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男性在接受艰苦军事训练时骨骼的宏观和微观结构适应性。

Skeletal macro- and microstructure adaptations in men undergoing arduous military training.

机构信息

Army Personnel Research Capability, Army Headquarters, Andover, United Kingdom.

Department of Occupational Medicine, HQ Army Recruiting and Initial Training Command, Upavon, United Kingdom.

出版信息

Bone. 2019 Aug;125:54-60. doi: 10.1016/j.bone.2019.05.009. Epub 2019 May 8.

Abstract

PURPOSE

Short periods of basic military training increase the density and size of the tibia, but the adaptive response of bone microarchitecture, a key component of bone strength, is not fully understood.

METHODS

Tibial volumetric bone mineral density (vBMD), geometry, microarchitecture and mechanical properties were measured using high-resolution peripheral quantitative computed tomography in 43 male British Army infantry recruits (mean ± SD, age 21 ± 3 years, height 1.76 ± 0.06 m, body mass 76.5 ± 9.4 kg). Bilateral scans were performed at the distal tibia at the start (week 1) and end (week 13) of basic military training. Concurrent measures were obtained for whole-body areal bone mineral density (aBMD) using DXA, and markers of bone metabolism (βCTX, P1NP, PTH, total 25(OH)D and ACa) from venous blood.

RESULTS

Training increased areal BMD for total body (1.4%) and arms (5.2%) (P ≤ 0.031), but not legs and trunk (P ≥ 0.094). Training increased trabecular (1.3 to 1.9%) and cortical vBMD (0.6 to 0.9%), trabecular volume (1.3 to 1.9%), cortical thickness (3.2 to 5.2%) and cortical area (2.6 to 2.8%), and reduced trabecular area (-0.4 to -0.5%) in both legs (P < 0.001). No changes in trabecular number, thickness and separation, cortical porosity, stiffness or failure load were observed (P ≥ 0.188). βCTX decreased (-0.11 μg∙l, P < 0.001) and total 25(OH)D increased (9.4 nmol∙l, P = 0.029), but no differences in P1NP, PTH or ACa were observed between timepoints (P ≥ 0.233).

CONCLUSION

A short period of basic military training increased density and altered geometry of the distal tibia in male military recruits. The osteogenic effects of basic military training are likely due to an increase in unaccustomed, dynamic and high-impact loading.

摘要

目的

短期基础军事训练会增加胫骨的密度和大小,但骨骼微结构的适应反应(骨骼强度的关键组成部分)尚未完全了解。

方法

采用高分辨率外周定量 CT 对 43 名英国陆军步兵新兵(平均年龄 21±3 岁,身高 1.76±0.06m,体重 76.5±9.4kg)的双侧胫骨进行测量,包括体积骨矿物质密度(vBMD)、几何形状、微结构和机械性能。在基础军事训练开始(第 1 周)和结束(第 13 周)时,在胫骨远端进行双侧扫描。同时使用双能 X 线吸收法(DXA)测量全身面积骨矿物质密度(aBMD),并从静脉血中测量骨代谢标志物(βCTX、P1NP、PTH、总 25(OH)D 和 ACa)。

结果

训练使全身(1.4%)和手臂(5.2%)的面积 BMD 增加(P≤0.031),但腿部和躯干没有增加(P≥0.094)。训练使双侧胫骨的小梁(1.3-1.9%)和皮质 vBMD(0.6-0.9%)、小梁体积(1.3-1.9%)、皮质厚度(3.2-5.2%)和皮质面积(2.6-2.8%)增加,而小梁面积减少(-0.4%至-0.5%)(P<0.001)。没有观察到小梁数量、厚度和分离、皮质孔隙率、刚度或破坏载荷的变化(P≥0.188)。βCTX 降低(-0.11μg·l,P<0.001),总 25(OH)D 增加(9.4nmol·l,P=0.029),但在两个时间点之间没有观察到 P1NP、PTH 或 ACa 的差异(P≥0.233)。

结论

短期基础军事训练增加了男性新兵胫骨远端的密度和几何形状。基础军事训练的成骨作用可能是由于不习惯的、动态的和高冲击的负荷增加所致。

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