中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (24): 4545-4552.doi: 10.3969/j.issn.2095-4344.2013.24.025
• 组织构建综述 tissue construction review • 上一篇 下一篇
文蔡雄
收稿日期:
2013-03-13
修回日期:
2013-04-04
出版日期:
2013-06-11
发布日期:
2013-06-11
作者简介:
文蔡雄,男,1963年生,海南省东方市人,汉族,1985年广州体育学院毕业,副教授,主要从事公共体育教学和体育健康教育的教学与研究。
wxw2002@yahoo.cn
Wen Cai-xiong
Received:
2013-03-13
Revised:
2013-04-04
Online:
2013-06-11
Published:
2013-06-11
About author:
Wen Cai-xiong, Associate professor, Department of Basis, Guangdong Teachers College of Foreign Language and Arts, Guangzhou 510507, Guangdong Province, China
wxw2002@yahoo.cn
摘要:
背景:老年人肌肉蛋白质代谢出现了负平衡状态,这被认为是老年人肌肉丢失和肌肉功能衰退的重要原因。近年来的许多研究都证实,抗阻训练和蛋白质补充可以有效地改善老年人肌肉蛋白质代谢的负平衡现象,并提高老年人肌肉质量,改善其肌肉功能。 目的:综述老年人抗阻训练、蛋白质补充以及抗阻训练结合蛋白质补充对老年人肌肉蛋白质代谢和肌肉功能的影响,探讨改善老年人肌肉功能和抑制肌肉丢失的可行办法。 方法:应用计算机检索CNKI 期刊全文数据库(2005年1月至2012年12月)和PubMed数据库(2010年1月至2012年12月)与肌肉蛋白质代谢、蛋白补充及抗阻训练对老年人肌肉蛋白质代谢影响的相关文献。检索词分别为“蛋白质代谢;肌细胞;肌肉丢失;抗阻训练;蛋白补充”和“muslce cell, resistance training,Sarcopenia,protein motablism”。 结果与结论:在检索到的81篇文献中排除22篇不符合标准的文献,最终纳入59篇文献进行了分析、综述。结果表明,老年人肌肉蛋白质代谢的负平衡状态是导致老年肌肉丢失的直接原因。抗阻训练和给予富含亮氨酸的蛋白质补充能够有效增强老年人肌肉蛋白质合成代谢水平,并改善老年人肌肉功能。但老年人肌肉蛋白合成代谢对抗阻训练和蛋白补充的反应能力远低于年轻人。
中图分类号:
文蔡雄. 抗阻训练与蛋白质补充:改善老年人肌肉蛋白质代谢[J]. 中国组织工程研究, 2013, 17(24): 4545-4552.
Wen Cai-xiong. Resistance training and protein supplement: Improvement of elderly muscle protein metabolism[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(24): 4545-4552.
[1] WHO: 2008 [http://www.who.int/topics/ageing].[2] Janssen I, Ross R.Linking age-related changes in skeletal muscle mass and composition with metabolism and disease.J Nutr Health Aging. 2005;9(6):408-419.http://www.ncbi.nlm.nih.gov/pubmed/?term=Linking+age-related+changes+in+skeletal+muscle+mass+and+composition+with+metabolism+and+disease[3] Janssen I.Influence of sarcopenia on the development of physical disability: the Cardiovascular Health Study.J Am Geriatr Soc. 2006;54(1):56-62.http://www.ncbi.nlm.nih.gov/pubmed/?term=Influence+of+sarcopenia+on+the+development+of+physical+disability%3A+the+Cardiovascular+Health+Study[4] Janssen I, Baumgartner RN, Ross R,et al.Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women.Am J Epidemiol. 2004;159(4):413-421.http://www.ncbi.nlm.nih.gov/pubmed/?term=Skeletal+muscle+cutpoints+associated+with+elevated+physical+disability+risk+in+older+men+and+women[5] Johnson ML, Robinson MM, Nair KS.Skeletal muscle aging and the mitochondrion.Trends Endocrinol Metab. 2013. pii: S1043-2760(12)00223-8.http://www.ncbi.nlm.nih.gov/pubmed/?term=Skeletal+muscle+aging+and+the+mitochondrion.+Trends+Endocrinol+Metab[6] Janssen I.Evolution of sarcopenia research.Appl Physiol Nutr Metab. 2010;35(5):707-712.http://www.ncbi.nlm.nih.gov/pubmed/20962927[7] Trappe T, Williams R, Carrithers J,et al.Influence of age and resistance exercise on human skeletal muscle proteolysis: a microdialysis approach.J Physiol. 