即使是少量运动也可改善骨骼健康


  【24drs.com】根据一篇横断面研究结果,即使只是散步或其它运动120分钟,都和停经前妇女的骨骼强度生物标记有关。和久坐型的对照组病患相比,为期8周的运动介入计划显著增加了骨骼强度的生物标记。
  
  沙特阿拉伯King Abdulaziz大学医院的Mohammed-Salleh M. Ardawi博士等人在8月3日的临床内分泌与代谢期刊在线发表他们的研究结果。
  
  Ardawi博士在新闻稿中表示,运动有益于骨骼健康且可降低硬化蛋白质(sclerostin),这是一种形成骨骼的抑制因子,且会促进IGF-1值,骨骼健康的正向效益因子;我们也发现,提高机械负荷的体能活动训练加上促蛋白合成治疗药物,将可为骨骼健康,特别是骨骼形成提供正面效益。
  
  这篇横断面研究包括了1,235名随机选样的停经前妇女,纵向追踪其中58人的8周体能训练课程(4天/周),另有62名对照组。
  
  在这横断面研究中,妇女们根据平均散步或运动程度分4组:每周少于30分钟、30-60分钟、60-120分钟以及120分钟以上。研究者发现,与久坐的对照组相比,每周运动120分钟以上的妇女,硬化蛋白质值低了36.8%且血清IGF-I值高出107%。他们的骨骼形成标记如血清骨钙素、血清1型前胶原氨基端前肽以及血清骨特异性碱性磷酸酶的值也较高。
  
  在这8周的纵向介入研究中,久坐妇女被指定到介入组完成8周的运动训练,每周4天、每次120分钟课程;课程结构包括20分钟速度渐增的散步、25分钟跑步的耐力训练处方、在跑步机上散步20分钟、骑脚踏车10分钟、10分钟踏阶、接著35分钟进行下半身和上半身的脊柱屈伸运动及机动运动。
  
  与每周运动不到30分钟的妇女相比,运动组妇女的血清硬化蛋白质值平均降低33.9%(P < .0001),骨骼形成标记和IGF-I值平均增加74.2%(P < .0001)。
  
  根据研究者指出,这篇研究的灵感来自于有数据显示长期不动的人,骨质流失和高硬化蛋白质值血症有显著相关,认为硬化蛋白质是人类机械卸载和废用性骨质疏松症的关键。
  
  研究者结论表示,就我们所知,这是首度指出停经研妇女血清硬化蛋白质值低与增加体能活动期间及血清IGF-I值有显著关联的研究。我们以纵向研究验证这些横断面观察,让久坐型的停经前妇女,采用连续8周(4天/周)的运动,导致血清硬化蛋白质显著降低、血清IGF-I值显著增加。
  
  在纵向研究中观察到,骨骼形成标记(BFM)增加和再吸收标记没有同步变化,和以往的研究结果相似,显示BFM对短期运动训练的反应强于骨骼再吸收标记。
  
  资料来源:http://www.24drs.com/professional/list/content.asp?x_idno=6916&x_classno=0&x_chkdelpoint=Y
  

Bone Health Improved Even by a Little Physical Activity

By Janis C. Kelly
Medscape Medical News

August 17, 2012 — As little as 120 minutes of walking or other exercise was associated with biomarkers of bone strength in premenopausal women, according to the results of a cross-sectional study. An 8-week physical activity intervention program significantly increased biomarkers of bone strength compared with sedentary control patients.

Mohammed-Salleh M. Ardawi, PhD, FRCPath, from King Abdulaziz University Hospital in Jeddah, Saudi Arabia, and colleagues report their results in an article published online August 3 in the Journal of Clinical Endocrinology and Metabolism.

"Physical activity is good for bone health and results in lowering sclerostin, a known inhibitor of bone formation and enhancing IGF-1 levels, a positive effector on bone health," Dr. Ardawi said in a news release. "We also found physical activity training that enhances mechanical loading in combination with anabolic therapeutic agents will have added positive effect on bone health, particularly bone formation."

The cross-sectional study of 1235 randomly selected premenopausal women included a subgroup of 58 women followed up longitudinally during an 8-week course of physical activity training (4 days/week) who were compared with 62 control patients.

In the cross-sectional study, women were classified into 4 groups according to average walking or exercising level: less than 30 minutes, 30 to 60 minutes, 60 to 120 minutes, and 120 minutes or longer per week. The researchers found that women who were active more than 120 minutes/week had 36.8% lower serum sclerostin and 107% higher serum IGF-I levels than sedentary control patients. They also had higher levels of bone formation markers such as serum osteocalcin, serum procollagen type 1 N terminal propeptide, and serum bone-specific alkaline phosphatase.

In the 8-week longitudinal intervention study, sedentary women assigned to the intervention group completed 8 weeks of exercise training consisting of 120-minute sessions 4 days per week. The structured session included 20 minutes of walking at increased speed and an endurance regimen of 25 minutes running, 20 minutes walking on a treadmill, 10 minutes cycling, and 10 minutes doing step-ups, followed by 35 minutes doing spine flexion-extension exercises and mobility exercises for the lower and upper trunk.

Compared with the women who had fewer than 30 minutes of exercise per week, the women in the exercise group had an average 33.9% decrease in serum sclerostin (P < .0001) and an average 74.2% increase in bone-formation markers and IGF-I (P < .0001).

According to the researchers, this research was inspired by data showing "significant hypersclerostinemia associated with bone loss in long-term immobilized patients [which] suggested that sclerostin could be a link between mechanical unloading and disuse osteoporosis in humans."

The researchers conclude, "To our knowledge, this study is the first to report a significant association between low serum sclerostin levels and increased [physical activity] duration and [serum]-IGF-I levels in premenopausal women. These cross-sectional observations were confirmed by our longitudinal study in which increasing the [physical activity] of sedentary premenopausal women for 8 consecutive weeks (4 d/wk) resulted in marked changes in serum sclerostin (decrease) and [serum]-IGF-I levels (increase).... The increase in BFM [bone formation markers] and the lack of concomitant changes in resorption markers observed in the longitudinal study parallels the findings of previous studies that showed that BFM are more responsive to short-term exercise training than bone resorption markers."

The authors have disclosed no relevant financial relationships.

J Clin Endocrinol Metabol. Published online August 3, 2012.

    
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