维生素D联合营养支持与运动干预在老年肌少症治疗中的临床效果

Clinical effects of vitamin D combined with nutritional support and exercise intervention in the treatment of sarcopenia in the elderly

摘要:

目的 分析维生素D联合营养支持与运动干预在老年肌少症治疗中的临床效果。方法 选取2021年10月—2024年12月中国人民解放军联勤保障部队第九六〇医院收治的肌少症患者104例，按照随机数字表法分为对照组和观察组，各52例。对照组给予维生素D治疗，观察组在对照组基础上给予营养支持和运动干预，两组均持续干预3个月。比较两组肌肉功能［四肢骨骼肌质量（ASM）、四肢骨骼肌质量指数（ASMI）、握力、步速］、血清炎症指标［白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、单核细胞趋化蛋白-1（MCP-1）、C反应蛋白（CRP）］及血清25羟基维生素D₃［25（OH）D₃］水平。并采用Pearson法分析干预后血清25（OH）D₃与ASMI、IL-6、TNF-α、MCP-1、CRP的相关性。结果 观察组干预前后ASM、ASMI、握力、步速、IL-6、TNF-α、25（OH）D₃、MCP-1、CRP的差值均大于对照组（P <0.05）。干预后，血清25（OH）D₃与血清ASMI水平呈正相关（r =0.496，P <0.05），与血清IL-6、TNF-α、MCP-1、CRP水平均呈负相关（r =-0.518、-0.440、-0.329和-0.237，均P <0.05）。结论 维生素D联合营养支持与运动干预可改善老年肌少症患者的肌肉功能，提高血清25（OH）D₃水平，降低炎症因子水平，具有较好的临床效果。

Abstract:

Objective To evaluate the clinical effects of vitamin D combined with nutritional support and exercise intervention in the treatment of sarcopenia in the elderly.Methods A total of 104 patients with sarcopenia admitted to the 960 Hospital of the People’s Liberation Army Joint Service Support Force between October 2021 and December 2024, were randomly assigned to either the control group (n = 52) or the observation group (n = 52). The control group received vitamin D supplementation, while the observation group received additional nutritional support and exercise intervention. Both groups underwent a 3-month intervention. Muscle function parameters, including appendicular skeletal muscle mass (ASM), appendicular skeletal muscle index (ASMI), handgrip strength, and gait speed, were assessed. Serum inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemotactic protein-1 (MCP-1), C-reactive protein (CRP), as well as serum 25-hydroxyvitamin D₃ [25(OH)D₃] levels, were measured. Pearson correlation analysis was performed to examine the associations of post-intervention serum 25(OH)D₃ levels with ASMI and IL-6, TNF-α, MCP-1 and CRP levels.Results The differences of ASM, ASMI, handgrip strength, gait speed, and levels of IL-6, TNF-α, 25(OH)D₃, MCP-1, and CRP before and after intervention in the observation group were all greater than those in the control group (P < 0.05). After the intervention, the serum level of 25(OH)D₃ was positively correlated with ASMI (r = 0.496, P < 0.05) and negatively correlated with levels of IL-6, TNF-α, MCP-1 and CRP (r = -0.518, -0.440, -0.329, -0.237, all P <0.05).Conclusion Vitamin D combined with nutritional support and exercise intervention effectively improves muscle function, increases serum 25(OH)D₃ levels, and reduces the levels of inflammatory cytokines, demonstrating favorable clinical efficacy.