2004;554(Pt 3):803-813.http://www.ncbi.nlm.nih.gov/pubmed/?term=Influence+of+age+and+resistance+exercise+on+human+skeletal+muscle+proteolysis%3A+a+microdialysis+approach.[8] Yarasheski KE, Zachwieja JJ, Bier DM.Acute effects of resistance exercise on muscle protein synthesis rate in young and elderly men and women.Am J Physiol. 1993;265(2 Pt 1):E210-214.http://www.ncbi.nlm.nih.gov/pubmed/?term=Acute+effects+of+resistance+exercise+on+muscle+protein+synthesis+rate+in+young+and+elderly+men+and+women[9] Trappe T, Williams R, Carrithers J,et al.Influence of age and resistance exercise on human skeletal muscle proteolysis: a microdialysis approach.J Physiol. 2004;554(Pt 3):803-813.http://www.ncbi.nlm.nih.gov/pubmed/?term=Influence+of+age+and+resistance+exercise+on+human+skeletal+muscle+proteolysis%3A+a+microdialysis+approach[10] Suetta C, Hvid LG, Justesen L,et al.Effects of aging on human skeletal muscle after immobilization and retraining.J Appl Physiol. 2009;107(4):1172-1180.http://www.ncbi.nlm.nih.gov/pubmed/19661454[11] Visser M.Obesity, sarcopenia and their functional consequences in old age.Proc Nutr Soc. 2011;70(1):114-118. http://www.ncbi.nlm.nih.gov/pubmed/?term=Obesity%2C+sarcopenia+and+their+functional+consequences+in+old+age[12] Hughes VA, Frontera WR, Wood M,et al.Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health.J Gerontol A Biol Sci Med Sci. 2001;56(5):B209-217.http://www.ncbi.nlm.nih.gov/pubmed/?term=Longitudinal+muscle+strength+changes+in+older+adults%3A+influence+of+muscle+mass%2C+physical+activity%2C+and+health[13] Mosoni L, Valluy MC, Serrurier B,et al.Altered response of protein synthesis to nutritional state and endurance training in old rats.Am J Physiol. 1995;268(2 Pt 1):E328-335.http://www.ncbi.nlm.nih.gov/pubmed/?term=Altered+response+of+protein+synthesis+to+nutritional+state+and+endurance+training+in+old+rats[14] Pannemans DL, Wagenmakers AJ, Westerterp KR,et al.Effect of protein source and quantity on protein metabolism in elderly women.Am J Clin Nutr. 1998;68(6):1228-1235.http://www.ncbi.nlm.nih.gov/pubmed/?term=Effect+of+protein+source+and+quantity+on+protein+metabolism+in+elderly+women[15] Katsanos CS, Kobayashi H, Sheffield-Moore M,et al.Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids.Am J Clin Nutr. 2005;82(5):1065-1073.http://www.ncbi.nlm.nih.gov/pubmed/?term=Aging+is+associated+with+diminished+accretion+of+muscle+proteins+after+the+ingestion+of+a+small+bolus+of+essential+amino+acids[16] Balage M, Averous J, Rémond D,et al.Presence of low-grade inflammation impaired postprandial stimulation of muscle protein synthesis in old rats.J Nutr Biochem. 