The effect of acute and 7-days dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with chronic obstructive pulmonary disease
The effect of acute and 7-days dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with chronic obstructive pulmonary disease
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DOI：
10.1016/j.clnu.2017.10.011
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发表时间：
2018-12-01
影响因子：
6.3
通讯作者：
Schols, Annemie M. W. J.
中科院分区：
文献类型：
--
作者：
Beijers, Rosanne J. H. C. G.;Huysmans, Stephanie M. D.;Schols, Annemie M. W. J.
背景与目的：许多COPD患者运动能力和机械效率降低，心脏代谢风险增加。本研究旨在评估饮食硝酸盐对COPD患者机械效率、运动表现和心脏生物标志物的急性和7天影响。方法：这项双盲、随机交叉安慰剂对照试验包括20例轻中度COPD患者（66.6 +/- 7.5岁），中度运动障碍，机械效率下降，BMI正常（26 +/- 3 kg/m(2)），但腹部肥胖患病率高（833%）。受试者被随机分配到7天硝酸钠摄入（类似于8天）和7天安慰剂（NaCl溶液）的治疗顺序，反之亦然，通过洗脱期分开。在干预前（第1天）和干预后（第7天）测量静息代谢率和亚最大周期代谢反应、循环耐力时间、血浆硝酸盐和亚硝酸盐水平、心脏血浆生物标志物（如心肌肌钙蛋白T、Nt-proBNP和肌酐激酶）和血压。随后计算了总机械效率、净机械效率和增量机械效率。结果：硝酸钠摄入后第1天和第7天血浆硝酸盐和亚硝酸盐浓度升高，而安慰剂摄入后无升高。收缩压和舒张压在摄入硝酸盐后没有变化。此外，在第1天和第7天，硝酸盐和安慰剂在亚极限运动时的总、净和δ机械效率、循环耐力时间和心脏生物标志物方面没有观察到差异。对所有COPD研究的荟萃分析也显示甜菜根汁对收缩压和舒张压没有有益作用。结论：急性和7天补充硝酸钠不会调节轻中度COPD患者的机械效率、血压或心脏生物标志物。(C) 2017爱思唯尔有限公司和欧洲临床营养与代谢学会。版权所有。
Background & aims: Many COPD patients have a reduced exercise capacity and mechanical efficiency and are at increased cardiometabolic risk. This study aimed to assess acute and 7-days effects of dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with COPD.Methods: This double-blind, randomized cross-over placebo controlled trial included 20 mild-to moderate COPD patients (66.6 +/- 7.5 years) with moderate exercise impairments and decreased mechanical efficiency, normal BMI (26 +/- 3 kg/m(2)) but high prevalence of abdominal obesity (833%). Subjects were randomly allocated to the treatment order of 7 days sodium nitrate ingestion (similar to 8 mmoliday) and 7 days placebo (NaCl solution) or vice versa, separated by a washout period. Before (Day-1) and after (Day-7) both intervention periods resting metabolic rate and the metabolic response during submaximal cycle ergometry, cycling endurance time, plasma nitrate and nitrite levels, cardiac plasma biomarkers (e.g. cardiac troponin T, Nt-proBNP and creatinine kinase) and blood pressure were measured. Subsequently, gross, net and delta mechanical efficiency were calculated.Results: Plasma nitrate and nitrite concentrations increased at Day-1 and Day-7 after sodium nitrate but not after placebo ingestion. Systolic and diastolic blood pressure did not change following nitrate ingestion. Furthermore, no differences were observed in gross, net, and delta mechanical efficiency during submaximal exercise, cycling endurance time and cardiac biomarkers between nitrate and placebo on Day-1 and Day-7. Meta-analysis of all available studies in COPD also showed no beneficial effect of beetroot juice on systolic and diastolic blood pressure.Conclusion: Acute as well as 7-days sodium nitrate supplementation does not modulate mechanical efficiency, blood pressure or cardiac biomarkers in mild-to-moderate COPD patients. (C) 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.