Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University, and Skåne University Hospital, Malmö, Sweden.
J Bone Miner Res. 2014 Jun;29(6):1325-36. doi: 10.1002/jbmr.2168.
Most pediatric exercise intervention studies that evaluate the effect on skeletal traits include volunteers and follow bone mass for less than 3 years. We present a population-based 6-year controlled exercise intervention study in children with bone structure and incident fractures as endpoints. Fractures were registered in 417 girls and 500 boys in the intervention group (3969 person-years) and 835 girls and 869 boys in the control group (8245 person-years), all aged 6 to 9 years at study start, during the 6-year study period. Children in the intervention group had 40 minutes daily school physical education (PE) and the control group 60 minutes per week. In a subcohort with 78 girls and 111 boys in the intervention group and 52 girls and 54 boys in the control group, bone mineral density (BMD; g/cm(2) ) and bone area (mm(2) ) were measured repeatedly by dual-energy X-ray absorptiometry (DXA). Peripheral quantitative computed tomography (pQCT) measured bone mass and bone structure at follow-up. There were 21.7 low and moderate energy-related fractures per 1000 person-years in the intervention group and 19.3 fractures in the control group, leading to a rate ratio (RR) of 1.12 (0.85, 1.46). Girls in the intervention group, compared with girls in the control group, had 0.009 g/cm(2) (0.003, 0.015) larger gain annually in spine BMD, 0.07 g (0.014, 0.123) larger gain in femoral neck bone mineral content (BMC), and 4.1 mm(2) (0.5, 7.8) larger gain in femoral neck area, and at follow-up 24.1 g (7.6, 40.6) higher tibial cortical BMC (g) and 23.9 mm(2) (5.27, 42.6) larger tibial cross-sectional area. Boys with daily PE had 0.006 g/cm(2) (0.002, 0.010) larger gain annually in spine BMD than control boys but at follow-up no higher pQCT values than boys in the control group. Daily PE for 6 years in at study start 6- to 9-year-olds improves bone mass and bone size in girls and bone mass in boys, without affecting the fracture risk.
大多数评估骨骼特征的儿科运动干预研究都包括志愿者，并将随访时间少于 3 年。我们报告了一项基于人群的 6 年控制运动干预研究，以骨骼结构和新发骨折为终点。在干预组中，417 名女孩和 500 名男孩（3969 人年）以及对照组中 835 名女孩和 869 名男孩（8245 人年）在研究开始时年龄为 6 至 9 岁，在 6 年的研究期间，登记了骨折。干预组的儿童每天有 40 分钟的学校体育课（PE），而对照组每周有 60 分钟。在干预组的 78 名女孩和 111 名男孩以及对照组的 52 名女孩和 54 名男孩的亚组中，通过双能 X 射线吸收法（DXA）反复测量骨矿物质密度（BMD；g/cm²）和骨面积（mm²）。外周定量计算机断层扫描（pQCT）在随访时测量骨量和骨结构。干预组每 1000 人年有 21.7 例低能量和中等能量相关骨折，对照组有 19.3 例骨折，导致发病率比（RR）为 1.12（0.85，1.46）。与对照组的女孩相比，干预组的女孩每年脊柱 BMD 增加 0.009g/cm²（0.003，0.015），股骨颈骨矿物质含量（BMC）增加 0.07g（0.014，0.123），股骨颈面积增加 4.1mm²（0.5，7.8），胫骨皮质 BMC（g）增加 24.1g（7.6，40.6），胫骨横截面面积增加 23.9mm²（5.27，42.6）。每天进行 PE 的男孩每年脊柱 BMD 增加 0.006g/cm²（0.002，0.010），比对照组男孩高，但随访时，pQCT 值没有比对照组男孩高。在研究开始时，6 至 9 岁的儿童每天进行 6 年的体育锻炼可以增加女孩的骨量和骨大小，增加男孩的骨量，而不会增加骨折风险。