2010;21(4):325-331.http://www.ncbi.nlm.nih.gov/pubmed/?term=Presence+of+low-grade+inflammation+impaired+postprandial+stimulation+of+muscle+protein+synthesis+in+old+rats[17] Burd NA, Wall BT, van Loon LJ.The curious case of anabolic resistance: old wives' tales or new fables.J Appl Physiol. 2012;112(7):1233-1235.http://www.ncbi.nlm.nih.gov/pubmed/22134695[18] Wolfe RR.The underappreciated role of muscle in health and disease.Am J Clin Nutr. 2006;84(3):475-482.http://www.ncbi.nlm.nih.gov/pubmed/16960159[19] Dardevet D, Rémond D, Peyron MA,et al.Muscle wasting and resistance of muscle anabolism: the "anabolic threshold concept" for adapted nutritional strategies during sarcopenia.ScientificWorldJournal. 2012;2012:269531.http://www.ncbi.nlm.nih.gov/pubmed/?term=Muscle+wasting+and+resistance+of+muscle+anabolism%3A+the+%22anabolic+threshold+concept%22+for+adapted+nutritional+strategies+during+sarcopenia[20] Balage M, Averous J, Rémond D,et al.Presence of low-grade inflammation impaired postprandial stimulation of muscle protein synthesis in old rats.J Nutr Biochem. 2010;21(4):325-331.http://www.ncbi.nlm.nih.gov/pubmed/?term=Presence+of+low-grade+inflammation+impaired+postprandial+stimulation+of+muscle+protein+synthesis+in+old+rats[21] Volpi E, Sheffield-Moore M, Rasmussen BB,et al.Basal muscle amino acid kinetics and protein synthesis in healthy young and older men.JAMA. 2001;286(10):1206-1212.http://www.ncbi.nlm.nih.gov/pubmed/?term=Basal+muscle+amino+acid+kinetics+and+protein+synthesis+in+healthy+young+and+older+men[22] Volpi E, Mittendorfer B, Rasmussen BB,et al.The response of muscle protein anabolism to combined hyperaminoacidemia and glucose-induced hyperinsulinemia is impaired in the elderly.J Clin Endocrinol Metab. 2000;85(12):4481-4490.http://www.ncbi.nlm.nih.gov/pubmed/?term=The+response+of+muscle+protein+anabolism+to+combined+hyperaminoacidemia+and+glucoseinduced+hyperinsulinemia+is+impaired+in+the+elderly.[23] Toth MJ, Matthews DE, Tracy RP,et al.Age-related differences in skeletal muscle protein synthesis: relation to markers of immune activation.Am J Physiol Endocrinol Metab. 2005;288(5):E883-E891. http://www.ncbi.nlm.nih.gov/pubmed/?term=Age-related+differences+in+skeletal+muscle+protein+synthesis%3A+relation+to+markers+of+immune+activation.+American+journal+of+physiology[24] Katsanos CS, Kobayashi H, Sheffield-Moore M,A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly.Am J Physiol Endocrinol Metab. 2006 Aug;291(2):E381-387.http://www.ncbi.nlm.nih.gov/pubmed/?term=A+high+proportion+of+leucine+is+required+for+optimal+stimulation+of+the+rate+of+muscle+protein+synthesis+by+essential+amino+acids+in+the+elderly[25] Weisleder N, Brotto M, Komazaki S,et al.Muscle aging is associated with compromised Ca2+ spark signaling and segregated intracellular Ca2+ release.J Cell Biol. 2006;174(5):639-645.http://www.ncbi.nlm.nih.gov/pubmed/?term=Muscle+aging+is+associated+with+compromised+Ca2%2B+spark+signaling+and+segregated+intracellular+Ca2%2B+release[26] Brotto