绝经后骨骼对间歇性行走训练的反应增加取决于基线骨密度。

Increased response of postmenopausal bone to interval walking training depends on baseline bone mineral density.

机构信息

Departments of Sports Medical Sciences, Shinshu University Graduate School of Medicine, Nagano, Japan.

Department of Anesthesiology and Resuscitology, Shinshu University Graduate School of Medicine, Nagano, Japan.

出版信息

PLoS One. 2024 Sep 5;19(9):e0309936. doi: 10.1371/journal.pone.0309936. eCollection 2024.

DOI:10.1371/journal.pone.0309936

PMID:39236022

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11376574/

Abstract

PURPOSE

To examine the hypothesis that an increase in response of postmenopausal bone to interval walking training (IWT) depends on baseline bone mineral densities (BMDs).

METHODS

Two hundred and thirty-four postmenopausal women (64±5 (SD) yr) with no medication for osteoporosis performed 5-month IWT, repeating fast and slow walking at ≥70% and ~40% peak aerobic capacity, respectively, for 3 minutes each per set, ≥5 sets/day, ≥4 days/week. They were recruited from those who had performed IWT ≥6 months before participating in the study so that their physical fitness and lifestyle-related disease symptoms had almost reached a steady state at the time of their participation. We measured BMDs for the lumbar spine (LS), bilateral femoral neck (FN), and bilateral total hip (TH) by dual-energy X-ray absorptiometry (DXA) before and after the intervention. We used a multiple regression analysis to identify significant independent factors for increasing BMDs after the intervention as baseline physical characteristics, exercise intensity, and exercise time during IWT were the candidates. For any bone site where the independent factor identified was singular, we analyzed the relationship between the identified factor vs increases in BMD after the intervention (ΔBMD) by the locally weighted scatterplot smoothing (LOWESS) method.

RESULTS

Almost all subjects completed the designated protocol with minimal adverse events. We found that significant determinants for increasing BMDs were the baseline BMDs for all bone sites, as well as age and body mass index for TH (all, P<0.02). Furthermore, the LOWESS trendline between ΔBMDs vs the baseline BMDs, divided equally into 10 bins for LS and FN, respectively, showed that ΔBMD responses (Y) were attenuated as the baseline BMDs (X) increased in the lower 4 bins and then showed a flat line (Y = ~0) in the remaining higher 6 bins for LS and FN. When the lower 4 bins and the higher 6 bins of the baseline BMD were pooled, respectively, BMDs significantly increased by 1.8% and 1.0% in the lower groups for LS and FN, respectively (both, P<0.001) while not in the higher groups after the intervention (both, P>0.3).

CONCLUSIONS

IWT may be of benefit with minimal adverse events to postmenopausal women, although the effects were greater in those with lower baseline BMDs.

TRIAL REGISTRATION

UMIN000047428. https://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000047428#.

摘要

目的

检验这样一个假设，即绝经后骨骼对间歇步行训练（IWT）的反应增加取决于基线骨密度（BMD）。

方法

234 名绝经后妇女（64±5（SD）岁）未服用骨质疏松药物，进行了 5 个月的 IWT，分别以≥70%和~40%的峰值有氧能力重复快速和慢速行走，每组各 3 分钟，每天≥5 组，每周≥4 天。她们是从那些在参加研究之前已经进行了至少 6 个月 IWT 的人中招募的，因此在参加研究时，她们的身体素质和与生活方式相关的疾病症状几乎已经达到稳定状态。我们使用双能 X 射线吸收法（DXA）在干预前后测量了腰椎（LS）、双侧股骨颈（FN）和双侧总髋（TH）的 BMD。我们使用多元回归分析来确定干预后 BMD 增加的显著独立因素，因为干预期间的基线身体特征、运动强度和运动时间是候选因素。对于任何确定的单一独立因素的骨部位，我们通过局部加权散点平滑（LOWESS）方法分析了确定因素与干预后 BMD 增加（ΔBMD）之间的关系。

结果

几乎所有受试者都完成了规定的方案，只有极少数不良反应。我们发现，所有骨部位的 BMD 增加的显著决定因素是所有骨部位的基线 BMD，以及 TH 的年龄和体重指数（均 P<0.02）。此外，LS 和 FN 的 LOWESS 趋势线分别将ΔBMD 与基线 BMD 之间的关系划分为 10 个等距的箱，表明 LS 和 FN 的较低 4 个箱中，ΔBMD 反应（Y）随着基线 BMD（X）的增加而减弱，而在剩下的较高 6 个箱中，Y 为~0）。当将基线 BMD 的较低 4 个箱和较高 6 个箱分别合并时，LS 和 FN 的较低组的 BMD 分别显著增加 1.8%和 1.0%（均 P<0.001），而干预后较高组的 BMD 没有增加（均 P>0.3）。