Chao D, Espeland M A, Farmer D, Register T C, Lenchik L, Applegate W B, Ettinger W H
Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
J Am Geriatr Soc. 2000 Jul;48(7):753-9. doi: 10.1111/j.1532-5415.2000.tb04749.x.
To examine the effect of diet and exercise-induced weight loss on bone mineral density in overweight postmenopausal women
A 1-year prospective, randomized clinical trial.
Two university medical school research centers.
Sixty-seven overweight postmenopausal women, a subset of the women who participated in the Trial of Nonpharmacological Interventions in the Elderly (TONE) to control hypertension. The participants were assigned randomly to one of four groups: usual care, weight loss only, sodium restriction only, or combined weight loss/sodium restriction.
All TONE participants in the treatment groups attended regular dietary intervention sessions to lose weight, reduce sodium intake, or both that they might refrain from using antihypertensive medications for a period of 15 to 36 months (median = 29 months).
Bone mineral density (BMD) assessed by dual energy X-ray absorptiometry (DXA), serum and urine markers of bone metabolism, and other demographic and clinical data were collected at baseline, 6 months, and 12 months.
Women assigned to the weight loss interventions lost 9.2 +/- 1.2 lbs (mean +/- SE) at 6 months and 7.7 +/- 2.0 lbs at 12 months compared with 1.8 +/- 1.0 lbs at 6 months and 1.9 +/- 1.6 lbs at 12 months for those assigned to no weight loss intervention (P < .0001). Weight loss was correlated with a decrease in total body BMD (P = .004) and an increase in osteocalcin (P = .004) after controlling for baseline bone measures, intervention assignment, and other baseline covariates. Regression analyses indicated that total body BMD decreased by 6.25 +/- 2.06 g/cm2 x 10-4 for each pound of weight loss.
Voluntary weight loss in overweight postmenopausal women is associated with modest decrease in total body BMD. Clinicians recommending weight loss for older postmenopausal women may need to include recommendations for reducing the risk of bone loss.
研究饮食和运动诱导的体重减轻对超重绝经后女性骨密度的影响
一项为期1年的前瞻性随机临床试验。
两个大学医学院研究中心。
67名超重绝经后女性，她们是参与老年人非药物干预试验（TONE）以控制高血压的女性子集。参与者被随机分配到四组之一：常规护理、仅体重减轻、仅钠限制或体重减轻/钠限制联合组。
治疗组的所有TONE参与者参加定期饮食干预课程以减轻体重、减少钠摄入或两者兼而有之，以便他们在15至36个月（中位数 = 29个月）内避免使用抗高血压药物。
在基线、6个月和12个月时收集通过双能X线吸收法（DXA）评估的骨密度（BMD）、骨代谢的血清和尿液标志物以及其他人口统计学和临床数据。
与未进行体重减轻干预的女性相比，分配到体重减轻干预组的女性在6个月时体重减轻了9.2±1.2磅（均值±标准误），在12个月时体重减轻了7.7±2.0磅，而未进行体重减轻干预的女性在6个月时体重减轻了1.8±1.0磅，在12个月时体重减轻了1.9±1.6磅（P <.0001）。在控制基线骨测量、干预分配和其他基线协变量后，体重减轻与全身BMD降低（P =.004）和骨钙素增加（P =.004）相关。回归分析表明，每减轻一磅体重，全身BMD降低6.25±2.06 g/cm²×10⁻⁴。
超重绝经后女性自愿体重减轻与全身BMD适度降低有关。为老年绝经后女性推荐减肥的临床医生可能需要包括降低骨质流失风险的建议。