MA, Nagaraj RY, Brotto LS,et al.Defective maintenance of intracellular Ca2+ homeostasis is linked to increased muscle fatigability in the MG29 null mice.Cell Res. 2004;14(5):373-378.http://www.ncbi.nlm.nih.gov/pubmed/?term=Defective+maintenance+of+intracellular+Ca2%2B+homeostasis+is+linked+to+increased+muscle+fatigability+in+the+MG29+null+mice[27] Kurebayashi N, Takeshima H, Nishi M,et al.Changes in Ca2+ handling in adult MG29-deficient skeletal muscle.Biochem Biophys Res Commun. 2003;310(4):1266-1272.http://www.ncbi.nlm.nih.gov/pubmed/?term=Changes+in+Ca2%2B+handling+in+adult+MG29-deficient+skeletal+muscle[28] Freichel M, Vennekens R, Olausson J,et al.Functional role of TRPC proteins in native systems: implications from knockout and knock-down studies.J Physiol. 2005;567(Pt 1):59-66.http://www.ncbi.nlm.nih.gov/pubmed/?term=Functional+role+of+TRPC+proteins+in+native+systems%3A+implications+from+knockout+and+knock-down+studies[29]闫万军.负重跑训练改善老龄大鼠肌肉丢失的效果与机理[D].石家庄:河北师范大学,2008.http://www.cnki.net/KCMS/detail/detail.aspx?QueryID=2&CurRec=1&recid=&filename=2008124649.nh&dbname=CDFD2008&dbcode=CDFD&pr=&urlid=&yx=[30] Paddon-Jones D, Sheffield-Moore M, Zhang XJ,et al.Amino acid ingestion improves muscle protein synthesis in the young and elderly.Am J Physiol Endocrinol Metab. 2004;286(3):E321-E328.http://www.ncbi.nlm.nih.gov/pubmed/?term=Amino+acid+ingestion+improves+muscle+protein+synthesis+in+the+young+and+elderly[31] Balage M, Dardevet D.Long-term effects of leucine supplementation on body composition.Curr Opin Clin Nutr Metab Care. 2010;13(3):265-270.http://www.ncbi.nlm.nih.gov/pubmed/20110810[32] Balage M, Averous J, Rémond D,et al.Presence of low-grade inflammation impaired postprandial stimulation of muscle protein synthesis in old rats.J Nutr Biochem. 2010;21(4):325-331.http://www.ncbi.nlm.nih.gov/pubmed/?term=Presence+of+low-grade+inflammation+impaired+postprandial+stimulation+of+muscle+protein+synthesis+in+old+rats[33] Magne H, Savary-Auzeloux I, Migné C,et al.Contrarily to whey and high protein diets, dietary free leucine supplementation cannot reverse the lack of recovery of muscle mass after prolonged immobilization during ageing.J Physiol. 2012;590(Pt 8):2035-2049.http://www.ncbi.nlm.nih.gov/pubmed/?term=Contrarily+to+whey+and+high+protein+diets%2C+dietary+free+leucine+supplementation+cannot+reverse+the+lack+of+recovery+of+muscle+mass+after+prolonged+immobilization+during+ageing[34] Coker RH, Miller S, Schutzler S,et al.Whey protein and essential amino acids promote the reduction of adipose tissue and increased muscle protein synthesis during caloric restriction-induced weight loss in elderly, obese individuals.Nutr J. 