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高强度抗阻训练对身体机能良好的老年人的骨形成具有短期益处。

Heavy resistance training provides short-term benefits on bone formation in well-functioning older adults.

作者信息

Bloch-Ibenfeldt Mads, Gates Anne Theil, Jørgensen Niklas Rye, Linneberg Allan, Aadahl Mette, Kjær Michael, Boraxbekk Carl-Johan

机构信息

Institute of Sports Medicine Copenhagen (ISMC), Department of Orthopedic Surgery M81, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Denmark; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Institute of Sports Medicine Copenhagen (ISMC), Department of Orthopedic Surgery M81, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Denmark; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

出版信息

Bone. 2025 Apr;193:117393. doi: 10.1016/j.bone.2025.117393. Epub 2025 Jan 18.

Abstract

OBJECTIVES

Maintained bone health is critical for independent living when aging. Currently, multimodal exercise regimes including weight-bearing exercises with impact are prescribed as optimal for maintaining bone health, while there is less consensus on the effects of resistance training at different intensities upon bone. Here we examined whether bone health was positively influenced by 1 year of supervised resistance training at two different intensities.

METHODS

Older adults at retirement age (mean age: 66 ± 3 years, n = 451) were randomized to either 1 year of heavy resistance training (HRT), moderate intensity training (MIT) or a non-exercising control group (CON) in the LISA (LIve active Successful Aging) study. Bone mineral density (BMD) was assessed at whole body level, femoral neck, and the lumbar region of the spine (L1-L4) using Dual-energy X-ray absorptiometry (DXA). Bone degradation and formation were evaluated with blood C-terminal telopeptide of type I collagen (CTX) and procollagen type I N-propeptide (PINP). Dephosphorylated uncarboxylated matrix Gla-protein (dp-ucMGP) was used as a biomarker of functional vitamin K status. Participants were assessed at baseline, immediately following the intervention (year 1), and at longitudinal follow-ups at years 2 and 4. Two-way mixed model ANOVAs were used to assess group differences at all time points.

RESULTS

At the 4-year follow-up n = 329 participants (58 % women) remained in the study. BMD was not influenced by training and decreased across all groups over the 4 years for total body (F = 4.617, p = 0.003, η = 0.01) and femoral neck both in the dominant (F = 45.135, p < 0.001, η = 0.13) and non-dominant leg (F = 33.821, p < 0.001, η = 0.10). Independent of group, CTX increased (F = 47.434, p < 0.001, η = 0.13) over the 4 years. HRT resulted in an increased bone formation (PINP rise) only after the first year with systematic training (t(936) = 3.357, p = 0.04), and it was more pronounced than in CON (t(312) = 2.494, p = 0.04). Plasma dp-ucMGP remained unaltered over time in all groups. In general, women had significantly lower BMD and higher levels of CTX and PINP compared to men.

CONCLUSION

We demonstrated that 1 year of heavy resistance training positively influenced short-term bone formation in well-functioning older adults, although the effect was not maintained at long-term follow ups. These minor changes in bone biomarkers were not reflected in changes in BMD measured with DXA.

TRIAL REGISTRATION

clinicaltrials.gov (NCT02123641).

摘要

目的

随着年龄增长,维持骨骼健康对于独立生活至关重要。目前,包括有冲击性负重运动在内的多模式运动方案被认为是维持骨骼健康的最佳方式,而对于不同强度的阻力训练对骨骼的影响,人们的共识较少。在此,我们研究了在两种不同强度下进行为期1年的有监督阻力训练是否对骨骼健康有积极影响。

方法

在LISA(积极生活成功衰老)研究中,将退休年龄的老年人(平均年龄:66±3岁,n = 451)随机分为三组,分别进行为期1年的高强度阻力训练(HRT)、中等强度训练(MIT)或不运动的对照组(CON)。使用双能X线吸收法(DXA)在全身、股骨颈和脊柱腰段(L1-L4)评估骨密度(BMD)。用血液中I型胶原C末端肽(CTX)和I型前胶原N端前肽(PINP)评估骨降解和形成。去磷酸化未羧化基质Gla蛋白(dp-ucMGP)用作功能性维生素K状态的生物标志物。在基线、干预结束后立即(第1年)以及第2年和第4年的纵向随访时对参与者进行评估。使用双向混合模型方差分析评估所有时间点的组间差异。

结果

在4年随访时,n = 329名参与者(58%为女性)仍在研究中。骨密度不受训练影响,4年中所有组的全身(F = 4.617,p = 0.003,η = 0.01)、优势侧(F = 45.135,p < 0.001,η = 0.13)和非优势侧股骨颈(F = 33.821,p < 0.001,η = 0.10)的骨密度均下降。与组无关,4年中CTX升高(F = 47.434,p < 0.001,η = 0.13)。高强度阻力训练仅在第一年系统训练后导致骨形成增加(PINP升高)(t(936) = 3.357,p = 0.04),且比对照组更明显(t(312) = 2.494,p = 0.04)。所有组血浆dp-ucMGP随时间保持不变。总体而言,女性的骨密度明显低于男性,CTX和PINP水平高于男性。

结论

我们证明,为期1年的高强度阻力训练对功能良好的老年人的短期骨形成有积极影响,尽管在长期随访中这种效果未得到维持。骨生物标志物的这些微小变化未反映在DXA测量的骨密度变化中。

试验注册

clinicaltrials.gov(NCT02123641)

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