Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America.
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America.
Bone. 2022 Jan;154:116214. doi: 10.1016/j.bone.2021.116214. Epub 2021 Sep 25.
States of chronic overnutrition and undernutrition are both associated with impaired bone health and increased fracture risk but there are no data on bone microarchitecture following short-term controlled nutritional challenges.
The purpose of our study was to evaluate the impact of short-term high-caloric feeding and fasting on bone microarchitecture. We hypothesized that both high-caloric feeding and fasting would have negative effects on microarchitecture.
We recruited 23 adult healthy subjects (13 males, 10 females, mean age 33.2 ± 1.4 years, mean BMI 26.0 ± 1.5 kg/m). Subjects underwent an in-patient 10-day high-caloric visit (caloric intake with goal to achieve 7% weight gain), after which they went home to resume a normal diet for 13-18 days (stabilization period), and were then readmitted for a 10-day in-patient fasting stay (no caloric intake). All subjects underwent HRpQCT (XtremeCT, Scanco Medical AG, Brüttisellen, Switzerland) of the distal tibia and distal radius after each visit to assess volumetric bone mineral density (vBMD), trabecular and cortical microarchitecture, and strength estimates. The Wilcoxon signed rank test was used to perform within group comparisons.
During the high-caloric period, there was a mean increase in weight by 6.3 + 1.7% (p < 0.0001). There were no significant changes in bone parameters in the distal tibia or distal radius (p > 0.05). During the stabilization period there was a significant reduction in weight by -2.7 + 1.9% (p < 0.0001) but no change in bone parameters (p > 0.05). During the fasting period there was a further reduction in weight by -8.8 + 1.2% (p < 0.0001). In the distal tibia, there was a significant increase in total and cortical vBMD, trabecular and cortical parameters as well as strength estimates (p < 0.05). In the distal radius there was an increase in total and trabecular vBMD (p < 0.05), while there were no changes in other microarchitecture parameters or strengths estimates.
Short-term fasting after high-caloric feeding improves vBMD, bone microarchitecture and strength estimates of the distal tibia, while short-term high-caloric feeding does not change vBMD or microarchitecture. These results suggest that short-term fasting after high-caloric feeding in healthy individuals improves bone health and that these changes can be detected using HRpQCT in-vivo.
慢性营养过剩和营养不足状态均与骨健康受损和骨折风险增加有关，但关于短期控制营养挑战后骨微观结构的数据尚缺乏。
本研究旨在评估短期高卡路里喂养和禁食对骨微观结构的影响。我们假设高卡路里喂养和禁食都会对微观结构产生负面影响。
我们招募了 23 名成年健康受试者（13 名男性，10 名女性，平均年龄 33.2 ± 1.4 岁，平均 BMI 26.0 ± 1.5 kg/m2）。受试者接受为期 10 天的住院高卡路里访问（热量摄入目标为体重增加 7%），之后他们回家恢复正常饮食 13-18 天（稳定期），然后再次住院进行为期 10 天的住院禁食（无热量摄入）。所有受试者在每次就诊后均接受 HRpQCT（XtremeCT，Scanco Medical AG，Brüttisellen，瑞士）检查，以评估远端胫骨和桡骨的体积骨密度（vBMD）、小梁和皮质微观结构以及强度估计值。采用 Wilcoxon 符号秩检验进行组内比较。
在高卡路里期间，体重平均增加了 6.3 ± 1.7%（p < 0.0001）。远端胫骨或桡骨的骨参数无显著变化（p > 0.05）。在稳定期，体重显著下降 2.7 ± 1.9%（p < 0.0001），但骨参数无变化（p > 0.05）。在禁食期间，体重进一步下降 8.8 ± 1.2%（p < 0.0001）。在远端胫骨中，总骨密度和皮质骨密度、小梁和皮质参数以及强度估计值均显著增加（p < 0.05）。在远端桡骨中，总骨密度和小梁骨密度增加（p < 0.05），而其他微观结构参数或强度估计值无变化。
高卡路里喂养后短期禁食可改善远端胫骨的 vBMD、骨微观结构和强度估计值，而短期高卡路里喂养不会改变 vBMD 或微观结构。这些结果表明，健康个体在高卡路里喂养后进行短期禁食可改善骨健康，并且这些变化可以通过 HRpQCT 体内检测到。
