即使是少量運動也可改善骨骼健康


  【24drs.com】根據一篇橫斷面研究結果,即使只是散步或其他運動120分鐘,都和停經前婦女的骨骼強度生物標記有關。和久坐型的對照組病患相比,為期8週的運動介入計劃顯著增加了骨骼強度的生物標記。
  
  沙烏地阿拉伯King Abdulaziz大學醫院的Mohammed-Salleh M. Ardawi博士等人在8月3日的臨床內分泌與代謝期刊線上發表他們的研究結果。
  
  Ardawi博士在新聞稿中表示,運動有益於骨骼健康且可降低硬化蛋白質(sclerostin),這是一種形成骨骼的抑制因子,且會促進IGF-1值,骨骼健康的正向效益因子;我們也發現,提高機械負荷的體能活動訓練加上促蛋白合成治療藥物,將可為骨骼健康,特別是骨骼形成提供正面效益。
  
  這篇橫斷面研究包括了1,235名隨機選樣的停經前婦女,縱向追蹤其中58人的8週體能訓練課程(4天/週),另有62名對照組。
  
  在這橫斷面研究中,婦女們根據平均散步或運動程度分4組:每週少於30分鐘、30-60分鐘、60-120分鐘以及120分鐘以上。研究者發現,與久坐的對照組相比,每週運動120分鐘以上的婦女,硬化蛋白質值低了36.8%且血清IGF-I值高出107%。他們的骨骼形成標記如血清骨鈣素、血清1型前膠原氨基端前肽以及血清骨特異性鹼性磷酸酶的值也較高。
  
  在這8週的縱向介入研究中,久坐婦女被指定到介入組完成8週的運動訓練,每週4天、每次120分鐘課程;課程結構包括20分鐘速度漸增的散步、25分鐘跑步的耐力訓練處方、在跑步機上散步20分鐘、騎腳踏車10分鐘、10分鐘踏階、接著35分鐘進行下半身和上半身的脊柱屈伸運動及機動運動。
  
  與每週運動不到30分鐘的婦女相比,運動組婦女的血清硬化蛋白質值平均降低33.9%(P < .0001),骨骼形成標記和IGF-I值平均增加74.2%(P < .0001)。
  
  根據研究者指出,這篇研究的靈感來自於有數據顯示長期不動的人,骨質流失和高硬化蛋白質值血症有顯著相關,認為硬化蛋白質是人類機械卸載和廢用性骨質疏鬆症的關鍵。
  
  研究者結論表示,就我們所知,這是首度指出停經研婦女血清硬化蛋白質值低與增加體能活動期間及血清IGF-I值有顯著關聯的研究。我們以縱向研究驗證這些橫斷面觀察,讓久坐型的停經前婦女,採用連續8週(4天/週)的運動,導致血清硬化蛋白質顯著降低、血清IGF-I值顯著增加。
  
  在縱向研究中觀察到,骨骼形成標記(BFM)增加和再吸收標記沒有同步變化,和以往的研究結果相似,顯示BFM對短期運動訓練的反應強於骨骼再吸收標記。
  
  資料來源: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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