Department of Nutrition and Exercise Physiology, Columbia, MO 65211, USA.
Eur J Clin Nutr. 2012 May;66(5):606-12. doi: 10.1038/ejcn.2011.212. Epub 2011 Dec 21.
BACKGROUND/OBJECTIVES: Moderate, long-term weight loss results in the loss of bone mass in overweight or obese premenopausal women. However, whether these changes persist during weight maintenance or regain remains to be determined.
SUBJECTS/METHODS: Overweight or obese (body mass index: 25.8-42.5 kg/m(2)) women (n=40) with at least two risk factors for the metabolic syndrome participated in this 12-month study that examined the effects of prescribed weight loss and regain, with or without exercise, on bone turnover and on bone mineral density (BMD) in a subset of participants (n=24). During the first 6 month, participants lost ≈ 10% of their initial body weight via energy restriction and supervised aerobic exercise. Following weight loss, participants were randomly assigned to either an exercise or a no exercise treatment for the regain (+50% of weight lost) phase. A one-way (time) repeated measures one-factor analysis of variance (RMANOVA) tested the effects of weight loss on BMD and bone turnover, and a two-way RMANOVA (time, exercise) was used to examine the effects of exercise during weight regain.
Hip (P=0.007) and lumbar spine (P=0.05) BMD decreased with weight loss, and remained reduced after weight regain with or without exercise. Likewise, the weight-loss-associated increases in osteocalcin (P<0.001) and C-terminal peptide of type I collagen (P<0.001) persisted following weight regain, independent of exercise.
The results of the present study, which is the first to examine changes in bone mass and turnover during carefully controlled weight regain, suggest that weight-loss-induced perturbations in bone mass and turnover persist after partial weight regain, regardless of whether regular weight-bearing aerobic exercise was continued.
背景/目的：适度的长期减重会导致超重或肥胖的绝经前妇女骨质流失。然而，这些变化在体重维持或反弹期间是否持续仍有待确定。
受试者/方法：本 12 个月研究纳入了至少有两种代谢综合征风险因素的超重或肥胖（体重指数：25.8-42.5kg/m²）女性（n=40），研究了规定的减重和反弹（伴或不伴运动）对骨转换和部分参与者（n=24）骨密度（BMD）的影响。在前 6 个月，参与者通过能量限制和监督的有氧运动减轻了约 10%的初始体重。在减重后，参与者随机分为运动或不运动组进行体重反弹（丢失体重的 50%）阶段。单向（时间）重复测量单因素方差分析（RMANOVA）检验了减重对 BMD 和骨转换的影响，双向 RMANOVA（时间、运动）用于检验运动在体重反弹期间的影响。
髋部（P=0.007）和腰椎（P=0.05）BMD 随减重而降低，无论是否运动，在体重反弹后仍保持降低。同样，与减重相关的骨钙素（P<0.001）和 I 型胶原 C 端肽（P<0.001）的增加在体重反弹后仍持续存在，独立于运动。
本研究是首次在严格控制的体重反弹期间检查骨量和骨转换变化的研究，结果表明，无论是否继续进行常规负重有氧运动，体重减轻引起的骨量和骨转换紊乱在部分体重反弹后仍持续存在。
