Pageau Annelise G, Burt Lauren A, Gabel Leigh, Boyd Steven K, Whittier Danielle E
McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.
Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.
J Bone Miner Res. 2025 Jul 29. doi: 10.1093/jbmr/zjaf099.
Childhood and adolescence are critical periods for skeletal development in establishing peak bone mass (PBM), an important determinant of lifelong fracture risk. This study investigates the relationship between cumulative physical activity during growth and bone density and microarchitecture attained surrounding PBM. Bone mineral density (BMD) and microarchitecture properties were obtained in 226 individuals (142 females; 84 males) surrounding PBM (aged 18-35 yr) using high resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and tibia, and dual-energy X-ray absorptiometry at the lumbar spine and femoral neck. Physical activity during growth up to peak bone mass was captured with the bone-specific physical activity questionnaire. Spearman's partial correlations, adjusted for age, height, and weight were used to determine sex-specific associations between bone properties and physical activity during growth. Higher physical activity during growth quantified by the bone-specific physical activity questionnaire (gBPAQ) was associated with higher tibia failure load and femoral neck areal BMD, in both sexes (ρ = 0.27-0.38, p ≤ .02). Higher gBPAQ scores were also associated with better trabecular BMD and bone volume fraction at the tibia in both sexes, where associations were stronger in males (ρ = 0.40-0.41, p < .01) than in females (ρ = 0.24-0.26, p < .05). Males additionally had significant associations with trabecular bone microarchitecture properties, including number, separation, and inhomogeneity at both the radius (ρ = 0.30-0.34, p ≤ .01) and tibia (ρ = 0.31-0.42, p ≤ .02). In contrast, gBPAQ scores were not associated with cortical bone properties at PBM for either sex or site. Physical activity during growth is associated with greater BMD and failure load at PBM, 2 predictors of lifelong fracture risk. However, compartment-specific differences indicate that trabecular bone, as opposed to cortical bone, is more responsive to physical activity during growth.
儿童期和青春期是骨骼发育的关键时期，对于建立峰值骨量（PBM）至关重要，而峰值骨量是终生骨折风险的一个重要决定因素。本研究调查了生长期间的累积身体活动与达到峰值骨量时的骨密度和骨微结构之间的关系。使用高分辨率外周定量计算机断层扫描（HR-pQCT）测量了226名处于峰值骨量阶段（年龄18 - 35岁）个体（142名女性；84名男性）桡骨远端和胫骨的骨矿物质密度（BMD）和骨微结构特性，并使用双能X线吸收法测量了腰椎和股骨颈的骨密度。通过特定于骨骼的身体活动问卷收集达到峰值骨量之前生长期间的身体活动情况。采用经年龄、身高和体重校正的斯皮尔曼偏相关分析来确定生长期间骨特性与身体活动之间的性别特异性关联。通过特定于骨骼的身体活动问卷（gBPAQ）量化的生长期间较高的身体活动与较高的胫骨破坏载荷和股骨颈面积骨密度相关，在男女两性中均如此（ρ = 0.27 - 0.38，p≤0.02）。较高的gBPAQ得分还与男女两性胫骨更好的小梁骨密度和骨体积分数相关，其中男性的关联更强（ρ = 0.40 - 0.41，p < 0.01），而女性（ρ = 0.24 - 0.26，p < 0.05）。男性还与小梁骨微结构特性有显著关联，包括桡骨（ρ = 0.30 - 0.34，p≤0.01）和胫骨（ρ = 0.31 - 0.42，p≤0.02）处的数量、间距和不均匀性。相比之下，gBPAQ得分与男女两性在峰值骨量时的皮质骨特性均无关联，无论在哪个部位。生长期间的身体活动与峰值骨量时更高的骨密度和破坏载荷相关，这是终生骨折风险的两个预测指标。然而，不同骨区的差异表明，与皮质骨相反，小梁骨在生长期间对身体活动的反应更敏感。
