Ito Eri, Sato Yuiko, Kobayashi Tami, Soma Tomoya, Matsumoto Tatsuaki, Kimura Atushi, Miyamoto Kana, Matsumoto Hideo, Matsumoto Morio, Nakamura Masaya, Sato Kazuki, Miyamoto Takeshi
Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinano-Machi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.
J Bone Miner Metab. 2023 Mar;41(2):182-192. doi: 10.1007/s00774-023-01413-2. Epub 2023 Mar 13.
In women, the female athlete triad, marked by low energy availability, functional hypothalamic amenorrhea and osteoporosis, is a recognized risk for stress fractures. Stress injuries also occur in men, but by contrast risks and mechanisms underlying them are less characterized.
5 week-old wild-type male mice were fed ad libitum (ad) or subjected to 60% food restriction (FR) for five weeks. In both groups, some mice were allowed access to an exercise wheel in cages to allow voluntary wheel running (ex) and/or treated with active vitamin D analogues. Mice were sacrificed and analyzed at 10 weeks of age.
Male FR mice exhibited significantly reduced testicle weight, serum testosterone levels and bone mass. Such bone losses in FR male mice were enhanced by exercise. Histological analysis revealed that both bone-resorbing and -forming activities were significantly reduced in FR or FR plus exercise (FR + ex) mice, mimicking a state of low bone turnover. Significantly reduced bone mass in FR or FR + ex male mice was significantly rescued by treatment with active vitamin D analogues, with significant restoration of osteoblastic activities. Serum levels of insulin-like growth factor I (IGF-I), which is critical for bone remodeling, were significantly lower in FR versus control male mice.
Low energy availability puts men at risk for stress injuries as well, and low energy availability is upstream of gonadal dysfunction and osteoporosis in males. Active vitamin D analogues could serve as therapeutic or preventive options for stress injuries in men.
在女性中,以能量供应不足、功能性下丘脑性闭经和骨质疏松为特征的女性运动员三联征是公认的应力性骨折风险因素。男性也会发生应力性损伤,但相比之下,其潜在风险和机制的特征描述较少。
对5周龄的野生型雄性小鼠随意喂食(ad)或进行为期5周的60%食物限制(FR)。在两组中,一些小鼠可以使用笼中的运动轮进行自愿轮转运动(ex)和/或用活性维生素D类似物进行处理。在10周龄时处死小鼠并进行分析。
FR雄性小鼠的睾丸重量、血清睾酮水平和骨量显著降低。运动加剧了FR雄性小鼠的这种骨质流失。组织学分析显示,FR或FR加运动(FR+ex)小鼠的骨吸收和成骨活性均显著降低,类似于低骨转换状态。用活性维生素D类似物治疗可显著挽救FR或FR+ex雄性小鼠显著降低的骨量,并显著恢复成骨活性。对于骨重塑至关重要的胰岛素样生长因子I(IGF-I)的血清水平,FR雄性小鼠明显低于对照雄性小鼠。
能量供应不足也会使男性面临应力性损伤风险,并且能量供应不足是男性性腺功能障碍和骨质疏松的上游因素。活性维生素D类似物可作为男性应力性损伤的治疗或预防选择。