Interventions for Treating Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies
Interventions for Treating Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies
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DOI：
10.1016/j.jamda.2017.03.019
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发表时间：
2017-06-01
影响因子：
7.6
通讯作者：
Arai, Hidenori
中科院分区：
文献类型：
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作者：
Yoshimura, Yoshihiro;Wakabayashi, Hidetaka;Arai, Hidenori
背景资料：目的：分析运动、营养、药物及联合干预治疗老年人肌肉减少症的有效性。方法：采用回顾性研究方法，分析运动、营养、药物及联合干预治疗老年人肌肉减少症的效果。我们通过PubMed、科克伦图书馆的科克伦评论和科克伦对照试验中心注册系统地检索了MEDLINE，和Ichushi-Web，用于2000年1月至2016年12月的随机对照试验（RCT）。我们评估了干预的类型，使用的队列，肌肉减少症的诊断方式，结果和证据的质量。我们荟萃分析的结果与组间治疗的净差异从基线到结束的study.Results：我们筛选了共2668记录，包括7个随机对照试验，研究运动（4个随机对照试验），营养（5个随机对照试验），药物（1个随机对照试验），并结合（4个随机对照试验）对肌肉质量，力量和功能的影响，在老年人与肌肉减少症。极低至低质量的证据表明：（1）运动干预可能在干预3个月内对改善肌肉质量、肌肉力量和步行速度起作用;（2）营养干预可能在干预3个月内对改善肌肉力量有效;（3）作为药物干预，选择性雄激素受体调节剂对肌肉质量、力量和身体功能无明显影响;结论：我们的系统回顾和荟萃分析显示，运动和营养干预对老年人肌肉减少症的治疗有一定的积极作用，尽管证据的质量较低。未来应实施高质量的RCT以加强结果。(C)2017年AMDA -急性后和长期护理医学协会。
Background: Much interest has been focused on interventions for treating sarcopenia; however, the effects have gained little evidence.Objective: To analyze the effectiveness of exercise, nutritional, drug, and combinational interventions for treating sarcopenia in older people.Method: We systematically searched MEDLINE via PubMed, the Cochrane Library of Cochrane Reviews and Cochrane Central Register of Controlled Trials, and Ichushi-Web for randomized controlled trials (RCTs) from January 2000 to December 2016. We have assessed the type of intervention, the cohort used, the way sarcopenia was diagnosed, the outcomes, and the quality of evidence. We meta-analyzed the outcomes with the net difference between-group treatment from baseline to the end of the study.Results: We screened a total of 2668 records and included seven RCTs that investigated the effects of exercise (4 RCTs), nutrition (5 RCTs), drug (1 RCT), and combination (4 RCTs) on muscle mass, strength, and function in older people with sarcopenia. Very low to low-quality evidence suggests that (1) exercise interventions may play a role in improving muscle mass, muscle strength, and walking speed in 3 months of intervention; (2) nutritional interventions may be effective in improving muscle strength in 3 months of intervention; (3) as drug intervention, selective androgen receptor modulator had no clear effect on muscle mass, strength, and physical function; and (4) a combined intervention of exercise and nutrition may have positive effects in improving the walking speed in 3 months of intervention.Conclusion: Our systematic review and meta-analysis showed some positive effects of exercise and nutritional interventions for treating sarcopenia in older people, although the quality of the evidence was low. Future high-quality RCTs should be implemented to strengthen the results. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.