The effect of dietary nitrate on exercise capacity in chronic kidney disease: a randomized controlled pilot study.
The effect of dietary nitrate on exercise capacity in chronic kidney disease: a randomized controlled pilot study.
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DOI：
10.1016/j.niox.2020.10.002
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发表时间：
2021-01-01
期刊：
影响因子：
--
通讯作者：
Edwards DG
中科院分区：
文献类型：
--
作者：
Ramick MG;Kirkman DL;Stock JM;Muth BJ;Farquhar WB;Chirinos JA;Doulias PT;Ischiropoulos H;Edwards DG
慢性肾脏病 (CKD) 患者的运动能力下降，影响生活质量。膳食补充硝酸盐已被证明可以通过降低运动的耗氧量来对疾病人群的运动能力产生有利的影响。这项研究调查了膳食硝酸盐是否会显着提高 CKD 患者的运动能力。在这项随机、双盲交叉研究中，12 名 3-4 期 CKD 患者（平均值±SEM：年龄，60 ± 5 岁；eGFR，50.3 ± 4.6ml/min/1.73m2）接受急性剂量的 12.6 mmol 膳食硝酸盐，形式为浓缩甜菜根汁 (BRJ) 和低硝酸盐安慰剂 (PLA)。使用近红外光谱评估骨骼肌线粒体氧化功能。在自行车测力计上进行心肺运动测试，强度每3分钟增加25W，直至意志疲劳。通过气相化学发光测定血浆一氧化氮 (NO) 代谢物（NOm；硝酸盐、亚硝酸盐、低分子量 S-亚硝基硫醇和金属结合的 NO）。 BRJ 后血浆 NOm 值显着增加（BRJ 与 PLA：1074.4±120.4 uM 与 28.4±6.6 μM，p<0.001）。 BRJ 后完成的总做功（44.4 ± 10.6 vs 39.6 ± 9.9kJ，p=0.03）和总运动时间（674 ± 85 vs 627 ± 86s，p=0.04）显着增加。 BRJ 还改善了通气阈值的耗氧量（0.90 ± 0.08 vs. 0.74 ± 0.06L/min，p=0.04）。这些变化是在骨骼肌线粒体氧化能力 (p=0.52) 和 VO2peak (p=0.35) 没有改善的情况下发生的。我们的研究结果表明，无机硝酸盐可以显着提高 CKD 患者的运动能力。未来的研究应研究长期补充硝酸盐对 CKD 相关运动不耐受的影响。
Chronic Kidney Disease (CKD) patients exhibit a reduced exercise capacity that impacts quality of life. Dietary nitrate supplementation has been shown to have favorable effects on exercise capacity in disease populations by reducing the oxygen cost of exercise. This study investigated whether dietary nitrates would acutely improve exercise capacity in CKD patients. In this randomized, double-blinded crossover study, 12 Stage 3–4 CKD patients (Mean±SEM: Age, 60 ± 5yrs; eGFR, 50.3 ± 4.6ml/min/1.73m2) received an acute dose of 12.6 mmol of dietary nitrate in the form of concentrated beetroot juice (BRJ) and a nitrate depleted placebo (PLA). Skeletal muscle mitochondrial oxidative function was assessed using near-infrared spectroscopy. Cardiopulmonary exercise testing was performed on a cycle ergometer, with intensity increased by 25W every 3 minutes until volitional fatigue. Plasma Nitric Oxide (NO) metabolites (NOm; nitrate, nitrite, low molecular weight S-nitrosothiols, and metal bound NO) were determined by gas-phase chemiluminescence. Plasma NOm values were significantly increased following BRJ (BRJ vs. PLA: 1074.4±120.4 uM vs. 28.4±6.6 μM, p<0.001). Total work performed (44.4 ± 10.6 vs 39.6 ± 9.9kJ, p=0.03) and total exercise time (674 ± 85 vs 627 ± 86s, p=0.04) were significantly greater following BRJ. Oxygen consumption at the ventilatory threshold was also improved by BRJ (0.90 ± 0.08 vs. 0.74 ± 0.06L/min, p=0.04). These changes occurred in the absence of improved skeletal muscle mitochondrial oxidative capacity (p=0.52) and VO2peak (p=0.35). Our findings demonstrate that inorganic nitrate can acutely improve exercise capacity in CKD patients. The effects of chronic nitrate supplementation on CKD related exercise intolerance should be investigated in future studies.
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