2012;11:105.http://www.ncbi.nlm.nih.gov/pubmed/?term=Whey+protein+and+essential+amino+acids+promote+the+reduction+of+adipose+tissue+and+increased+muscle+protein+synthesis+during+caloric+restriction-induced+weight+loss+in+elderly%2C+obese+individuals[35] Rooyackers OE, Adey DB, Ades PA,et al.Effect of age on in vivo rates of mitochondrial protein synthesis in human skeletal muscle.Proc Natl Acad Sci U S A. 1996;93(26):15364-15369.http://www.ncbi.nlm.nih.gov/pubmed/?term=Effect+of+age+on+in+vivo+rates+of+mitochondrial+protein+synthesis+in+human+skeletal+muscle[36] Dillon EL.Nutritionally essential amino acids and metabolic signaling in aging.Amino Acids. 2012. [Epub ahead of print]http://www.ncbi.nlm.nih.gov/pubmed/?term=Nutritionally+essential+amino+acids+and+metabolic+signaling+in+aging.[37] Welle S, Thornton C, Jozefowicz R,et al.Myofibrillar protein synthesis in young and old men.Am J Physiol. 1993;264(5 Pt 1):E693-698.http://www.ncbi.nlm.nih.gov/pubmed/?term=Myofibrillar+protein+synthesis+in+young+and+old+men[38] Katsanos CS, Kobayashi H, Sheffield-Moore M,et al.Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids.Am J Clin Nutr. 2005;82(5):1065-1073.http://www.ncbi.nlm.nih.gov/pubmed/?term=Aging+is+associated+with+diminished+accretion+of+muscle+proteins+after+the+ingestion+of+a+small+bolus+of+essential+amino+acids[39] Katsanos CS, Kobayashi H, Sheffield-Moore M,et al.A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly.Am J Physiol Endocrinol Metab. 2006;291(2):E381-387.http://www.ncbi.nlm.nih.gov/pubmed/?term=A+high+proportion+of+leucine+is+required+for+optimal+stimulation+of+the+rate+of+muscle+protein+synthesis+by+essential+amino+acids+in+the+elderly[40] Paddon-Jones D, Short KR, Campbell WW,et al.Role of dietary protein in the sarcopenia of aging.Am J Clin Nutr. 2008;87(5):1562S-1566S.http://www.ncbi.nlm.nih.gov/pubmed/18469288[41] Pennings B, Boirie Y, Senden JM,et al.Whey protein stimulates postprandial muscle protein accretion more effectively than do casein and casein hydrolysate in older men.Am J Clin Nutr. 2011;93(5):997-1005.http://www.ncbi.nlm.nih.gov/pubmed/?term=Whey+protein+stimulates+postprandial+muscle+protein+accretion+more+effectively+than+do+casein+and+casein+hydrolysate+in+older+men[42] Scognamiglio R, Piccolotto R, Negut C,et al.Oral amino acids in elderly subjects: effect on myocardial function and walking capacity.Gerontology. 2005;51(5):302-308.http://www.ncbi.nlm.nih.gov/pubmed/?term=Oral+amino+acids+in+elderly+subjects%3A+effect+on+myocardial+function+and+walking+capacity[43] Trappe TA, Carroll CC, Dickinson JM,et al.Influence of acetaminophen and ibuprofen on skeletal muscle adaptations to resistance exercise in older adults.Am J Physiol Regul Integr Comp Physiol. 