单独补充蛋白质或结合运动治疗肌肉疏松症和身体虚弱：随机对照试验的系统回顾和荟萃分析

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2025-02-11 DOI:10.1016/j.archger.2025.105783

Yoshihiro Yoshimura , Ayaka Matsumoto , Tatsuro Inoue , Masatsugu Okamura , Masafumi Kuzuya

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引用次数: 0

摘要

骨骼肌减少症和身体虚弱是与年龄相关的综合征，其特征是肌肉质量和功能的进行性丧失，显著影响老年人的死亡率和生活质量。本系统综述评估了蛋白质补充干预对这些疾病的有效性。方法系统检索2000年1月至2023年3月的Medline、CENTRAL和Ichushi Web，并将人工检索时间延长至2024年3月。纳入随机对照试验，研究≥65岁肌肉减少症或身体虚弱的成年人单独或联合补充蛋白质。主要结果是肌肉质量、力量和身体表现的变化。结果通过数据库检索（Medline: 357, CENTRAL: 275, Ichushi Web: 639）系统检索文献1506篇，手工检索文献235篇。最终，13项随机对照试验（n=1,057）符合纳入标准。与单独运动相比，蛋白质和运动联合干预在骨骼肌指数（MD = 0.89 kg/m²，95% CI: 0.45至1.33）和握力（MD: +2.64 kg, 95% CI: +0.75至+4.53）方面有显著改善。单独补充蛋白质对肌肉力量有一定的好处，但对身体表现的影响有限。无严重不良事件报告。结论：虽然蛋白质补充与运动相结合对肌肉减少症或身体虚弱的老年人的肌肉质量和力量有很好的效果，但证据质量一直被评为非常低。需要进一步的高质量试验来确定最佳的补充策略。RegistrationPROSPERO: CRD42023408529

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Protein supplementation alone or combined with exercise for sarcopenia and physical frailty: A systematic review and meta-analysis of randomized controlled trials

Background

Sarcopenia and physical frailty are age-related syndromes characterized by progressive loss of muscle mass and function, significantly impacting mortality and quality of life in older adults. This systematic review evaluated the effectiveness of protein supplementation interventions for these conditions.

Methods

We systematically searched Medline, CENTRAL, and Ichushi Web from January 2000 to March 2023, with additional manual searching extended to March 2024. Randomized controlled trials investigating protein supplementation, alone or combined with exercise, in adults aged ≥65 years with sarcopenia or physical frailty were included. The primary outcomes were changes in muscle mass, strength, and physical performance.

Results

The systematic literature search identified 1,506 records through database searching (Medline: 357, CENTRAL: 275, Ichushi Web: 639) and 235 additional records through hand searching. Finally, 13 randomized controlled trials (n=1,057) met the inclusion criteria. Combined protein and exercise interventions demonstrated significant improvements in skeletal muscle index (MD = 0.89 kg/m², 95 % CI: 0.45 to 1.33) and handgrip strength (MD: +2.64 kg, 95 % CI: +0.75 to +4.53) compared to exercise alone. Protein supplementation alone showed modest benefits in muscle strength but limited effects on physical performance. No serious adverse events were reported.

Conclusions

While protein supplementation combined with exercise shows promising effects on muscle mass and strength in older adults with sarcopenia or physical frailty, the evidence quality was consistently rated as very low. Further high-quality trials are needed to establish optimal supplementation strategies.

Registration

PROSPERO: CRD42023408529

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.