身体活动和 BMI SDS 对儿童和青少年骨代谢的影响。
Effect of physical activity and BMI SDS on bone metabolism in children and adolescents.
机构信息
Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany.
LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Medical Faculty, Leipzig, Germany.
出版信息
Bone. 2021 Dec;153:116131. doi: 10.1016/j.bone.2021.116131. Epub 2021 Jul 24.
OBJECTIVE
Children with obesity are known to have reduced bone density and are at a higher risk for fractures. This may be caused by decreased physical activity or a metabolic phenomenon. In this study, we evaluated associations of physical activity with bone metabolism in children and adolescents with and without obesity.
METHODS
Results from 574 visits of 397 subjects, 191 girls and 206 boys aged five to 18 years (mean: 11.7 ± 2.8) representing 180 children with (mean BMI SDS 2.5 ± 0.4) and 217 without obesity (mean BMI SDS 0.2 ± 1.0) from the LIFE Child study, a population-based cohort of children/adolescents with normal weight and with obesity were analyzed for the impact of their daily physical activity (MET/day, SenseWear Accelerometer) on serum SDS levels for bone formation (alkaline phosphatase, osteocalcin, procollagen type I N propeptide [P1NP]), bone resorption (beta-crosslaps), and calcium homeostasis (parathormone, OH-25-vitamin D) by a linear regression model adjusted for gender- and age-based differences.
RESULTS
For male subjects, BMI SDS significantly influenced the association of physical activity to PTH, vitamin D, and beta-crosslaps SDS levels. A higher physical activity was accompanied by increased PTH but decreased vitamin D SDS levels in children with normal weight. In males with obesity, all levels remained unaltered. In females, BMI SDS significantly impacted the association of physical activity to PTH, vitamin D, P1NP, beta-crosslaps, and osteocalcin SDS levels. In females with obesity, higher physical activity was related to higher SDS levels of vitamin D, P1NP, and beta-crosslaps. In contrast, in normal weight females, only PTH SDS was higher.
CONCLUSIONS
The effect of daily physical activity on bone metabolic markers and calciotropic hormones depends significantly on gender and BMI SDS. However, higher levels of physical activity were associated with increased bone turnover for female subjects with obesity only. Thus, motivating especially girls with obesity to be physically active may help improve their bone health.
目的
肥胖儿童的骨密度降低，骨折风险更高。这可能是由于体力活动减少或代谢现象所致。在这项研究中，我们评估了肥胖和非肥胖儿童和青少年的体力活动与骨代谢之间的关联。
方法
来自 LIFE Child 研究的 397 名受试者的 574 次就诊结果，其中 191 名女孩和 206 名男孩，年龄 5 至 18 岁（平均：11.7 ± 2.8），代表 180 名肥胖儿童（平均 BMI SDS 2.5 ± 0.4）和 217 名非肥胖儿童（平均 BMI SDS 0.2 ± 1.0）。对来自基于人群的正常体重和肥胖儿童/青少年队列的儿童/青少年的日常体力活动（MET/天，SenseWear 加速度计）对血清 SDS 水平（骨形成标志物：碱性磷酸酶、骨钙素、I 型前胶原 N 端前肽 [P1NP]）、骨吸收标志物（β-胶原交联）和钙稳态标志物（甲状旁腺激素、OH-25-维生素 D）的影响进行了线性回归模型分析，并根据性别和年龄差异进行了调整。
结果
对于男性受试者，BMI SDS 显著影响体力活动与甲状旁腺激素、维生素 D 和β-胶原交联 SDS 水平的相关性。在正常体重的儿童中，较高的体力活动伴随着甲状旁腺激素的增加，但维生素 D SDS 水平降低。在肥胖的男性中，所有水平均保持不变。在女性中，BMI SDS 显著影响体力活动与甲状旁腺激素、维生素 D、P1NP、β-胶原交联和骨钙素 SDS 水平的相关性。在肥胖的女性中，较高的体力活动与维生素 D、P1NP 和β-胶原交联的 SDS 水平升高有关。相比之下，在正常体重的女性中，只有甲状旁腺激素 SDS 较高。
结论
日常体力活动对骨代谢标志物和钙调节激素的影响显著取决于性别和 BMI SDS。然而，只有肥胖女性的体力活动水平较高与骨转换增加有关。因此，激励特别是肥胖的女孩积极运动可能有助于改善她们的骨骼健康。
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