Effects of protein-rich nutritional supplementation and bisphosphonates on body composition, handgrip strength and health-related quality of life after hip fracture: a 12-month randomized controlled study.
Effects of protein-rich nutritional supplementation and bisphosphonates on body composition, handgrip strength and health-related quality of life after hip fracture: a 12-month randomized controlled study.
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DOI：
10.1186/s12877-015-0144-7
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发表时间：
2015-11-17
期刊：
影响因子：
4.1
通讯作者：
Hedström M
中科院分区：
文献类型：
--
作者：
Flodin L;Cederholm T;Sääf M;Samnegård E;Ekström W;Al-Ani AN;Hedström M
髋部骨折后的分解代谢状态会导致肌肉质量和力量的减少，即肌肉减少症，影响功能能力和健康相关的生活质量。预防此类术后长期后果的措施值得关注。本研究的目的是评估富含蛋白质的营养补充和双膦酸盐对髋部骨折后身体成分、握力和健康相关生活质量的综合影响。该研究纳入了79名髋部骨折的男性和女性，平均年龄79岁（SD 9），没有严重的认知障碍，骨折前可以独立行走和生活。术后患者随机接受液体补充，在骨折后6个月内每天提供40克蛋白质和600千卡热量，此外每周补充一次双膦酸盐，持续12个月（N组，N = 26），或每周只补充一次双膦酸盐，持续12个月（B组，N = 28）。所有患者，包括对照组（C组，n = 25）每天服用钙1 g和维生素D3 800 IU。在基线、术后6个月和12个月记录双能x线吸收仪（DXA）测量的身体成分、握力（HGS）和健康相关生活质量（HRQoL）。在研究期间，各组无脂质量指数（FFMI）、HGS或HRQoL的变化没有差异。组内分析显示，在基线和6个月期间，N组的HGS有所改善（P = 0.04）。C组和B组第一年HRQoL下降（P = 0.03和P = 0.01），而营养补充N组无下降（P = 0.22）。在这组相对健康的髋部骨折患者中，富含蛋白质的营养补充不能比单独使用维生素D和钙或联合使用双膦酸盐更有效地保护FFMI。然而，在营养补充后，观察到对HGS和HRQoL的积极影响趋势。Clinicaltrials.gov NCT01950169（注册日期2013年9月23日）。本文的在线版本（doi:10.1186/s12877-015-0144-7）包含补充材料，授权用户可以使用。
The catabolic state that follows hip fracture contributes to loss of muscle mass and strength, that is sarcopenia, which impacts functional ability and health-related quality of life. Measures to prevent such long-term postoperative consequences are of important concern. The aim of this study was to evaluate the combined effects of protein-rich nutritional supplementation and bisphosphonate on body composition, handgrip strength and health-related quality of life following hip fracture. The study included 79 men and women with hip fracture, mean age 79 years (SD 9), without severe cognitive impairment, who were ambulatory and living independently before fracture. Patients were randomized postoperatively to receive liquid supplementation that provided 40 g of protein and 600 kcal daily for six months after the fracture, in addition to bisphosphonates once weekly for 12 months (group N, n = 26), or bisphosphonates alone once weekly for 12 months (group B, n = 28). All patients, including the controls (group C, n = 25) received calcium 1 g and vitamin D3 800 IU daily. Body composition as measured by dual-energy X-ray absorptiometry (DXA), handgrip strength (HGS) and health-related quality of life (HRQoL) were registered at baseline, six and 12 months postoperatively. There were no differences among the groups regarding change in fat-free mass index (FFMI), HGS, or HRQoL during the study year. Intra-group analyses showed improvement of HGS between baseline and six months in the N group (P = 0.04). HRQoL decreased during the first year in the C and B groups (P = 0.03 and P = 0.01, respectively) but not in the nutritional supplementation N group (P = 0.22). Protein-rich nutritional supplementation was unable to preserve FFMI more effectively than vitamin D and calcium alone, or combined with bisphosphonate, in this relatively healthy group of hip fracture patients. However, trends toward positive effects on both HGS and HRQoL were observed following nutritional supplementation. Clinicaltrials.gov NCT01950169 (Date of registration 23 Sept 2013). The online version of this article (doi:10.1186/s12877-015-0144-7) contains supplementary material, which is available to authorized users.