Välimäki M J, Kärkkäinen M, Lamberg-Allardt C, Laitinen K, Alhava E, Heikkinen J, Impivaara O, Mäkelä P, Palmgren J, Seppänen R
Department of Medicine, Helsinki University Central Hospital, Finland.
BMJ. 1994 Jul 23;309(6949):230-5. doi: 10.1136/bmj.309.6949.230.
To evaluate the contribution to peak bone mass of exercise, smoking, and calcium intake in adolescents and young adults.
Prospective cohort study with end point measurement (bone mineral density) after 11 years' follow up for lifestyle.
Five university hospital clinics.
264 (153 females, 111 males) subjects aged 9 to 18 years at the beginning of the follow up and 20 to 29 years at the time of measurement of bone mineral density.
Bone mineral density of lumbar spine and femoral neck by dual energy x ray absorptiometry; measures of physical activity and smoking and estimates of calcium intake repeated three times during follow up.
In the groups with the lowest and highest levels of exercise the femoral bone mineral densities (adjusted for age and weight) were 0.918 and 0.988 g/cm2 for women (P = 0.015, analysis of covariance) and 0.943 and 1.042 g/cm2 for men (P = 0.005), respectively; at the lumbar spine the respective values were 1.045 and 1.131 (P = 0.005) for men. In men the femoral bone mineral densities (adjusted for age, weight, and exercise) were 1.022 and 0.923 g/cm2 for the groups with the lowest and highest values of smoking index (P = 0.054, analysis of covariance). In women the adjusted femoral bone mineral density increased by 4.7% together with increasing calcium intake (P = 0.089, analysis of covariance). In multiple regression analysis on bone mineral density of the femoral neck, weight, exercise, age, and smoking were independent predictors for men; with weight, exercise, and age for women. These predictors together explained 38% of the variance in bone mineral density in women and 46% in men. At the lumbar spine, weight, smoking, and exercise were predictors for men; and only weight for women.
Regular exercise and not smoking is important in achieving maximal peak bone mass in adolescents and young adults.
评估运动、吸烟和钙摄入量对青少年及年轻成年人峰值骨量的影响。
前瞻性队列研究，对生活方式进行11年随访后测量终点指标（骨密度）。
五家大学医院诊所。
随访开始时年龄为9至18岁，测量骨密度时年龄为20至29岁的264名受试者（153名女性，111名男性）。
采用双能X线吸收法测量腰椎和股骨颈的骨密度；随访期间三次重复测量身体活动、吸烟情况及钙摄入量。
运动水平最低组和最高组中，女性股骨骨密度（校正年龄和体重后）分别为0.918 g/cm²和0.988 g/cm²（协方差分析，P = 0.015），男性分别为0.943 g/cm²和1.042 g/cm²（P = 0.005）；腰椎处男性相应值分别为1.045和1.131（P = 0.005）。男性中，吸烟指数最低组和最高组的股骨骨密度（校正年龄、体重和运动后）分别为1.022 g/cm²和0.923 g/cm²（协方差分析，P = 0.054）。女性中，校正后的股骨骨密度随钙摄入量增加而升高4.7%（协方差分析，P = 0.089）。在股骨颈骨密度的多元回归分析中，体重、运动、年龄和吸烟是男性的独立预测因素；女性的预测因素为体重、运动和年龄。这些预测因素共同解释了女性骨密度变化的38%和男性的46%。在腰椎处，体重、吸烟和运动是男性的预测因素；女性仅体重是预测因素。
规律运动和不吸烟对青少年及年轻成年人达到最大峰值骨量很重要。
