補充富含支鏈胺基酸營養品對於社區中老年肌少症之成效

Supplmented with Enriched Branched Chain Amino Acid Nutrient for Sarcopenia in Community Dwelling Middle-Aged and Old People

柯俊宏(Chun-Hung Ko) ； 吳幸娟(Shin-Jiuan Wu) ； 李宜樺(Yi-Hua Lee) ； 張尹凡(Yin-Fan Chang) ； 張秦松(Chin-Sung Chang) ； 許永河(Yuan-Ho Hsu) ； 莊華盈(Hua-Ying Chuang) ； 吳至行(Chih-Hsing Wu)

《台灣老年醫學暨老年學雜誌》 12卷1期 (2017/02) Pp. 29-41

https://doi.org/10.29461/TGG.201702_12(1).0003

摘要

背景：本研究探討社區有肌少症高風險之中老年人，給予富含支鏈胺基酸營養品補充前後之變化，藉此了解營養補充於改善肌少症的可能成效。方法：本研究採介入性研究設計，共收集33位(男/女=6/27)符合肌少症前期、肌少症高風險或肌少症受試者，平均年齡66.6歲。肌少症判定根據為2014年AWGS修訂版，每位受試者均給予富含支鏈胺基酸(BCAA, Amino Vital Pro®)營養品，每日早晚各一包持續補充35天，補充期間受試者不改變平日飲食與活動習慣。以單頻八極生物電阻抗分析儀(Tanita, BC-418, Tokyo, Japan)分析身體組成，評估支鏈胺基酸補充前後身體質量指數、體脂肪、骨骼肌肉質量指數、手握力和六公尺行走速度變化。結果：全體33位個案持續接受富含支鏈胺基酸營養品補充5週後發現骨骼肌肉質量指數增加0.15公斤/公尺^2 (p=0.008)、六公尺行走速度改善0.12公尺/秒(p＜0.001)、手握力增加3.4公斤(p＜0.001)。針對21位肌少症者以富含支鏈胺基酸營養品補充5週後分析發現體重稍微增加0.45公斤(p=0.041)、身體質量指數增加0.18公斤/公尺^2 (p=0.032)、骨骼肌肉質量指數增加0.24公斤/公尺^2(p=0.001)、六公尺行走速度改善0.12公尺/秒(p＜0.001)、手握力增加2.99公斤(p＜0.001)。結論：有肌少症前期、肌少症高風險或肌少症社區中老年人經由5週富含支鏈胺基酸的營養補充可以改善肌少症的相關指標。

關鍵字

肌少症 ； 支鏈胺基酸 ； 營養補充 ； 中老年人

並列摘要

Background: Sarcopenia is an age-related, progressive, generalized loss of muscle mass and the decrement in physical activity. Sarcopenia is associated with subsequent health hazards such as disability, falls, functional degeneration, hospitalization and death. Nutrition plays an important role for muscle maintenance. However, the effect of nutritional supplement for sarcopenia is still uncertain. We try to figure out the effect of enriched branched-chain amino acid (BCAA) nutrient on muscle mass, strength and physical performance of sarcopenia in the middle-aged and old people in Tainan. Design: Thirty-three subjects aged 46-80 year-old (mean: 66.6, M/F: 6/27) with pre-sarcopenia, at risk of sarcopenia or sarcopenia were purposed to receive BCAA-Amino Vital Pro 7.2 g (Leucine 1.08 g, Isoleucine 0.86 g, Valine 0.72 g, Glutamine 1.30 g, Arginine 1.22 g, other amino acids 2.02 g) daily for five weeks. The dietary habit and physical activity were recorded without specific intervention for each subject. Body composition measured by bioelectrical impedance analysis (BC-418, Tanita Corp., Tokyo, Japan), grip strength (TKK 5101 Grip-D; Takey, Tokyo, Japan) and gait speed were evaluated at baseline and after five weeks of nutritional supplement. Skeletal muscle mass was estimated by Janssen’s equation. Sarcopenia was defined according to the modified 2014 consensus of the Asian Working Group on Sarcopenia (AWGS). Results: After 5-week enriched branched chain amino acid supplement, there are significant improvements in skeletal muscle mass index (SMI, +0.15 kg/m^2, p=0.008), 6-meter gait speed (+0.12 m/s, p＜0.001), and grip strength (+3.4 kg, p＜0.001) in 33 subjects. Furthermore, in 21 sarcopenia subjects, the significant improvements are found in SMI (+0.24 kg/m^2, p=0.001), 6-meter gait speed (+0.14 m/s, p＜0.001), and grip strength (+2.99 kg, p＜0.001). Conclusions: A 5-week intervention of oral enriched branched chain amino acid nutritional supplement results in the improvements in skeletal muscle mass, muscle strength and physical performance in middle-aged and old adults with pre-sarcopenia, at risk of sarcopenia and sarcopenia.

並列關鍵字

Sarcopenia ； branched-chain amino acid (BCAA) ； nutritional supplement ； middle-aged and old people