大豆蛋白和乳清蛋白对肺癌相关肌少症住院患者人体成分的影响  

Impact of soy protein and whey protein on body composition in hospitalized lung cancer patients with cancer-related sarcopenia

作　　者：张玉 王师佳 刘潇衍 杜扬 于康 Zhang Yu;Wang Shijia;Liu Xiaoyan;Du Yang;Yu Kang(Department of Clinical Nutrition,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing100730,China;Department of Clinical Nutrition,the Second Affiliated Hospital of Soochow University,Suzhou215004,China;Department of Respiratory and Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院临床营养科,北京100730 [2]苏州大学附属第二医院临床营养科,苏州215004 [3]中国医学科学院、北京协和医学院、北京协和医院呼吸与危重症医学科,北京100730

出　　处：《中华临床营养杂志》2024年第5期270-278,共9页Chinese Journal of Clinical Nutrition

基　　金：国家重点研发计划项目(2022YFF1100600/2022YFF1100604);全民营养科研基金(CNS-NNSRG2021-129)。

摘　　要：目的评估大豆蛋白和乳清蛋白对肺癌相关肌少症住院患者的人体成分和肌肉功能的影响。方法采用配对设计方法,对患者干预前后自身配对。所有纳入的非小细胞肺癌合并癌症相关性肌少症患者被分为大豆蛋白组(30 g/d)和乳清蛋白组(30 g/d),进行为期12周的干预。观察两组干预前后肌肉量(muscle mass,MM)、肌肉功能指标变化量的组内和组间差异。结果研究共纳入48例患者,32例患者完成干预及随访,其中乳清蛋白组16例,大豆蛋白组16例。12周干预后:乳清蛋白干预组的躯干MM(trunk fat mass,TMM)(P=0.014)和身高校正的TMM(TMM/Ht2)(P=0.011)均显著增加;大豆蛋白干预组的四肢MM(appendicular muscle mass,AMM)(P=0.049)、体重指数校正的AMM(AMM/BMI)(P=0.044)、去脂体重(fat free mass,FFM)(P=0.041)和MM(P=0.038)均显著增加。经广义估计方程校正后,乳清蛋白干预组患者仅有TMM/Ht2显著增加(P=0.049),而大豆蛋白干预组患者的TMM(P=0.040)和TMM/Ht2(P=0.005)显著增加。经协方差分析校正后,乳清蛋白和大豆蛋白干预后,患者的肌肉量相关指标均呈增加趋势,但组间差异无统计学意义。结论大豆蛋白和乳清蛋白干预均有助于改善和(或)维持肺癌相关肌少症患者的MM和肌肉功能。另外,大豆蛋白可能对肺癌相关肌少症患者产生与乳清蛋白相似的干预效果。ObjectiveThis study aims to assess the effects of soy and whey protein on body composition and muscle function in hospitalized lung cancer patients with cancer-related sarcopenia.MethodsPaired comparison method was adopted for data collected before and after intervention.All enrolled non-small cell lung cancer patients with cancer-related sarcopenia were assigned to either the soy protein(30 g/d)or the whey protein(30 g/d)group to receive the 12-week intervention.Changes in muscle mass(MM)and muscle function before and after intervention were observed to assess intra-group and inter-group differences.ResultsThe study included 48 patients,32 of whom completed the intervention and follow-up(16 from the whey protein group and 16 from the soy protein group).After 12 weeks of intervention with whey protein,significant increases were observed in trunk muscle mass(TMM,P=0.014)and TMM adjusted for height(TMM/Ht 2,P=0.011).After 12 weeks of intervention with soy protein,significant increases were noted in appendicular muscle mass(AMM,P=0.049),AMM adjusted for body mass index(AMM/BMI,P=0.044),fat free mass(FFM,P=0.041),and MM(P=0.038).After adjustment using generalized estimating equations,only TMM/Ht 2(P=0.049)showed a significant increase in the whey protein group,while TMM(P=0.040)and TMM/Ht 2(P=0.005)significantly increased in the soy protein group.Despite that all MM-related indices increased in both groups,there were no significant inter-group differences after adjusted by covariate analysis.ConclusionsInterventions with soy protein and whey protein can help maintain and improve muscle mass and muscle function in patients with lung cancer-related sarcopenia.Soy protein and whey protein may have comparable benefits in patients with lung cancer-related sarcopenia.

关 键 词：肺癌 癌症相关性肌少症 大豆蛋白 乳清蛋白 

分 类 号：R734.2[医药卫生—肿瘤] R685[医药卫生—临床医学]