Department of Family & Community Medicine, University of Toronto, The Scarborough General Medical Mall, 309-3030 Lawrence Avenue East, Scarborough, Ontario M1P 2T7, Canada.
Osteoporos Int. 2012 Jan;23(1):39-51. doi: 10.1007/s00198-011-1734-7. Epub 2011 Aug 3.
Inconsistent study findings of exercise on areal bone density highlight the need to include parameters of bone geometry and volumetric bone density measurements. Using a systematic review and meta-analysis, we found a decrease in bone loss through the maintenance of cortical and trabecular volumetric bone mineral density (BMD). Studies with longer exercise durations and larger sample sizes are needed.
Exercise has long been recommended to prevent age-related loss of bone mass in postmenopausal women. However, inconsistent study findings on the effect of exercise on BMD preservation have highlighted the importance of extending the evaluation of bone to include the parameters of bone geometry. We conducted both a systematic review and meta-analysis of the effects of exercise on bone geometry and volumetric BMD in postmenopausal women.
We searched MEDLINE, PubMed, and EMBASE from 1950 to April 2009 and included prospective, randomized controlled trials of healthy postmenopausal women where the intervention involved exercise or sport and outcomes included quantitative or peripheral quantitative computed tomography bone parameters. Outcome variables included: total volumetric BMD, cortical volumetric BMD (CvBMD), trabecular volumetric BMD (TrvBMD), total bone mineral content, cortical BMC, total bone area, cortical area, polar stress-strain index, and bone strength index.
Six studies satisfied our inclusion and exclusion criteria. Lower extremity exercises resulted in small (∼0.9%) but significant improvements in TrvBMD of the distal tibia (p = 0.0006) and in CvBMD of the tibial shaft (p = 0.0007). Studies with longer durations of exercise (12 months) and those in early postmenopausal women showed significant changes in CvBMD at the tibial shaft.
We conclude that exercise in postmenopausal women may decrease bone loss by maintaining cortical and trabecular volumetric BMD. To better understand the effect of exercise on bone geometric structure and strength, more studies of longer duration and larger sample sizes are needed.
运动对骨密度的影响研究结果不一致，这突出表明需要将骨几何参数和体积骨密度测量纳入研究。本研究采用系统评价和荟萃分析的方法，发现通过维持皮质和小梁体积骨密度（BMD）可以减少骨丢失。需要进行持续时间更长和样本量更大的研究。
运动一直被推荐用于预防绝经后妇女的骨量丢失。然而，运动对 BMD 保留影响的不一致研究结果强调了扩展骨骼评估以包括骨骼几何参数的重要性。我们对运动对绝经后妇女骨骼几何和体积 BMD 的影响进行了系统评价和荟萃分析。
我们检索了 MEDLINE、PubMed 和 EMBASE 数据库（1950 年至 2009 年 4 月），纳入了涉及运动或运动的健康绝经后妇女的前瞻性随机对照试验，且干预措施包括运动或运动，其结局包括定量或外周定量 CT 骨参数。结局变量包括：总体积 BMD、皮质体积 BMD（CvBMD）、小梁体积 BMD（TrvBMD）、总骨矿物质含量、皮质 BMC、总骨面积、皮质面积、极向应力度和骨强度指数。
有 6 项研究符合我们的纳入和排除标准。下肢运动可使远端胫骨（p = 0.0006）和胫骨骨干（p = 0.0007）的 TrvBMD 分别出现小（约 0.9%）但有统计学意义的改善，且下运动肢持续时间较长（12 个月）和绝经早期的研究显示胫骨骨干 CvBMD 有显著变化。
我们的结论是，绝经后妇女的运动可以通过维持皮质和小梁体积 BMD 来减少骨丢失。为了更好地了解运动对骨骼几何结构和强度的影响，需要进行持续时间更长和样本量更大的研究。
