School of Education, Department of Health Promotion, Sport and Leisure Studies, University of Iceland, 101 Reykjavik, Iceland.
Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC H3H 2R9, Canada.
J Bone Miner Res. 2024 Apr 19;39(3):231-240. doi: 10.1093/jbmr/zjae004.
Sedentary behavior (SB) or sitting is associated with multiple unfavorable health outcomes. Bone tissue responds to imposed gravitational and muscular strain with there being some evidence suggesting a causal link between SB and poor bone health. However, there are no population-based data on the longitudinal relationship between SB, bone change, and incidence of fragility fractures. This study aimed to examine the associations of sitting/SB (defined as daily sitting time), areal BMD (by DXA), and incident low trauma (fragility) osteoporotic fractures (excluding hands, feet, face, and head). We measured baseline (1995-7) and 10-yr self-reported SB, femoral neck (FN), total hip (TH), and lumbar spine (L1-L4) BMD in 5708 women and 2564 men aged 25 to 80+ yr from the population-based, nationwide, 9-center Canadian Multicentre Osteoporosis Study. Incident 10-yr fragility fracture data were obtained from 4624 participants; >80% of fractures were objectively confirmed by medical records or radiology reports. Vertebral fractures were confirmed by qualitative morphological methods. All analyses were stratified by sex. Multivariable regression models assessed SB-BMD relationships; Cox proportional models were fit for fracture risk. Models were adjusted for age, height, BMI, physical activity, and sex-specific covariates. Women in third/fourth quartiles had lower adjusted FN BMD versus women with the least SB (first quartile); women in the SB third quartile had lower adjusted TH BMD. Men in the SB third quartile had lower adjusted FN BMD than those in SB first quartile. Neither baseline nor stable 10-yr SB was related to BMD change nor to incident fragility fractures. Increased sitting (SB) in this large, population-based cohort was associated with lower baseline FN BMD. Stable SB was not associated with 10-yr BMD loss nor increased fragility fracture. In conclusion, habitual adult SB was not associated with subsequent loss of BMD nor increased risk of fracture.
久坐行为（SB）或坐姿与多种不良健康结果相关。骨骼组织会对施加的重力和肌肉张力做出反应，有一些证据表明 SB 与骨骼健康状况不佳之间存在因果关系。然而，目前还没有关于 SB、骨变化和脆性骨折发生率之间的纵向关系的基于人群的数据。本研究旨在检查久坐/ SB（定义为每日坐姿时间）、面积骨密度（通过 DXA）和新发低创伤（脆性）骨质疏松性骨折（不包括手、脚、面部和头部）之间的关联。我们测量了基线（1995-7 年）和 10 年的自我报告的 SB、股骨颈（FN）、全髋关节（TH）和腰椎（L1-L4）骨密度，参与者来自于人群基础、全国性、9 中心加拿大骨质疏松症多中心研究的 5708 名女性和 2564 名 25 岁至 80 岁以上的男性。10 年新发脆性骨折数据来自 4624 名参与者；超过 80%的骨折通过病历或放射学报告得到客观确认。椎体骨折通过定性形态学方法确认。所有分析均按性别分层。多变量回归模型评估 SB-骨密度关系；使用 Cox 比例风险模型拟合骨折风险。模型根据年龄、身高、BMI、体力活动和性别特异性协变量进行调整。与 SB 最少（第一四分位）的女性相比，第三/四分位的女性 FN 骨密度调整后较低；SB 第三四分位的女性 TH 骨密度调整后较低。与 SB 第一四分位的男性相比，SB 第三四分位的男性 FN 骨密度调整后较低。基线或稳定的 10 年 SB 与骨密度变化或脆性骨折发生率均无关。在这个大型人群队列中，久坐时间增加与基线 FN 骨密度较低有关。稳定的 SB 与 10 年的骨密度损失或脆性骨折发生率增加无关。总之，习惯性成人 SB 与随后的骨密度丢失或骨折风险增加无关。
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