2011;300(3):R655-662.http://www.ncbi.nlm.nih.gov/pubmed/?term=Influence+of+acetaminophen+and+buprofen+on+skeletal+muscle+adaptations+to+resistance+exercise+in+older+adults[44] Onambélé-Pearson GL, Breen L, Stewart CE.Influences of carbohydrate plus amino acid supplementation on differing exercise intensity adaptations in older persons: skeletal muscle and endocrine responses.Age (Dordr). 2010;32(2):125-138.http://www.ncbi.nlm.nih.gov/pubmed/?term=.Influences+of+carbohydrate+plus+amino+acid+supplementation+on+differing+exercise+intensity+adaptations+in+older+persons%3A+skeletal+muscle+and+endocrine+responses[45] Katsanos CS, Chinkes DL, Paddon-Jones D,et al.Whey protein ingestion in elderly persons results in greater muscle protein accrual than ingestion of its constituent essential amino acid content.Nutr Res. 2008;28(10):651-658.http://www.ncbi.nlm.nih.gov/pubmed/?term=Whey+protein+ingestion+in+elderly+persons+results+in+greater+muscle+protein+accrual+than+ingestion+of+its+constituent+essential+amino+acid+content[46] Katsanos CS, Chinkes DL, Paddon-Jones D,et al.Whey protein ingestion in elderly persons results in greater muscle protein accrual than ingestion of its constituent essential amino acid content.Nutr Res. 2008;28(10):651-658.http://www.ncbi.nlm.nih.gov/pubmed/?term=Whey+protein+ingestion+in+elderly+persons+results+in+greater+muscle+protein+accrual+than+ingestion+of+its+constituent+essential+amino+acid+content[47] Hayes A, Cribb PJ.Effect of whey protein isolate on strength, body composition and muscle hypertrophy during resistance training.Curr Opin Clin Nutr Metab Care. 2008;11(1):40-44.http://www.ncbi.nlm.nih.gov/pubmed/?term=Effect+of+whey+protein+isolate+on+strength%2C+body+composition+and+muscle+hypertrophy+during+resistance+training[48] Onambélé-Pearson GL, Breen L, Stewart CE.Influence of exercise intensity in older persons with unchanged habitual nutritional intake: skeletal muscle and endocrine adaptations.Age (Dordr). 2010;32(2):139-153.http://www.ncbi.nlm.nih.gov/pubmed/?term=Influence+of+exercise+intensity+in+older+persons+with+unchanged+habitual+nutritional+intake%3A+skeletal+muscle+and+endocrine+adaptations[49] Walker DK, Dickinson JM, Timmerman KL,et al.Exercise, amino acids, and aging in the control of human muscle protein synthesis.Med Sci Sports Exerc. 2011;43(12):2249-2258.http://www.ncbi.nlm.nih.gov/pubmed/21606874[50] Faure C, Raynaud-Simon A, Ferry A,et al.Leucine and citrulline modulate muscle function in malnourished aged rats.Amino Acids. 2012;42(4):1425-1433.http://www.ncbi.nlm.nih.gov/pubmed/?term=Moinard+C.Leucine+and+citrulline+modulate+muscle+function+in+malnourished+aged+rats[51] Paddon-Jones D, Rasmussen BB.Dietary protein recommendations and the prevention of sarcopenia.Curr Opin Clin Nutr Metab Care. 2009;12(1):86-90.http://www.ncbi.nlm.nih.gov/pubmed/19057193[52] Cermak NM, Res PT, de Groot LC,et al.Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis.Am J Clin Nutr. 2012;96(6):1454-1464.http://www.ncbi.nlm.nih.gov/pubmed/?term=Protein+supplementation+augments+the+adaptive+response+of+skeletal+muscle+to+resistance-type+exercise+training%3A+a+meta-analysis.[53] Bemben MG, Witten MS, Carter JM,et al.The effects of supplementation with creatine and protein on muscle strength following a traditional resistance training program in middle-aged and older men.J Nutr Health Aging. 2010;14(2):155-159.http://www.ncbi.nlm.nih.gov/pubmed/?term=.The+effects+of+supplementation+with+creatine+and+protein+on+muscle+strength+following+a+traditional+resistance+training+program+in+middle-aged+and+older+men[54] Drummond MJ, Dreyer HC, Pennings B,et al.Skeletal muscle protein anabolic response to resistance exercise and essential amino acids is delayed with aging.J Appl Physiol. 2008;104(5):1452-1461.http://www.ncbi.nlm.nih.gov/pubmed/?term=Skeletal+muscle+protein+anabolic+response+to+resistance+exercise+and+essential+amino+acids+is+delayed+with+aging[55] Abe T, Sato Y, Inoue K, et al. Muscle size and IGF-1 increased after two weeks of low-intensity “Kaatsu” resistance training. Med Sci Sports Exerc. 2004; 36:S353-S353.[56] Abe T, Kearns CF, Sato Y.Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training.J Appl Physiol. 2006;100(5):1460-1466.http://www.ncbi.nlm.nih.gov/pubmed/?term=Muscle+size+and+strength+are+increased+following+walk+training+with+restricted+venous+blood+flow+from+the+leg+muscle%2C[57] Gustafsson T, Osterlund T, Flanagan JN,et al.Effects of 3 days unloading on molecular regulators of muscle size in humans.J Appl Physiol. 2010;109(3):721-727.http://www.ncbi.nlm.nih.gov/pubmed/?term=Effects+of+3+days+unloading+on+molecular+regulators+of+muscle+size+in+humans[58] Tang JE, Manolakos JJ, Kujbida GW,et al.Minimal whey protein with carbohydrate stimulates muscle protein synthesis following resistance exercise in trained young men.Appl Physiol Nutr Metab. 2007;32(6):1132-1138.http://www.ncbi.nlm.nih.gov/pubmed/?term=Minimal+whey+protein+with+carbohydrate+stimulates+muscle+protein+synthesis+following+resistance+exercise+in+trained+young+men[59] Symons TB, Sheffield-Moore M, Mamerow MM,et al.The anabolic response to resistance exercise and a protein-rich meal is not diminished by age.J Nutr Health Aging. 2011;15(5):376-381.http://www.ncbi.nlm.nih.gov/pubmed/?term=The+anabolic+response+to+resistance+exercise+and+a+protein+rich+meal+is+not+diminished+by+age |
[1] | 王诗琦, 张金生. 中医药调控缺血缺氧微环境对骨髓间充质干细胞增殖、分化及衰老的影响[J]. 中国组织工程研究, 2021, 25(7): 1129-1134. |
[2] | 李 上, 黄 骧, 陈 铭, 雷明星, 程 实, 张里程, 尹鹏滨, 唐佩福. 信号蛋白3A有望成为骨骼肌损伤修复的新靶点[J]. 中国组织工程研究, 2021, 25(20): 3232-3238. |
[3] | 蔺海旗, 陈 亮, 唐 璐, 翁锡全, 林文弢. 尿液蛋白质组学评估机体病理性变化的意义[J]. 中国组织工程研究, 2021, 25(20): 3259-3266. |
[4] | 高元慧, 向 杨, 曹 卉, 王顺兰, 郑琳麟, 何浩伟, 张应爱, 张淑芳, 黄邓高. 两种月龄近交系五指山小型猪脂肪间充质干细胞生物学特性的比较[J]. 中国组织工程研究, 2021, 25(19): 2988-2993. |
