Association of Physical Activity and Nutritional Intake with Muscle Quantity and Quality Changes in Acute Stroke Patients
Association of Physical Activity and Nutritional Intake with Muscle Quantity and Quality Changes in Acute Stroke Patients
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DOI：
10.1016/j.jstrokecerebrovasdis.2022.106442
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发表时间：
2022-03-16
影响因子：
2.5
通讯作者：
Ichihashi, Noriaki
中科院分区：
文献类型：
--
作者：
Tanaka, Hiroki;Kitamura, Gakuto;Ichihashi, Noriaki
目的：纵向评估急性脑卒中患者的肌肉特性，并检查体力活动与营养摄入之间的关系。材料和方法：本研究纳入了21例卒中患者（72.7 ± 10.4岁）。在基线（3天内）和卒中发作后2周，使用生物电阻抗装置评估肌肉数量（无脂肪质量、无脂肪骨骼肌质量）和质量（细胞外水/细胞内水比率、相位角）。根据加速度计数据计算身体活动和久坐。总能量和蛋白质摄入量是根据膳食调查计算的营养摄入量。研究了体力活动、久坐和营养摄入与肌肉特性变化率的关系。结果如下：两周后，去脂质量显著降低（从43.4 +/- 8.0降至42.2 +/- 7.6 kg），骨骼肌无变化（从17.8 +/- 4.2降至17.7 +/- 4.0 kg）。细胞外水/细胞内水比率显著增加（从0.63 +/-0.02至0.65 +/-0.03），相位角显著减小（从5.1 +/-0.6至4.9 +/-0.8度），表明肌肉质量下降。相关分析表明，细胞外水/细胞内水比值与体力活动[代谢当量]显著相关（rho=-0.61）]和久坐（rho=0.67），相位角与体力活动[代谢当量]显著相关（rho=0.69）]、久坐（rho=-0.68）和营养摄入[总能量（r=0.45）、蛋白质（r=0.45）]。结论：中风后两周，无脂肪质量和肌肉质量（细胞外水/细胞内水比率和相位角）下降。肌肉质量下降的患者的体力活动和营养摄入量较低，表明运动和营养在急性期的重要性。
Objectives: To evaluate longitudinally the muscle properties of acute stroke patients and examine the association between physical activity and nutritional intake. Materials and methods: This study enrolled 21 stroke patients (72.7 +/- 10.4 years). Muscle quantity (fat-free mass, appendicular skeletal muscle mass) and quality (extracellular water/intracellular water ratio, phase angle) were assessed using a bioelectrical impedance device at baseline (within three days) and two weeks after stroke onset. Physical activity and sedentary were calculated from the accelerometer data. Total energy and protein intake were calculated from the dietary surveys as nutritional intake. The association of physical activity, sedentary, and nutritional intake with the rate of changes in muscle properties was examined. Results: The fat-free mass significantly decreased (from 43.4 +/- 8.0 to 42.2 +/- 7.6 kg), and the skeletal muscle was unchanged (from 17.8 +/- 4.2 to 17.7 +/- 4.0 kg) after two weeks. The extracellular water/intracellular water ratio significantly increased (from 0.63 +/- 0.02 to 0.65 +/- 0.03) and the phase angle significantly decreased (from 5.1 +/- 0.6 to 4.9 +/- 0.8 degrees), suggesting that the muscle quality have declined. Correlation analysis showed that the extracellular water /intracellular water ratio was significantly associated with physical activity [metabolic equivalents (rho=-0.61)] and sedentary (rho=0.67) and that the phase angle was significantly associated with physical activity [metabolic equivalents (rho=0.69)], sedentary (rho=-0.68), and nutritional intake [total energy (r=0.45), protein (r=0.45)]. Conclusions: The fat-free mass and muscle quality (extracellular water/intracellular water ratio and phase angle) declined two weeks after stroke. Physical activity and nutritional intake were lower in patients with decreased muscle quality, suggesting the importance of exercise and nutrition in the acute phase.