Brahm H, Mallmin H, Michaëlsson K, Ström H, Ljunghall S
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Calcif Tissue Int. 1998 May;62(5):400-12. doi: 10.1007/s002239900452.
Lifetime occupational and leisure time activities were assessed by a questionnaire in order to evaluate their relationship to bone mass measurements and biochemical markers of bone metabolism in a population of 61 women and 61 men, randomly selected from a Swedish population register, to represent ages between 22 and 85 years. We also considered possible confounders by using questions about smoking habits, milk consumption, hormone replacement therapy (HRT), and menopausal age. Bone mineral density (BMD) and bone mineral content (bone mass, BMC) of the total body, lumbar spine, and proximal femur (neck, trochanter, Ward's triangle) were measured by dual energy X-ray absorptiometry (DXA), and BMD of the forearm with single energy X-ray absorptiometry (SXA). In addition, both DXA and SXA provided information on bone area. Quantitative ultrasound measurements (QUS) at the heel were performed to assess the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Fasting blood samples were analyzed for biochemical markers of bone metabolism as well as parathyroid hormone (PTH) and total serum calcium. After adjustment for confounding factors, neither BMD nor QUS measurements were consistently related to lifetime leisure time or occupational activities; nor were there any consistent patterns relating biochemical markers of bone metabolism to bone mass measurements. However, physical activity seemed to influence bone mass, area, and width more than density. In men, high levels of leisure time activity were associated with raised values for lumbar spine area (6.2%) and width (3.3%) as well as for femoral neck area (5.5%) compared with their low activity counterpart. Men exposed to high levels of occupational activity demonstrated lower lumbar spine BMD (10.9%) and area (5.3%) than men with low activity levels. Within an unselected Swedish population, estimation of lifetime occupational and sport activities as well as bedrest, using a questionnaire, demonstrated no major effects on bone density. However, the association between high levels of lifetime activity and raised values for bone mass, area, and width indicate that geometrical changes in bone may provide better estimations of mechanically induced bone strength than bone density, at least in men.
通过问卷调查评估了一生的职业和休闲活动，以评估其与61名女性和61名男性骨量测量值及骨代谢生化标志物之间的关系。这些人从瑞典人口登记册中随机选取，年龄在22至85岁之间。我们还通过询问吸烟习惯、牛奶摄入量、激素替代疗法（HRT）和绝经年龄等问题来考虑可能的混杂因素。采用双能X线吸收法（DXA）测量全身、腰椎和股骨近端（颈部、大转子、Ward三角）的骨密度（BMD）和骨矿物质含量（骨量，BMC），采用单能X线吸收法（SXA）测量前臂的BMD。此外，DXA和SXA都提供了骨面积信息。在足跟进行定量超声测量（QUS）以评估声速（SOS）和宽带超声衰减（BUA）。采集空腹血样分析骨代谢生化标志物以及甲状旁腺激素（PTH）和总血清钙。在对混杂因素进行调整后，BMD和QUS测量值与一生的休闲活动或职业活动均无一致的关联；骨代谢生化标志物与骨量测量值之间也没有任何一致的模式。然而，身体活动似乎对骨量、骨面积和骨宽度的影响大于对骨密度的影响。在男性中，与低活动水平的男性相比，高水平的休闲活动与腰椎面积（6.2%）、宽度（3.3%）以及股骨颈面积（5.5%）的升高有关。从事高水平职业活动的男性腰椎BMD（10.9%）和面积（5.3%）低于低活动水平的男性。在未经过选择的瑞典人群中，通过问卷调查评估一生的职业和体育活动以及卧床休息情况，结果显示对骨密度没有重大影响。然而，高水平的一生活动与骨量、骨面积和骨宽度升高之间的关联表明，至少在男性中，骨的几何变化可能比骨密度更能准确估计机械诱导的骨强度。
