Rempe Jakob, Rosengren Björn E, Jehpsson Lars, Swärd Per, Dencker Magnus, Karlsson Magnus K
Department of Orthopedics, Helsingborg Hospital, Lund University, Helsingborg, Sweden.
Clinical and Molecular Osteoporosis Research Unit, Clinical Sciences, Lund University, Malmo, Sweden.
Front Physiol. 2022 Apr 7;13:828508. doi: 10.3389/fphys.2022.828508. eCollection 2022.
Physical activity (PA) increases bone mass, especially in late prepuberty and early puberty, but it remains unclear if and how PA affects both bone formation and bone resorption.
We included 191 boys and 158 girls aged 7.7 ± 0.6 (mean ± SD) in a population-based PA intervention study. The intervention group (123 boys and 94 girls) received daily physical education (PE) in school (40 min/day; 200 min/week) from study start and during the nine compulsory school years in Sweden. The controls (68 boys and 64 girls) received the national standard of 1-2 classes PE/week (60 min/week). During the intervention, blood samples were collected at ages 9.9 ± 0.6 ( = 172; all in Tanner stages 1-2) and 14.8 ± 0.8 ( = 146; all in Tanner stages 3-5) and after termination of the intervention at age 18.8 ± 0.3 ( = 93; all in Tanner stage 5) and 23.5 ± 0.7 ( = 152). In serum, we analyzed bone formation markers [bone-specific alkaline phosphatase (bALP), osteocalcin (OC), and N-terminal propeptide of collagen type 1 (PINP)] and bone resorption markers [C-terminal telopeptide cross links (CTX) and tartrate-resistant acid phosphatase (TRAcP 5b)]. Linear regression was used to compare age and sex-adjusted mean differences between intervention children and controls in these markers.
Two years after the intervention was initiated (at Tanner stages 1-2), we found higher serum levels of bALP and OC, and lower serum levels of TRAcP 5b in the intervention compared with the control group. The mean difference (95% CI) was for bALP: 13.7 (2.1, 25.3) μg/L, OC: 9.1 (0.1, 18.1) μg/L, and TRAcP 5b: -2.3 (-3.9, -0.7) U/L. At Tanner stages 3-5 and after the intervention was terminated, bone turnover markers were similar in the intervention and the control children.
Daily school PA in the late prepubertal and early pubertal periods is associated with higher bone formation and lower bone resorption than school PA 1-2 times/week. In late pubertal and postpubertal periods, bone formation and resorption were similar. Termination of the intervention is not associated with adverse bone turnover, indicating that PA-induced bone mass benefits gained during growth may remain in adulthood.
体育活动（PA）可增加骨量，尤其是在青春发育晚期和青春发育期早期，但PA是否以及如何影响骨形成和骨吸收仍不清楚。
在一项基于人群的PA干预研究中，我们纳入了191名男孩和158名女孩，年龄为7.7±0.6（均值±标准差）。干预组（123名男孩和94名女孩）从研究开始时起以及在瑞典九年义务教育期间，每天在学校接受体育教育（PE）（40分钟/天；200分钟/周）。对照组（68名男孩和64名女孩）接受每周1 - 2节体育课（60分钟/周）的国家标准。在干预期间，分别于9.9±0.6岁（n = 172；均处于坦纳1 - 2期）、14.8±0.8岁（n = 146；均处于坦纳3 - 5期）采集血样，并在18.8±0.3岁（n = 93；均处于坦纳5期）和23.5±0.7岁（n = 152）干预结束后采集血样。在血清中，我们分析了骨形成标志物[骨特异性碱性磷酸酶（bALP）、骨钙素（OC）和I型胶原N端前肽（PINP）]以及骨吸收标志物[C端交联端肽（CTX）和抗酒石酸酸性磷酸酶（TRAcP 5b）]。采用线性回归比较干预组儿童和对照组儿童在这些标志物上经年龄和性别调整后的均值差异。
干预开始两年后（坦纳1 - 2期），我们发现干预组血清bALP和OC水平高于对照组，而TRAcP 5b血清水平低于对照组。均值差异（95%可信区间）为：bALP：13.7（2.1，25.3）μg/L，OC：9.1（0.1，18.1）μg/L，TRAcP 5b： - 2.3（ - 3.9， - 0.7）U/L。在坦纳3 - 5期及干预结束后，可以发现干预组儿童和对照组儿童的骨转换标志物相似。
青春发育晚期和青春发育期早期每天的学校体育活动与每周1 - 2次的学校体育活动相比，可促进更高的骨形成和更低的骨吸收。在青春发育晚期和青春期后，骨形成和骨吸收相似。干预的终止与不良的骨转换无关，这表明在生长过程中PA诱导的骨量增加益处可能会持续到成年期。
