and body weight.

METHODS: 29 acutely admitted old (>65 years) patients were randomly assigned to the intervention (n = 14) or to standard care (n = 15). The Intervention Group received 1.7 g protein/kg/day during admission and a daily protein supplement (18.8 g protein) and resistance training 3 times per week the 12 weeks following discharge. Muscle mass was assessed by Dual-energy X-ray Absorptiometry. Muscle strength was assessed by Hand Grip Strength and Chair Stand Test. Functional ability was assessed by the de Morton Mobility Index, the Functional Recovery Score and the New Mobility Score. Changes in outcomes from time of admission to three-months after discharge were analysed by linear regression analysis.

RESULTS: The intention-to-treat analysis showed no significant effect of the intervention on lean mass (unadjusted: β-coefficient = -1.28 P = 0.32, adjusted for gender: β-coefficient = -0.02 P = 0.99, adjusted for baseline lean mass: β-coefficient = -0.31 P = 0.80). The de Morton Mobility Index significantly increased in the Control Group (β-coefficient = -11.43 CI: 0.72-22.13, P = 0.04). No other differences were found.

CONCLUSION: No significant effect on muscle mass was observed in this group of acutely ill old medical patients. High compliance was achieved with the dietary intervention, but resistance training was challenging.

Clinical trials identifier NCT02077491.

KEYWORDS: Geriatric; Muscle mass; Nutrition; Oral Nutritional Supplement; Resistance training; Systemic Inflammatory Response Syndrome

PMID: 25796103

DOI: 10.1016/j.clnu.2015.02.015