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体重训练对患有骨质疏松的绝经后乳腺癌幸存者的骨密度和骨转换的影响:一项为期 24 个月的随机对照试验。

The effect of weight training on bone mineral density and bone turnover in postmenopausal breast cancer survivors with bone loss: a 24-month randomized controlled trial.

机构信息

Lincoln Division, University of Nebraska Medical Center College of Nursing, Lincoln, NE USA.

出版信息

Osteoporos Int. 2010 Aug;21(8):1361-9. doi: 10.1007/s00198-009-1083-y. Epub 2009 Oct 3.

Abstract

SUMMARY

This study examined whether 24 months of weight training exercises enhanced the effectiveness of risedronate, calcium, and vitamin D in maintaining or improving bone mineral density (BMD) in 223 postmenopausal breast cancer survivors. Subjects who were > or =50% adherent to exercise had no improvement in BMD but were less likely to lose BMD.

INTRODUCTION

This study examined whether (1) postmenopausal breast cancer survivors (BCS) with bone loss taking 24 months of risedronate, calcium, and vitamin D had increased bone mineral density (BMD) at the total hip, femoral neck, L1-L4 spine, total radius and 33% radius, and decreased bone turnover; (2) subjects who also participated in strength/weight training (ST) exercises had greater increases in BMD and greater decreases in bone turnover; and (3) subjects who also exercised were more likely to preserve (at least maintain) BMD.

METHODS

Postmenopausal BCS (223) were randomly assigned to exercise plus medication or medication only groups. Both groups received 24 months of 1,200 mg of calcium and 400 IU of vitamin D daily and 35 mg of risedronate weekly, and the exercise group additionally had ST exercises twice weekly.

RESULTS

After 24 months, women who took medications without exercising had significant improvements in BMD at the total hip (+1.81%) and spine (+2.85%) and significant decreases in Alkphase B (-8.7%) and serum NTx (-16.7%). Women who also exercised had additional increases in BMD at the femoral neck (+0.29%), total hip (+0.34%), spine (+0.23%), total radius (+0.30%), and additional decreases in Alkphase B (-2.4%) and Serum NTx (-6.5%). Additional changes in BMD and bone turnover with exercise were not significant. Subjects who were > or =50% adherent to exercise were less likely to lose BMD at the total hip (chi-square [1] = 4.66, p = 0.03) and femoral neck (chi-square [1] = 4.63, p = 0.03).

CONCLUSION

Strength/weight training exercises may prevent loss of BMD in postmenopausal BCS at risk for bone loss.

摘要

摘要

本研究旨在探讨 24 个月的举重训练是否能增强利塞膦酸钠、钙和维生素 D 在维持或改善 223 例绝经后乳腺癌幸存者骨密度(BMD)方面的作用。对坚持锻炼率≥50%的患者进行分析,发现其 BMD 并无改善,但骨密度下降的风险降低。

介绍

本研究旨在探讨以下问题:(1)接受利塞膦酸钠、钙和维生素 D 治疗 24 个月的绝经后乳腺癌幸存者(BCS),其髋部、股骨颈、腰椎(L1-L4)、全髋、33%桡骨和桡骨近端的骨矿物质密度(BMD)是否增加,骨转换率是否降低;(2)接受力量/举重训练(ST)的患者,其 BMD 是否增加更多,骨转换率是否降低更多;(3)坚持锻炼的患者是否更有可能维持(至少保持)BMD。

方法

将 223 例绝经后 BCS 患者随机分为锻炼加药物组或单纯药物组。两组患者均接受 1200mg 钙和 400IU 维生素 D 每日一次,35mg 利塞膦酸钠每周一次,锻炼组同时进行每周两次的 ST 锻炼。

结果

24 个月后,不锻炼但服用药物的女性,髋部(+1.81%)和脊柱(+2.85%)BMD 显著增加,碱性磷酸酶 B(-8.7%)和血清 NTx(-16.7%)显著降低。同时锻炼的女性,股骨颈(+0.29%)、髋部(+0.34%)、脊柱(+0.23%)、全髋(+0.30%)BMD 进一步增加,碱性磷酸酶 B(-2.4%)和血清 NTx(-6.5%)进一步降低。但锻炼对 BMD 和骨转换的其他变化没有显著影响。坚持锻炼率≥50%的患者,其髋部(卡方[1]=4.66,p=0.03)和股骨颈(卡方[1]=4.63,p=0.03)BMD 下降的风险较低。

结论

力量/举重训练可能有助于预防绝经后有骨质流失风险的乳腺癌幸存者的 BMD 丢失。

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