Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil.
Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK.
Syst Rev. 2020 Dec 12;9(1):291. doi: 10.1186/s13643-020-01551-y.
Bone is a plastic tissue that is responsive to its physical environment. As a result, exercise interventions represent a potential means to influence the bone. However, little is currently known about how various exercise and participant characteristics interact to influence bone metabolism. Acute, controlled, interventions provide an in vivo model through which the acute bone response to exercise can be investigated, typically by monitoring circulating bone biomarkers. Currently, substantial heterogeneity in factors such as study design, quality, exercise, and participant characteristics render it difficult to synthesize and evaluate the available evidence. Using a systematic review and meta-analytic approach, the aim of this investigation is to quantify the effect of an acute exercise bout on circulating bone biomarkers as well as examine the potential factors that may moderate this response, e.g., variation in participant, exercise, and sampling characteristics.
This protocol was designed in accordance with the PRISMA-P guidelines. Seven databases (MEDLINE, Embase, Sport Discus, Cochrane CENTRAL, PEDro, LILACS, and Ibec) will be systematically searched and supplemented by a secondary screening of the reference lists of all included articles. The PICOS (Population, Intervention, Comparator, Outcomes and Study Design) approach was used to guide the determination of the eligibility criteria. Participants of any age, sex, training, or health status will be considered for inclusion. We will select studies that have measured the bone biomarker response before and after an acute exercise session. All biomarkers considered to represent the bone metabolism will be considered for inclusion, and sensitivity analyses will be conducted using reference biomarkers for the measurement of bone resorption and formation (namely β-CTX-1 and P1NP). Multi-level, meta-regression models within a Bayesian framework will be used to explore the main effect of acute exercise on bone biomarkers as well as potential moderating factors. The risk of bias for each individual study will be evaluated using a modified version of the Downs and Black checklist while certainty in resultant outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
A better understanding of the bone metabolic response to an acute bout of exercise has the potential to advance our understanding of the mechanisms through which this stimulus impacts bone metabolism, including factors that may moderate this response. Additionally, we will identify current gaps in the evidence base and provide recommendations to inform future research.
This protocol was prospectively registered in the Open Science Framework Registry ( https://osf.io/6f8dz ).
骨骼是一种对其物理环境有响应的可塑组织。因此，运动干预代表了一种影响骨骼的潜在手段。然而，目前对于各种运动和参与者特征如何相互作用影响骨代谢知之甚少。急性、受控的干预提供了一个体内模型，通过该模型可以研究运动对骨骼的急性反应，通常通过监测循环骨生物标志物来实现。目前，研究设计、质量、运动和参与者特征等因素存在很大差异，使得难以综合和评估现有证据。本研究采用系统评价和荟萃分析方法，旨在量化急性运动对循环骨生物标志物的影响，并研究可能调节这种反应的潜在因素，例如参与者、运动和采样特征的变化。
本方案根据 PRISMA-P 指南设计。将对 7 个数据库（MEDLINE、Embase、Sport Discus、Cochrane CENTRAL、PEDro、LILACS 和 Ibec）进行系统检索，并对所有纳入文章的参考文献进行二次筛选。使用 PICOS（人群、干预、对照、结局和研究设计）方法来指导确定纳入标准。任何年龄、性别、训练或健康状况的参与者都将被考虑纳入。我们将选择在急性运动前后测量骨生物标志物反应的研究。所有被认为代表骨代谢的生物标志物都将被考虑纳入，并且使用骨吸收和形成的参考生物标志物（即β-CTX-1 和 P1NP）进行敏感性分析。贝叶斯框架内的多水平荟萃回归模型将用于探索急性运动对骨生物标志物的主要影响以及潜在的调节因素。使用改进的 Downs 和 Black 清单评估每个单独研究的偏倚风险，使用推荐评估、制定和评估（GRADE）方法评估结果的确定性。
更好地了解急性运动对骨代谢的反应有可能增进我们对这种刺激影响骨代谢的机制的理解，包括可能调节这种反应的因素。此外，我们将确定现有证据基础中的差距，并提出建议，为未来的研究提供信息。
本方案已在开放科学框架注册库（https://osf.io/6f8dz）中进行了前瞻性注册。
