Division of Endocrinology, Department of Internal Medicine, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Division of Endocrinology, Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
Osteoporos Int. 2017 Sep;28(9):2507-2519. doi: 10.1007/s00198-017-4076-2. Epub 2017 May 26.
Sedentary behaviour (SB) is increasing in Western societies and some studies suggest a deleterious effect of SB on bone. The aim of this systematic review was to examine the association between SB and bone health in children, adolescents and young adults. Electronic databases (PubMed, MEDLINE, PsycINFO and Science Citation Index) were searched for relevant articles up to January 9, 2017. Studies were included when results on bone health (e.g. strength, mass and structure) and either subjectively (questionnaires) or objectively (accelerometry) measured SB were reported in healthy participants ≤24 years. Two reviewers independently screened titles and abstracts for eligibility, rated methodological quality and extracted data. Seventeen observational studies were included. Several studies that used DXA or quantitative ultrasound suggested that objectively measured SB was negatively associated with lower extremity bone outcomes, such as femoral neck bone mineral density. The magnitude of this negative association was small and independent of moderate-to-vigorous physical activity. In contrast to the lower extremities, there was insufficient evidence for an association of lumbar spine bone outcomes with objectively measured SB. In high-quality studies that used DXA, no association was observed between objectively measured SB and total body bone outcomes. In studies using questionnaires, none of these relationships were observed. Well-designed longitudinal studies, objectively measuring SB, are needed to further unravel the effect of SB, physical activity and their interaction on bone health.
久坐行为（SB）在西方社会中呈上升趋势，一些研究表明 SB 对骨骼有不良影响。本系统综述的目的是研究儿童、青少年和年轻人中 SB 与骨骼健康之间的关系。截至 2017 年 1 月 9 日，电子数据库（PubMed、MEDLINE、PsycINFO 和科学引文索引）对相关文章进行了检索。当研究报告了健康参与者（<24 岁）中骨骼健康（如骨强度、骨量和结构）的结果以及使用主观（问卷）或客观（加速度计）测量的 SB 时，将纳入研究。两名评审员独立筛选标题和摘要以确定其是否符合入选标准，评估方法学质量并提取数据。共纳入了 17 项观察性研究。一些使用 DXA 或定量超声的研究表明，客观测量的 SB 与下肢骨结局（如股骨颈骨密度）呈负相关。这种负相关的程度较小，且与中等到剧烈的体力活动无关。与下肢不同，腰椎骨结局与客观测量的 SB 之间的关联没有足够的证据。在使用 DXA 的高质量研究中，未观察到客观测量的 SB 与全身骨结局之间存在关联。在使用问卷的研究中，未观察到这些关系。需要进行设计良好的纵向研究，客观地测量 SB，以进一步阐明 SB、体力活动及其相互作用对骨骼健康的影响。
