Effects Of α-keto Acid Combined With Taijiquan On Nutritional Status And Myostatin Levels In Patients With MHD

Objective:To investigate the effects of α-keto acid combined with Taijiquan on the levels of serum myostatin and nutritional status in patients performing maintenance hemodialysis,as well as providing corresponding theoretical basis for clinical treatment.Methods:This study included 42 patients who underwent hemodialysis and protein energy expenditure at the Nephrology Center of the First Affiliated Hospital of Xinjiang Medical University from 2016 to 2018.Taking α-keto acid(Kaitong)and Taijiquan as intervention programs,the patients were divided into three groups.The non-intervened patients served as the control group(group A),taken the α-keto acid group(group B)and the α-keto acid combined with Taijiquan group(group C),and those were followed up for a total of40 weeks.Enzyme-linked immunosorbent assay was used to monitor the serum MSTN and Hs-CRP levels and related blood biochemical indicators of patients before intervention and every 20 weeks after treatment,and tracked the changes of related nutritional indicators such as patients’ height,weight,calf circumference,girth and grip strength.Result:(1)In this study,the serum MSTN of group A,group B and group C before treatment were(2.0,37.0)ng/ml,8.7(3.9,18.9)ng/ml,9.0(1.4,13.9)ng/ml,without statistical significance(P>0.05).After 40 weeks of treatment,the serum MSTN of the three groups were 21.0(11.2,69.2)ng / ml,9.5(2.2,47.2)ng/ml,and 3.2(1.7,11.6)ng/ml,showing a gradually increasing trend,which the difference was statistically significant(P<0.05).(2)After 20 and 40 weeks of treatment,there was no significant difference in serum albumin and prealbumin among the three groups(P>0.05).After follow-up,serum albumin and prealbumin in each group were significantly higher than baseline.(3)After the two investigation after treatment,the BMI of the patients in the three groups all gradually increased,and the difference was not statistically significant(P>0.05).(4)The three groups of patients were followed up to the 40 th week,and their average grip strengths were(24.3± 12.5)kgf,(27.9 ± 7.5)kgf,and(29.4 ± 9.4)kgf,and the differences were statistically significant(P<0.05).From a longitudinal perspective,comparison of the three groups before and after,the grip strength levels of group A and group B gradually decreased with the change of treatment time,while the average grip strength of group C gradually increased with the change of treatment time,and the difference was statistically significant(P<0.05).(5)The blood phosphorus of the three groups of patients during follow-up to the20 th week were(2.3 ± 0.6)mmol/L,(1.9 ± 0.5)mmol / L,(1.8 ± 0.7)mmol / L,and parathyroid hormone were(71.8 ± 61.6)pmol / L,(46.6 ± 29.9)pmol /L,and 43.8(34.9,72.7)pmol/L,all showed a gradual decreasing trend,and the differences were not statistically significant(P>0.05).During the follow-up to the 40 th week,the mean values of blood phosphorus were(1.9 ± 0.6)mmol /L,(1.8 ± 0.6)mmol/L,and(1.6 ± 0.6)mmol/L,showing a gradual decreasing trend.The parathyroid hormone in group B and C was lower than that in group A,without statistically significant(P>0.05).Conclusion: α-keto acid combined with Taijiquan can significantly reduce the serum MSTN level of hemodialysis patients,increasing the levels of albumin,prealbumin,BMI and grip strength,reducing parathyroid hormone and blood phosphorus,so as to improve the nutritional status of patients and correct calcium and phosphorus metabolism disorders.