有氧运动对超重和肥胖慢性肾脏病患者骨代谢标志物的影响。
Effect of Aerobic Exercise on Markers of Bone Metabolism of Overweight and Obese Patients With Chronic Kidney Disease.
机构信息
Nutrition Program, Federal University of São Paulo, São Paulo, Brazil.
Division of Nephrology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil.
出版信息
J Ren Nutr. 2017 Sep;27(5):364-371. doi: 10.1053/j.jrn.2017.04.009. Epub 2017 Jun 9.
OBJECTIVE
The aim of the study was to investigate the effect of aerobic exercise on markers of bone metabolism in overweight and obese nondialysis-dependent patients with chronic kidney disease.
METHODS
This is a post-hoc study with 39 sedentary patients (55.5 ± 8.3 years, body mass index 31.2 ± 4.4 kg/m, estimated glomerular filtration rate 26.9 ± 11.7 mL/minute) who were randomly assigned to the aerobic exercise group (n = 24) or the control group (n = 15). The aerobic training (walking) was prescribed according to ventilatory threshold and was performed 3 times per week during 24 weeks. Carboxylated and undercarboxylated osteocalcin (GLA and GLU), sclerostin and tartrate-resistant acid phosphatase isoform 5b (TRAP-5b), parathyroid hormone, total alkaline phosphatase (AP), body composition, cardiorespiratory, and functional capacity tests were measured at baseline and after the follow-up.
RESULTS
At baseline, carboxylated osteocalcin (GLA) and undercarboxylated osteocalcin (GLU) were inversely correlated with estimated glomerular filtration rate (r = -0.64; r = -0.38, respectively). Both osteocalcin fragments were positively correlated with total AP (GLA: r = 0.36; GLU: r = 0.53). An inverse correlation was found between GLA and sclerostin with body fat (r = -0.36; r = -0.46, respectively). GLU was negatively correlated with markers of muscle mass (r = -0.34). TRAP-5b and sclerostin were inversely correlated with 6-minute walk test and time up and go test, respectively (r = -0.34; r = -0.35, respectively). After 24 weeks, all physical capacity parameters increased in the exercise group (P < .001). Except for total AP that increased after 24 weeks in the exercise group (P < .05), no other changes were observed in both groups in relation to the bone metabolism biomarkers investigated.
CONCLUSION(S): In this post-hoc study, the aerobic training used did not promote relevant changes in the bone metabolism markers investigated.
目的
本研究旨在探讨有氧运动对超重和肥胖非透析依赖的慢性肾脏病患者骨代谢标志物的影响。
方法
这是一项事后研究，共纳入 39 名久坐不动的患者（55.5±8.3 岁，体重指数 31.2±4.4kg/m2，估算肾小球滤过率 26.9±11.7mL/min），他们被随机分配到有氧运动组（n=24）或对照组（n=15）。根据通气阈为患者制定有氧运动（步行）方案，并在 24 周内每周进行 3 次。测量基线和随访后的羧化和未羧化骨钙素（GLA 和 GLU）、硬化蛋白和抗酒石酸酸性磷酸酶 5b 同工酶（TRAP-5b）、甲状旁腺激素、总碱性磷酸酶（AP）、身体成分、心肺功能和功能能力测试。
结果
基线时，羧化骨钙素（GLA）和未羧化骨钙素（GLU）与估算肾小球滤过率呈负相关（r=-0.64；r=-0.38）。两种骨钙素片段与总 AP 呈正相关（GLA：r=0.36；GLU：r=0.53）。GLA 与身体脂肪呈负相关（r=-0.36），GLU 与肌肉质量标志物呈负相关（r=-0.34）。TRAP-5b 和硬化蛋白与 6 分钟步行试验和起立行走测试分别呈负相关（r=-0.34；r=-0.35）。24 周后，运动组所有身体能力参数均增加（P<0.001）。除运动组的总 AP 在 24 周后增加（P<0.05）外，两组在研究的骨代谢标志物方面均未观察到其他变化。
结论
在这项事后研究中，所使用的有氧运动并未促进所研究的骨代谢标志物的显著变化。
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