Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease
Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease
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DOI：
10.1053/j.ajkd.2003.12.025
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发表时间：
2004-04-01
影响因子：
13.2
通讯作者：
Levey, AS
中科院分区：
文献类型：
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作者：
Castaneda, C;Gordon, PL;Levey, AS
背景：全身性炎症和蛋白质能量营养不良可能与肾脏疾病的不良结局相关。方法：我们研究了26名成年人（年龄65 +/- 10 [SD]岁）患有慢性肾脏疾病，未接受透析治疗。受试者被随机分配到阻力训练组（n = 14）或对照组（n = 12），持续12周，同时建议摄入低蛋白饮食（蛋白质，类似于0.6 g/kg/d）。我们确定了阻力训练是否降低了炎症介质（血清C反应蛋白[CRP]和白细胞介素-6 [IL-6]）的水平，除了先前报道的营养和功能状态的改善，在同一受试者人群。结果：与对照组（1.5mg/L）相比，抗阻训练组（1.7mg/L）血清CRP水平明显降低（P = 0.05）。同样，与对照组相比，抗阻运动组的IL-6水平降低（-4.2 vs 2.3 pg/mL; P = 0.01）。阻力训练导致骨骼肌肥大，表现为与对照组相比，1型肌纤维横截面积增加（24% +/- 31%）和II型肌纤维横截面积增加（22% +/- 41%）（分别为-14% +/- 34%和-13% +/-18%; P < 0.05）。与对照组（-13% +/- 22%; P = 0.001）相比，阻力训练组（28% +/- 14%）的肌肉力量也有所改善。结论：阻力训练减少了炎症，改善了中度慢性肾脏疾病患者的营养状况，消耗低蛋白饮食。这些结果需要在更大的不同阶段肾病患者队列中进一步研究，以确定阻力训练是否可以长期改善疾病结局。
Background: Systemic inflammation and protein-energy malnutrition may be associated with poor outcomes in kidney disease. Methods: We studied 26 adults (age, 65 +/- 10 [SD] years) with chronic kidney disease, not on dialysis therapy. Subjects were randomly assigned to resistance training (n = 14) or a control group (n = 12) for 12 weeks, while counseled to consume a low-protein diet (protein, similar to0.6 g/kg/d). We determined whether resistance training reduces levels of inflammatory mediators (serum C-reactive protein [CRP] and interleukin-6 [IL-6]), in addition to previously reported improvements in nutritional and functional status in this same subject population. Results: Serum CRP levels were reduced in subjects undergoing resistance training (similar to1.7 mg/L) compared with controls (1.5 mg/L; P = 0.05). Similarly, IL-6 levels were reduced in the resistance-exercise group versus controls (-4.2 versus 2.3 pg/mL; P = 0.01). Resistance training lead to skeletal muscle hypertrophy, shown by increases in type 1 (24% +/- 31%) and type II (22% +/- 41%) muscle fiber cross-sectional areas, compared with control subjects (-14% +/- 34% and -13% +/- 18%, respectively; P < 0.05). Muscle strength also improved with resistance training (28% +/- 14%) compared with controls (-13% +/- 22%; P = 0.001). Conclusion: Resistance training reduced inflammation and improved nutritional status in individuals with moderate chronic kidney disease consuming a low-protein diet. These results need to be investigated further in larger cohorts of patients with varying stages of kidney disease to determine whether resistance training can improve disease outcomes long term.