Effect of β-hydroxy-β-methylbutyrate on Protein Metabolism in Bed-ridden Elderly Receiving Tube Feeding

補充羥基甲基丁酸鹽影響管灌臥床老人之蛋白質代謝

Lan-Chi Hsieh ； Chau-Jen Chow ； Wen-Chou Chang ； Tsung-Han Liu ； Chen-Kang Chang

《Asia Pacific Journal of Clinical Nutrition》 19卷2期 (2010/05) Pp. 200-208

https://doi.org/10.6133/apjcn.2010.19.2.07

摘要

營養不良與肌肉流失是護理之家老年臥床住民常見的情況。過去研究顯示，補充β-羥基-β-甲基丁酸鹽（HMB）可以避免數種代謝分解狀態下的肌肉流失。本研究目的為探討補充HMB對接受管灌飲食的護理之家老年臥床住民，身體組成與蛋白質代謝的影響。受試者隨機分為HMB組（39位，每天補充2 g）或控制組（40位），於補充14天前後進行人體測量，並收集血液與24小時尿液樣本；其中部分受試者（HMB組19位，控制組20位）繼續補充14天。控制身體質量指數（BMI）基準值後，14天或28天後體重與BMI改變量，在兩組間並無顯著差異；HMB組血液尿素氮14天後顯著降低，在控制組則無顯著改變；HMB組尿液尿素氮在14與28天後顯著降低，控制組則呈現增加的趨勢。控制BMI基準值後，血液尿素氮與尿液尿素氮的變化量在兩組間有顯著差異。本研究顯示，補充HMB 2至4週，可以減緩接受管灌飲食的護理之家老年臥床住民的肌肉損耗。

關鍵字

肌肉流失 ； 蛋白質分解 ； 護理之家 ； 營養不良 ； 尿液尿素氮排泄

並列摘要

Malnutrition and muscle loss are common in bed-ridden elderly nursing home residents. Supplementation of β-hydroxy-β-methylbutyrate (HMB) has been shown to prevent muscle loss in several catabolic conditions. The aim of this study was to investigate the effect of HMB supplementation on body composition and protein metabolism in bed-ridden elderly nursing home residents receiving tube feeding. The subjects were randomly assigned to HMB (n=39, 2 g/d) or control group (n=40). Anthropometry measurements, blood sampling, and 24-hr urine collection were performed on the day before and 14 days after the start of the study. A subgroup of subjects (HMB: n=19, control: n=20) continued the study for another 14 days. Changes in body weight and BMI were not significantly different between the groups after 14 or 28 days after controlling for baseline BMI. Blood urea nitrogen significantly decreased in the HMB group, while it remained unchanged in the control group after 14 days. Urinary urea nitrogen excretion significantly decreased in the HMB group, while it showed a trend of increase in the control group after 14 and 28 days, respectively. Changes in blood urea nitrogen and urinary urea nitrogen excretion were significantly different between the groups after controlling for baseline BMI. This study suggested that HMB supplementation for 2-4 weeks could reduce muscle breakdown in bed-ridden elderly nursing home residents receiving tube feeding.

並列關鍵字

muscle wasting ； proteolysis ； nursing home ； malnutrition ； urinary urea nitrogen excretion