Muscle protein synthesis in cancer patients can be stimulated with a specially formulated medical food.
Muscle protein synthesis in cancer patients can be stimulated with a specially formulated medical food.
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DOI：
10.1016/j.clnu.2011.05.008
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发表时间：
2011-12
期刊：
影响因子：
--
通讯作者：
Wolfe RR
中科院分区：
文献类型：
--
作者：
Deutz NE;Safar A;Schutzler S;Memelink R;Ferrando A;Spencer H;van Helvoort A;Wolfe RR
维持肌肉质量对改善癌症患者的预后和生活质量至关重要。刺激肌肉蛋白质合成是维持肌肉质量的代谢基础，但在癌症患者中，正常饮食摄入对肌肉蛋白质合成的影响最小。在高蛋白补充剂中添加亮氨酸可以刺激健康老年人的肌肉蛋白质合成。其目的是确定一种特别配制的富含亮氨酸和蛋白质的医疗食品是否比传统的医疗食品更能刺激癌症患者的肌肉蛋白质合成。在25例有放射学癌症证据的患者中采用随机、对照、双盲、平行组设计。患者在癌症治疗开始前或治疗完成或停止后4周进行研究。用L-[环-13 C6]-苯丙氨酸示踪掺入技术测定肌肉蛋白质合成分数率（FSR）。实验组（n = 13）接受含有40 g蛋白质的医疗食品，该医疗食品基于酪蛋白和乳清蛋白并富含10%游离亮氨酸和其它特定组分，而对照组（n = 12）给予仅基于酪蛋白的常规使用的医疗食品（24 g）。在基础状态和摄入药物食物后5 h采集血液和肌肉样品。癌症患者处于炎症状态，表现为高水平的C反应蛋白（CRP）、IL-1β和TNF-α，但不存在胰岛素抵抗（HOMA）。实验药物食物摄入后，血浆亮氨酸增加到约400 μM，而对照药物食物摄入后的峰值为200 μM（p < 0.001）。实验性医疗食品的摄入使肌肉蛋白FSR从0.073（SD：0.023）%/h增加到0.097（SD：0.033）%/h（p = 0.0269）。相比之下，摄入对照医疗食品没有增加肌肉FSR; 0.073（SD：0.022）和0.065（SD：0.028）%/h。在癌症患者中，常规营养补充剂在刺激肌肉蛋白质合成方面无效。这种合成代谢阻力可以用特殊配方的营养补充剂来克服。
Maintenance of muscle mass is crucial to improving outcome and quality of life in cancer patients. Stimulating muscle protein synthesis is the metabolic basis for maintaining muscle mass, but in cancer patients normal dietary intake has minimal effects on muscle protein synthesis. Adding leucine to high protein supplements stimulates muscle protein synthesis in healthy older subjects. The objective was to determine if a specially formulated medical food, high in leucine and protein, stimulates muscle protein synthesis acutely in individuals with cancer to a greater extent than a conventional medical food. A randomized, controlled, double-blind, parallel-group design was used in 25 patients with radiographic evidence of cancer. Patients were studied before their cancer treatment was started or 4 weeks after their treatment was completed or halted. The fractional rate of muscle protein synthesis (FSR) was measured using the tracer incorporation technique with L-[ring-13C6]-phenylalanine. The experimental group (n = 13) received a medical food containing 40 g protein, based on casein and whey protein and enriched with 10% free leucine and other specific components, while the control group (n = 12) was given a conventionally used medical food based on casein protein alone (24 g). Blood and muscle samples were collected in the basal state and 5h hours after ingestion of the medical foods. The cancer patients were in an inflammatory state, as reflected by high levels of C-reactive protein (CRP), IL-1β and TNF-α, but were not insulin resistant (HOMA). After ingestion of the experimental medical food, plasma leucine increased to about 400 μM as compared to the peak value of 200 μM, after the control medical food (p < 0.001). Ingestion of the experimental medical food increased muscle protein FSR from 0.073 (SD: 0.023) to 0.097 (SD: 0.033) %/h (p = 0.0269). In contrast, ingestion of the control medical food did not increase muscle FSR; 0.073 (SD: 0.022) and 0.065 (SD: 0.028) %/h. In cancer patients, conventional nutritional supplementation is ineffective in stimulating muscle protein synthesis. This anabolic resistance can be overcome with a specially formulated nutritional supplement.
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影响因子：
7.1
作者：
Luiking, Yvette C.;Poeze, Martijn;Deutz, Nicolaas E. P.
通讯作者：
Deutz, Nicolaas E. P.
影响因子：
8.8
作者：
Faber J;Vos P;Kegler D;van Norren K;Argilés JM;Laviano A;Garssen J;van Helvoort A
通讯作者：
van Helvoort A
DOI：
10.1097/mco.0b013e3282fa17fb
发表时间：
2008-05-01
影响因子：
3.1
作者：
Drummond, Micah J.;Rasmussen, Blake B.
通讯作者：
Rasmussen, Blake B.
影响因子：
6.3
作者：
Borsheim, Elisabet;Bui, Quynh-Uyen T.;Wolfe, Robert R.
通讯作者：
Wolfe, Robert R.
影响因子：
6.3
作者：
Dillon, E. L.;Volpi, Elena;Sheffield-Moore, Melinda
通讯作者：
Sheffield-Moore, Melinda