Effect of vitamin C and E supplementation and elastic-band resistance training on muscle mass, strength, physical performance, oxidative stress, and inflammation in older women with sarcopenia: A 12-week randomized, double-blind, placebo-controlled trial

Purpose: This study aimed to explore the effects of 12 weeks of elastic-band resistance training (RT) with vitamin C and E supplementation on muscle mass, strength, physical performance, and blood parameters of oxidative stress (OS) and inflammation in older women with sarcopenia.
Methods: Seventy participants (60 to 75 years) were randomized to an antioxidant supplementation group (AS; 1000 mg/d vitamin C and 335 mg/d vitamin E; n = 35) or a placebo group (PLA; n = 35) following the same RT program (three sessions per week). Muscle mass (measured by dual-energy X-ray absorptiometry), strength (measured by handgrip strength and knee extension strength), physical performance (5-Repetition Chair Stand Test, Timed Up and Go Test, and 6-meter Gait Speed), OS-related indices (reduced [GSH] and oxidized [GSSG] glutathione, GSH/GSSG ratio, malondialdehyde [MDA], and protein carbonyl [PCO]), and pro-inflammatory factors (interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-α]) were evaluated at baseline and after the 12-week intervention.
Results: RT improved muscle mass, muscle strength and physical performance. The AS group had higher increases in arm lean mass (P = 0.003; d = 0.74), SMI (p = 0.004; d = 0.71), handgrip strength (P = 0.047; d = 0.51), and knee extension strength (P < 0.001; d = 0.89) than the PLA group but showed no additional improvement in all physical performance tests. In terms of blood parameters, the PLA group had increased serum levels of GSSG, MDA, and PCO and decreased GSH/GSSG ratio. By contrast, the AS group had increased GSH (P < 0.001; d = 1.52) and GSH/GSSG ratio (P < 0.001; d = 1.52) and reduced GSSG (P < 0.001; d = 0.96) and MDA (P < 0.001; d = 1.65). The levels of IL-6 and TNF-α significantly decreased in the PLA and AS groups, and serum IL-6 level was lower in the AS group than in the PLA group (P < 0.001; d = 1.16).
Conclusions: Vitamin C and E supplementation combined with RT may enhance neuromuscular adaptations (i.e., muscle mass and strength) in older women with sarcopenia by improving OS and inflammation levels post-training.

研究目的：本研究旨在探讨为期12周的弹力带抗阻训练（RT）联合维生素C、E补充剂对肌少症老年女性的肌肉质量、肌力、躯体运动机能以及氧化应激（OS）与炎症相关血液指标的影响。
研究方法：本研究招募70名年龄介于60至75岁的受试者，采用随机分组法将其分为抗氧化补充组（AS：每日予1000mg维生素C与335mg维生素E，n=35）及安慰剂组（PLA，n=35），两组均执行相同的弹力带抗阻训练方案，每周训练3次。分别于基线期与12周干预结束时，对下述指标进行评估：肌肉质量（采用双能X射线吸收测定法检测）、肌力（含握力与膝伸肌力量）、躯体运动机能（含5次坐立试验、计时起立行走试验与6米步行速度测试）、氧化应激相关指标（还原型谷胱甘肽[GSH]、氧化型谷胱甘肽[GSSG]、GSH/GSSG比值、丙二醛[MDA]与蛋白质羰基[PCO]）以及促炎因子（白细胞介素-6[IL-6]与肿瘤坏死因子-α[TNF-α]）。
研究结果：弹力带抗阻训练可改善肌肉质量、肌力与躯体运动机能。抗氧化补充组的上肢瘦体重（P=0.003；d=0.74）及骨骼肌质量指数（SMI，P=0.004；d=0.71）、握力（P=0.047；d=0.51）与膝伸肌力量（P<0.001；d=0.89）的提升幅度均显著高于安慰剂组，但在所有躯体运动机能测试中未表现出额外获益。血液指标方面，安慰剂组受试者的血清GSSG、MDA及PCO水平升高，GSH/GSSG比值降低；与之相反，抗氧化补充组的GSH水平（P<0.001；d=1.52）与GSH/GSSG比值（P<0.001；d=1.52）显著升高，GSSG（P<0.001；d=0.96）与MDA（P<0.001；d=1.65）水平显著降低。两组受试者的IL-6与TNF-α水平均显著降低，且抗氧化补充组的血清IL-6水平显著低于安慰剂组（P<0.001；d=1.16）。
研究结论：维生素C、E补充剂联合弹力带抗阻训练，可通过改善训练后氧化应激状态与炎症水平，提升肌少症老年女性的神经肌肉适应性（即肌肉质量与肌力）。