Effects of WB-EMS and protein supplementation on body composition, physical function, metabolism and inflammatory biomarkers in middle-aged and elderly patients with sarcopenic obesity: A meta-analysis of randomized controlled trials.

BACKGROUND: The patients with sarcopenic obesity (SO) have the characteristics of both sarcopenia and obesity, that is, less muscle mass and increased fat mass, and their morbidity, disability and mortality are higher than patients with sarcopenia or obesity alone. OBJECTIVES: To investigate the effects of whole-body electromyostimulation (WB-EMS) training and protein supplementation intervention on body composition, physical function, metabolism and inflammatory biomarkers in middle-aged and elderly patients with SO. METHODS: We searched for randomized controlled trials in seven databases, including PubMed, Web of Science, Embase, Cochrane Library, Scopus, SinoMed, and CNKI as of July 3, 2021. The methodological quality of each included study was assessed using the Physiotherapy Evidence Database (PEDro) scale. The Cochrane Risk of Bias Tool was used to assess the risk of bias. Statistical analysis was performed using Review Manager 5.3. RESULTS: Eleven randomized controlled studies with a total of 779 participants were included in this meta-analysis. WB-EMS training improved sarcopenia Z-score (MD = -1.52, 95 % CI: -2.27, -0.77, P < 0.0001) and waist circumference (WC) (MD = -1.41, 95 % CI: -2.62, -0.20, P = 0.02), and increased skeletal muscle mass index (SMI) (MD = 1.27, 95 % CI: 0.66,1.88, P < 0.0001) and appendicular skeletal muscle mass (ASMM) (MD = 0.68, 95 % CI: 0.08, 1.27, P = 0.03). Protein supplementation intervention reduced body fat rate (BF%) (MD = -1.28, 95 % CI: -1.88, -0.68, P < 0.0001, I2 = 0 %), total body fat (TBF) (MD = -0.98, 95 % CI: -1.65, -0.31, P = 0.004, I2 = 0 %) and trunk body fat mass (TBFM) (MD = -0.50, 95 % CI: -0.94, -0.06, P = 0.03, I2 = 0 %), and increased grip strength (GS) (MD = 1.13, 95 % CI: 0.06, 2.21, P = 0.04, I2 = 0 %). The combination of WB-EMS and protein supplements is beneficial to most body components and physical functions, such as SMI (MD = 1.21, 95 % CI: 0.73, 1.51, P < 0.00001, I2 = 0 %), GS (MD = 1.60, 95 % CI: 0.80, 2.40, P < 0.0001, I2 = 45 %) and walking speed (WS) (MD = 0.04, 95 % CI: 0.02, 0.06, P < 0.0001, I2 = 49 %). Compared with protein supplementation alone, WB-EMS could have an additional beneficial effect on BF% (MD = -0.92, 95 % CI: -1.80, -0.04, P = 0.04) and WC (MD = -1.03, 95 % CI: -1.70, -0.36, P = 0.003). Nevertheless, the addition of protein supplements did not provide any additional benefit compared with WB-EMS alone. In addition, there was almost no positive effect of WB-EMS and protein supplements on metabolic and inflammatory biomarkers. CONCLUSIONS: As things stand, protein supplementation intervention can effectively reduce body fat percentage, fat mass, and increase grip strength in SO patients. Both WB-EMS and protein supplementation intervention had no significant effects on metabolic and inflammatory biomarkers. WB-EMS combined with protein supplementation intervention was beneficial for SO patients in many ways. Due to the small number of studies, further studies are needed to confirm the efficacy of WB-EMS alone or in combination with protein supplementation intervention in SO patients. REGISTRATION NUMBER: INPLASY202190096 DOI:10.37766/inplasy2021.9.0096.

[The protective effects of Haematococcus pluvialis on the exercise-induced myocardial injury in rat].

OBJECTIVE: To study the protective effects of Haematococcus pluvialis (H. pluvialis) on myocardial injury of rats induced by endurance and intensive exercise. METHODS: The model was based on intensive endurance training. Sixty-five male aged 42 days Wistar rats were randomly divided into 5 groups:control group (C group), general training group (M group), low dose H. pluvialis + training group (HM I group), middle dose H. Pluvialis + training group (HM Ⅱ group), high dose H. pluvialis + training group (HM Ⅲ group). Each group included 12 rats, and the rats were assigned to go on a 42-day swimming training regime. Professional gavage were taken daily. The rats in HM I, HM Ⅱ and HM Ⅲ group were treated with H. pluvialis at the doses of 0.067,0.133 and 0.4 g/kg by ig at 5 ml/kg and the normal saline were given to other groups. After a 42-day swimming training regime, myocardial injury markers such as serum alanine aminotransferase (ALT), myocardial superoxide dismutase(SOD) and malondialdehyde (MDA) were detected, the biochemical indexes such as serum and myocardial endothelin (ET) and calcitonin gene related peptide (CGRP)were detected. RESULTS: Serum ALT, lactate dehydrogenase(LDH), creatine kinase(CK), a-hydroxybutyrate dehydrogenase(a-HBDH), ET, myocardial MDA and ET in M group were significantly higher than those in C group (P<0.05 or P<0.01). The myocardial SOD activity and the myocardial and serum CGRP in M group were significantly lower than those in C group(P<0.05 or P<0.01). The contents of serum ALT, LDH and CK in HM groups were lower than those in the M group but there was no significant difference between the two groups. Compared with M group, H. pluvialis could decrease the levels of serum a-HBDH, ET and myocardial ET in a dose-dependent manner (P<0.05 or P<0.01). The above mentioned three parameters in HM Ⅲ group were lower than those in HM I group (P<0.05). H. pluvialis could decrease the levels of myocardial MDA and increase the levels of myocardial SOD activity and serum or myocardial CGRP in a dose-dependent manner (P<0.05 or P<0.01). CONCLUSIONS: The different doses of H.pluvialis can effectively reduce the free radicals caused by endurance and intensive training and enhance the immune function. Meanwhile H.pluvialis is able to guarantee the relative balance in ET an CGRP`s concentration. Therefore, the myocardial lipid peroxidation and myocardial injury are encumbered. Additionaly, high dose of H. pluvialis is proven to be the most effective.