[5] | 胡万东, 何佳林, 张隆盛, 廖文波. 胸椎黄韧带骨化患者的差异蛋白组学研究[J]. 中国组织工程研究, 2021, 25(17): 2625-2629. |
[6] | 张 辉, 王少华, 王 茜, 王 辉, 甘洪全, 崔逸爽, 李琪佳, 王志强. RGD多肽修饰多孔钽可激活MG63细胞整合素/黏着斑激酶信号通路[J]. 中国组织工程研究, 2021, 25(16): 2535-2540. |
[7] | 来帅威, 张沙沙, 刘晓芸, Haniya Mazhar, Amber Naz, 贺 林, 朱洪新. 心脏细胞衰老与Uvrag基因的缺失[J]. 中国组织工程研究, 2021, 25(14): 2241-2246. |
[8] | 王严影, 杨育坤, 朱向情, 李 晔, 何 洁, 田 川, 何志旭, 潘兴华. 骨髓间充质干细胞移植干预衰老猕猴胸腺结构和功能的变化[J]. 中国组织工程研究, 2021, 25(1): 13-19. |
[9] | 许国峰, 李学斌, 唐一钒, 赵 寅, 周盛源, 陈雄生, 贾连顺. 人黄韧带细胞骨化发生过程中的自噬[J]. 中国组织工程研究, 2020, 24(8): 1174-1181. |
[10] | 周 玉, 龙小安, 李 宁, 王 纯. 有限元法分析髌腱炎状态时的生物力学变化[J]. 中国组织工程研究, 2020, 24(8): 1280-1286. |
[11] | 杨银辉, 杨 帆, 樊 旭, 徐风瑞, 郑 梁, 刘 薇, 何明武. 改良型富血小板纤维蛋白膜包裹颗粒软骨移植的长期组织学改变[J]. 中国组织工程研究, 2020, 24(34): 5486-5492. |
[12] | 赵忠海, 闫 彤, 李洪秋, 潘 海. 抗阻训练干预绝经后骨质疏松患者骨密度的系统综述和Meta分析[J]. 中国组织工程研究, 2020, 24(30): 4914-4920. |
[13] | 杨 军, 张少生. 骨骼肌肥大的核糖体生物发生机制及其运动适应[J]. 中国组织工程研究, 2020, 24(27): 4383-4388. |
[14] | 谢明忠, 李 森, 朱 凯, 姜铧财, 戚力升. 衰老髓核细胞中环状RNA浆细胞瘤转化迁移基因1的表达及调控机制[J]. 中国组织工程研究, 2020, 24(17): 2718-2723. |
[15] | 秦丹莹, 张玉恒, 李学拥, 杨雯娴. 脂肪干细胞来源外泌体在组织损伤修复中的蛋白组学分析[J]. 中国组织工程研究, 2020, 24(13): 2011-2019. |
1.1 资料来源 以“肌肉丢失”、“抗阻训练”、“肌纤维类型”、“肌肉蛋白代谢”、“衰老”等为关键词进行不同组合,检索中国知网CNKI期刊全文数据库(2005年1月至2012年12月);以“sarcopenia”、“resistance training”、“muscle fiber type”、“muscle protein metabolism”、“aging”为关键词进行不同组合,检索PubMed数据库(2010年1月至2012年12月)。全部检索于2013年1月完成。
1.3 质量评估 检索共得到81篇英文相关文献,7篇中文相关文献,将实验设计不合理、内容重复和综述性的文章排除,对最终得到的59篇文献进行分析、归纳。从这些文献的研究结果可以看出,对于骨骼肌衰老的研究已从现象、机制的探讨进入了干预与抑制衰老的新阶段,关于肌肉蛋白质代谢的干预研究已取得了一些有意义的成果。文章将这些最新的研究成果进行比较、综述,旨在为国内康复医学界关于抑制肌肉丢失的临床康复研究提供理论和方法上的参考。
1 此问题的已知信息:老年人肌肉丢失和肌肉功能退化是随衰老而表现出的自然规律,但近年来这个问题备受学界关注,原因在于:一方面肌肉丢失出现的较早,一般40岁左右便开始出现明显的肌肉丢失现象;另一方面,肌肉丢失和肌肉功能退化与老年人基础代谢率低下,身体运动能力降低以及老年人摔倒具有密切关系。抗阻训练和蛋白质补充一直是学界探讨的改善老年人肌肉功能和抑制肌肉丢失的干预手段。研究发现,即使是90岁以上的老人也可以通过抗阻训练提高肌肉力量,改善肌肉功能,但这些研究仅局限于老年人握力的研究,抗阻力负荷也相当小,研究结果不具有普遍意义。同时,老年人肌肉丢失与其饮食中蛋白摄入不足密切相关。因此,关于老年人蛋白补充对其肌肉丢失效果的研究有许多报道,但结果并不一致。 2 文章增加的新信息: 近年来的研究发现,老年人饮食中蛋白质摄入减少、体力活动减少以及体内某些蛋白合成激素的减少等综合作用导致老年人肌肉蛋白质代谢出现了负平衡,其中蛋白合成减少和蛋白分解增多同时存在。在蛋白补充的研究中,学者们提出了“合成代谢抵抗”的概念,即:当饮食补充蛋白时,老年人肌细胞对蛋白合成的反应比年轻人显著低,因此合成蛋白的能力比年轻人低。尽管如此,蛋白补充对于抑制老年人肌肉丢失仍然是有效的。而且,在补充的蛋白质中,富含亮氨酸和晶氨酸的蛋白质能够明显增强肌细胞mTOR的信号转导,因而是最有效的蛋白补充剂。同时,抗阻训练结合蛋白补充可以更加有效地抑制老年人肌肉丢失,增强老年人肌肉功能。其机制在于,老年人肌肉蛋白质消耗后再补充,能够使肌肉蛋白合成“超量恢复”,从而有效地增加老年人肌肉质量。 3 临床应用的意义:文章结果可以为老年人肌肉功能的临床康复提供参考。目前,老年人下肢不稳、老年人摔倒、老年人慢性代谢性疾病与肌肉丢失和肌肉功能衰退有关,因此,世界各国的学者们都在努力探讨改善老年人肌肉功能的有效途径。文章分析了近来本领域的最新研究成果,并对结果进行了最精炼的总结,从众多的研究结果中将抗阻训练结合蛋白补充对老年人肌肉功能改善的方法界定在较小的范围内,因而具有较强的临床指导意义。
从本研究可以看出,虽然抗阻训练结合蛋白补充被认为是最有效的抑制肌肉丢失和改善老年人肌肉功能的最有效手段,但关于老年人抗阻训练的具体负荷强度、负荷形式等还没有成熟和完善的数据。这也是近年来的研究热点,即老年人抗阻训练的方法。按照传统的肌肉力量训练理论,老年人从事高强度的抗阻训练是不安全的,不仅对于肌肉本身,而且对于老年人心血管系统都有可能造成伤害。但近来越来越多的研究开始探讨老年人高负荷强度的抗阻训练。因为老年人肌肉丢失主要表现为Ⅱ型纤维的丢失,而只有较高强度的负荷刺激才能促使Ⅱ型纤维参与收缩。另外,近来的研究已发现了最有效的抑制肌肉丢失的蛋白成分,而且也有相应的蛋白产品问世,未来可能会有更多、更具有针对性的蛋白补充的研究,这将会对老年人肌肉丢失相关的临床康复提供有价值的成果。
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||