RESTORATION OF MUSCLE PROTEIN, MASS, AND STRENGTH AFTER HIP SURGERY/HIP FRACTURE

髋关节手术/髋部骨折后肌肉蛋白质、质量和强度的恢复

• 批准号: 7378709
• 负责人: ARNY A FERRANDO
• 金额: $ 0.31万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7378709
• 关键词: RESTORATION; MUSCLE; PROTEIN; MASS; STRENGTH

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Muscle wasting and weakness after major orthopedic surgery affects rehabilitative efforts, compromises independence, and delays the return to work. Quadriceps muscle wasting is prominent in the affected side of patients with osteoarthritic hips. The atrophy of quadriceps muscle is exacerbated by hip arthroplasty, such that further loss of muscle and fiber mass is evident as early as 5d post-operatively. The combination of hypercortisolemia and inactivity in healthy subjects increases muscle protein breakdown to a degree analogous to burn patients. It has also been demonstrated that uncomplicated surgery alone decreases muscle protein synthesis. Thus, the loss of muscle protein associated with hip arthroplasty is potentially the result of two catabolic mechanisms. Muscle protein will be lost by the inhibition of protein synthesis, and/or through the increase in muscle protein breakdown resulting from persistent hypercortisolemia. We propose to study whole-body and skeletal muscle protein metabolism during hip arthroplasty to ascertain the metabolic mechanisms responsible for loss of body protein. Further, we propose interventions to potentially correct each of these metabolic deficiencies. We hypothesize that the amelioration of the hypercortisolemic response and/or the stimulation of muscle protein synthesis will preserve body nitrogen. We propose the following aims. To study/investigate: 1) muscle protein metabolism in patients with osteoarthritis and hip fracture during hip arthroplasty, 2) the perioperative effects of diminished cortisol synthesis, 3) the effects of amino acid provision throughout hip arthroplasty on protein synthesis, 4) the perioperative effects of concurrent diminished cortisol and stimulated protein synthesis by amino acid administration during hip arthroplasty.

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。大型整形外科手术后的肌肉萎缩和虚弱影响康复努力，损害独立性，并推迟恢复工作。髋关节骨性关节炎患者患侧股四头肌萎缩明显。髋关节置换术加剧了股四头肌的萎缩，使得肌肉和纤维质量的进一步丧失早在术后5d就很明显。健康受试者的高皮质醇血症和缺乏运动相结合会增加肌肉蛋白质的分解，其程度类似于烧伤患者。也有研究表明，单纯的简单手术会减少肌肉蛋白质的合成。因此，髋关节置换术相关的肌肉蛋白质丢失可能是两种分解代谢机制的结果。肌肉蛋白质会因蛋白质合成受阻和/或持续性高皮质醇引起的肌肉蛋白质分解增加而丢失。我们建议在髋关节置换术中研究全身和骨骼肌的蛋白质代谢，以确定导致身体蛋白质丢失的代谢机制。此外，我们提出了可能纠正这些代谢缺陷的干预措施。我们假设，高皮质醇反应的改善和/或肌肉蛋白质合成的刺激将保留体氮。我们提出了以下目标。研究/探讨：1)髋关节置换术中骨关节炎和髋部骨折患者的肌肉蛋白质代谢；2)围手术期皮质醇合成减少的影响；3)全髋关节置换术中氨基酸供应对蛋白质合成的影响；4)髋关节置换术中皮质醇减少和氨基酸促进蛋白质合成的围术期效应。