MRC Unit for Lifelong Health and Ageing at UCL, London, UK.
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
J Bone Miner Res. 2019 Feb;34(2):252-261. doi: 10.1002/jbmr.3607. Epub 2018 Dec 10.
Leisure-time physical activity (LTPA) is widely recommended for the prevention of osteoporosis and fractures in older populations. However, whether the beneficial effects of LTPA on bone accumulate across life and are maintained even after reduction or cessation of regular PA in later life is unknown. We examined whether LTPA across adulthood was cumulatively associated with volumetric and areal bone mineral density (vBMD, aBMD) at ages 60 to 64 and whether associations were mediated by lean mass. Up to 1498 participants from the Medical Research Council National Survey of Health and Development were included in analyses. LTPA was self-reported at ages 36, 43, 53, and 60 to 64, and responses summed to generate a cumulative score (range 0 = inactive at all four ages to 8 = most active at all four ages). Total and trabecular vBMD were measured at the distal radius using pQCT and aBMD at the total hip and lumbar spine (L1 to L4) using DXA. Linear regression was used to test associations of the cumulative LTPA score with each bone outcome. After adjustment for height and weight, a 1-unit increase in LTPA score (95% CI) in men was associated with differences of 1.55% (0.78% to 2.31%) in radial trabecular vBMD, 0.83% (0.41% to 1.25%) in total hip aBMD, and 0.97% (0.44% to 1.49%) in spine aBMD. Among women, positive associations were seen for radial trabecular vBMD and total hip aBMD, but only among those of greater weight (LTPA × weight interaction p ≤ 0.01). In men, there was evidence to suggest that lean mass index may partly mediate these associations. These findings suggest that there are cumulative benefits of LTPA across adulthood on BMD in early old age, especially among men. The finding of weaker associations among women suggests that promotion of specifıc types of LTPA may be needed to benefit bone health in women. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.
闲暇时间体力活动（LTPA）被广泛推荐用于预防老年人骨质疏松症和骨折。然而，LTPA 是否对骨骼有益，并且这种益处是否会随着生命的积累而保持，甚至在以后的生活中减少或停止常规体育活动后仍然存在，这些都不得而知。我们研究了成年时期的 LTPA 是否与 60 至 64 岁时的体积和面积骨矿物质密度（vBMD、aBMD）呈累积相关，以及这些关联是否通过瘦体重来介导。多达 1498 名来自医学研究委员会国民健康与发展调查的参与者被纳入分析。LTPA 是在 36、43、53 岁以及 60 至 64 岁时自我报告的，并对各年龄的反应进行了汇总，得出了一个累积分数（范围为 0=四个年龄都不活跃，8=四个年龄都最活跃）。使用 pQCT 测量桡骨远端的总骨密度和骨小梁骨密度，使用 DXA 测量全髋关节和腰椎（L1 到 L4）的 aBMD。线性回归用于测试累积 LTPA 评分与各骨骼结果之间的关联。在调整身高和体重后，男性 LTPA 评分每增加 1 个单位（95%CI），桡骨小梁 vBMD 差异为 1.55%（0.78%至 2.31%），全髋关节 aBMD 差异为 0.83%（0.41%至 1.25%），脊柱 aBMD 差异为 0.97%（0.44%至 1.49%）。对于女性，桡骨小梁 vBMD 和全髋关节 aBMD 呈正相关，但仅在体重较大的女性中存在（LTPA×体重交互作用 p≤0.01）。在男性中，有证据表明瘦体重指数可能部分介导了这些关联。这些发现表明，成年时期的 LTPA 对老年人早期的 BMD 有累积益处，尤其是对男性而言。女性中关联较弱的发现表明，可能需要促进特定类型的 LTPA 以有益于女性的骨骼健康。
