Effect of Aerobic or Resistance Exercise, or Both, on Bone Mineral Density and Bone Metabolism in Obese Older Adults While Dieting: A Randomized Controlled Trial
Effect of Aerobic or Resistance Exercise, or Both, on Bone Mineral Density and Bone Metabolism in Obese Older Adults While Dieting: A Randomized Controlled Trial
复制标题
DOI：
10.1002/jbmr.3905
复制
发表时间：
2019-12-04
影响因子：
6.2
通讯作者：
Villareal, Dennis T.
中科院分区：
文献类型：
--
作者：
Armamento-Villareal, Reina;Aguirre, Lina;Villareal, Dennis T.
肥胖老年人的减肥治疗受到体重减轻引起的骨矿物质密度（BMD）降低的限制，这可能加剧持续的年龄相关性骨丢失并增加骨折的风险。因此，建议肥胖老年人的减肥治疗应包括干预措施，如定期运动，以减少伴随的骨丢失。然而，在老年人群中，最适合联合收割机与减肥治疗相结合的运动类型尚不清楚。在一项随机对照试验中，我们对160名肥胖老年人在匹配的10%体重减轻期间进行了有氧运动或阻力运动或两者兼而有之的头对头比较。我们测量了BMD（全髋关节、股骨颈、转子、转子间、三分之一半径、腰椎）和骨标记物的变化。使用混合模型重复测量方差分析来分析组间变化。经过6个月的强化生活方式干预后，阻力组（-0.006 g/cm（2）[-0.7%]）和联合组（-0.012 g/cm（2）[-1.1%]）的BMD下降幅度小于有氧组（-0.027 g/cm（2）[-2.6%]）（组间比较p = 0.001）。有氧运动组的血清C-端肽、1型前胶原N-前肽和骨钙素浓度（分别为33%、16%和16%）比抵抗组（分别为7%、2%和0%）和联合治疗组（分别为11%、2%和5%）增加更多（组间比较p = 0.004至0.048）。多元回归分析显示，全身质量和血清瘦素的下降是髋部BMD下降的独立预测因素（多元R = 0.45 [p <0.001]）。这些结果表明，与有氧运动相比，阻力和有氧和阻力联合运动与体重减轻引起的髋部BMD降低和体重减轻引起的骨转换增加较少相关。因此，在老年肥胖症患者的减肥治疗过程中，可以推荐抗阻运动和有氧运动与抗阻运动相结合来防止骨质流失。（LITOE ClinicalTrials.gov编号NCT 01065636。）(c)2019年美国骨与矿物质研究学会。发布于2019年。本条目属于美国政府作品，在美国属于公有领域。
Weight loss therapy of older adults with obesity is limited by weight loss-induced decrease in bone mineral density (BMD), which could exacerbate ongoing age-related bone loss and increase the risk for fractures. Therefore, it is recommended that weight loss therapy of older adults with obesity should include an intervention such as regular exercise to reduce the concomitant bone loss. However, the most appropriate exercise types to combine with weight loss therapy in this older population is unknown. In a randomized controlled trial, we performed a head-to-head comparison of aerobic or resistance exercise, or both, during matched 10% weight loss in 160 older adults with obesity. We measured changes in BMD (total hip, femoral neck, trochanter, intertrochanter, one-third radius, lumbar spine) and bone markers. Changes between groups were analyzed using mixed-model repeated measures analyses of variance. After 6 months of intensive lifestyle interventions, BMD decreased less in the resistance group (-0.006 g/cm(2) [-0.7%]) and combination group (-0.012 g/cm(2) [-1.1%]) than in the aerobic group (-0.027 g/cm(2) [-2.6%]) (p = 0.001 for between-group comparisons). Serum C-telopeptide, procollagen type 1 N-propeptide, and osteocalcin concentrations increased more in the aerobic group (33%, 16%, and 16%, respectively) than in the resistance group (7%, 2%, and 0%, respectively) and combination group (11%, 2%, and 5%, respectively) (p = 0.004 to 0.048 for between-group comparisons). Multiple regression analyses revealed that the decline in whole body mass and serum leptin were the independent predictors of the decline in hip BMD (multiple R = 0.45 [p < .001]). These findings indicate that compared with aerobic exercise, resistance and combined aerobic and resistance exercise are associated with less weight loss-induced decrease in hip BMD and less weight loss-induced increase in bone turnover. Therefore, both resistance and combined aerobic and resistance exercise can be recommended to protect against bone loss during weight loss therapy of older adults with obesity. (LITOE ClinicalTrials.gov number NCT01065636.) (c) 2019 American Society for Bone and Mineral Research. Published 2019. This article is a U.S. Government work and is in the public domain in the USA.