n-3脂肪酸在老年肌少症中的疗效研究  

Effect of n-3 fatty acids in senile sarcopenia

作　　者：周洪[1] 胡钧 廖斌 ZHOU Hong;HU Jun;LIAO Bin(Department of Geriatrics,Hunan Provincial People’s Hospital,Changsha 410016,Hunan,China)

机构地区：[1]湖南省人民医院老年科,湖南长沙410016

出　　处：《中国现代医生》2023年第33期19-22,共4页China Modern Doctor

基　　金：湖南省长沙市科技计划项目(kq2004109)。

摘　　要：目的评估老年肌少症患者的营养状况和炎症因子,探讨n-3脂肪酸(n-3 fatty acids,n-3 PUFA)在老年肌少症患者中的作用。方法选取2020年1月至6月在湖南省人民医院老年科住院及体检科健康体检的70岁以上能行走的老年人,根据欧洲老年人肌少症工作组(European working group on sarcopenia in the elderly,EWGSOP)诊断标准分为无肌少症组和肌少症组,检测入选者的营养指标,测定炎性细胞因子水平。肌少症组患者分为实验组和对照组,在高蛋白饮食[1.2g/(kg·d)]并维持营养指标正常的基础上实验组患者补充n-3 PUFA 1000mg/d,比较分析补充后炎性细胞因子水平的变化。结果肌少症组患者的外周血25-羟基维生素D[25-hydroxyvitamin D,25(OH)D]、血钙、血磷及血红蛋白较无肌少症组降低,差异有统计学意义(P<0.05)。肌少症组患者的外周血肿瘤坏死因子α(tumornecrosisfactorα,TNF-α)、白细胞介素(interleukin,IL)-6、C反应蛋白(C-reactive protein,CRP)高于对照组,差异有统计学意义(P<0.05),补充n-3 PUFA24周后患者的TNF-α、IL-6、CRP下降,但差异无统计学意义(P>0.05)。补充n-3 PUFA 48周后患者的TNF-α、IL-6、CRP继续下降,差异有统计学意义(P<0.05),IL-10升高,差异无统计学意义(P>0.05)。结论肌少症患者的血25(OH)D、血钙、血磷及血红蛋白等营养指标减少、致炎因子增加可能是老年人肌少症的发病机制之一,补充n-3 PUFA可通过抑制炎症成为肌少症的防治手段之一。Objective The nutritional status and inflammatory factors were designed in senile sarcopenia,the role of n-3 fatty acids(n-3 PUFA)was explored in senile sarcopenia.Methods According to European working group on sarcopenia in the elderly(EWGSOP)diagnostic criteria,patients over 70 years old who could walk were divided into non-sarcopenia group and sarcopenia group.The nutritional indexes of all patients were detected and the levels of inflammatory cytokines were determined.The patients with sarcopenia were divided into experimental group and control group.On the basis of high protein diet[1.2 g/(kg·d)]and maintaining normal nutritional indexes,experimental group was supplemented with n-3 PUFA 1000mg/d,and the changes of inflammatory cytokines after supplementation of n-3PUFA were compared.Results The levels of 25-hydroxyvitamin D[25(OH)D],calcium,phosphorus and hemoglobin in sarcopenia group decreased compared with those in non-sarcopenia group,there was statistically significant(P<0.05).The levels of tumor necrosis factorα(TNF-α),interleukin(IL)-6 and C-reactive protein(CRP)in patients with sarcopenia were higher than those in control group,the difference was statistically significant(P<0.05),the levels of TNF-α,IL-6 and CRP decreased in patients with sarcopenia for 24 weeks with n-3 PUFA supplementation,the difference was not statistically significant(P>0.05).For 48 weeks with n-3 PUFA supplementation,the levels of TNF-α,IL-6 and CRP decreased,the difference was statistically significant(P<0.05),the levels of IL-10 increased,but the difference was not statistically significant(P>0.05).Conclusion The decrease of serum 25(OH)D,serum calcium,serum phosphorus,hemoglobin and other nutritional indexes in patients with sarcopenia,the increase in inflammatory factors may be one of the pathogenesis of sarcopenia in the elderly,and supplementing n-3 PUFA can become one of the prevention and treatment methods for sarcopenia by inhibiting inflammation.

关 键 词：肌少症 N-3脂肪酸 炎症因子 

分 类 号：R591[医药卫生—内科学]