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：本研究旨在探究为期12周的弹性带抗阻力训练（RT）联合维生素C和E补充剂对老年女性肌肉减少症患者的肌肉量、力量、体能表现以及氧化应激（OS）和炎症相关血液指标的影响。研究方法：将70名（60至75岁）参与者随机分为抗氧化剂补充组（AS；每日1000毫克维生素C和335毫克维生素E；n = 35）或安慰剂组（PLA；n = 35），两组均遵循相同的RT方案（每周三次）。通过双能X射线吸收法测量肌肉量，通过握力测试和膝关节伸展力测试测量力量，通过5次重复椅站测试、计时站立走测试和6米步行速度测试评估体能表现，通过谷胱甘肽（GSH）和氧化型谷胱甘肽（GSSG）、GSH/GSSG比值、丙二醛（MDA）和蛋白羰基（PCO）等指标评估OS相关指标，通过白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）等指标评估促炎因子。在基线和12周干预后评估上述指标。研究结果：RT改善了肌肉量、肌肉力量和体能表现。与PLA组相比，AS组在臂部瘦体重（P = 0.003；d = 0.74）、肌肉量指数（SMI）（p = 0.004；d = 0.71）、握力（P = 0.047；d = 0.51）和膝关节伸展力（P < 0.001；d = 0.89）方面有更高的增加，但在所有体能表现测试中均未显示出额外的改善。在血液参数方面，PLA组的血清GSSG、MDA和PCO水平升高，GSH/GSSG比值降低。相比之下，AS组的GSH（P < 0.001；d = 1.52）和GSH/GSSG比值（P < 0.001；d = 1.52）升高，GSSG（P < 0.001；d = 0.96）和MDA（P < 0.001；d = 1.65）降低。PLA组和AS组的IL-6和TNF-α水平显著降低，且AS组的血清IL-6水平低于PLA组（P < 0.001；d = 1.16）。研究结论：维生素C和E补充剂联合RT可能通过改善训练后的OS和炎症水平，增强老年女性肌肉减少症患者的神经肌肉适应（即肌肉量和力量）。