Effect of alendronate and exercise on bone and physical performance of postmenopausal women:: a randomized controlled trial
Effect of alendronate and exercise on bone and physical performance of postmenopausal women:: a randomized controlled trial
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DOI：
10.1016/s8756-3282(03)00082-6
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发表时间：
2003-07-01
期刊：
影响因子：
4.1
通讯作者：
Vuori, I
中科院分区：
文献类型：
--
作者：
Uusi-Rasi, K;Kannus, P;Vuori, I
在这项随机、双盲、安慰剂对照的12个月试验中，我们评估了负重跳跃运动和口服阿仑膦酸钠单独或联合对绝经后妇女骨质量和结构、跌倒风险因素（肌肉力量和力量、姿势摇摆和动态平衡）以及心肺功能的影响。共有164名健康、久坐、绝经早期的妇女被随机分配到四个实验组中的一个：（1）每天5 mg阿仑膦酸钠加渐进式跳跃运动，（2）5 mg阿仑膦酸钠，（3）安慰剂加渐进式跳跃运动，或（4）安慰剂。主要终点是12个月时骨量和几何结构（在多个轴向和肢体部位采用双能X线吸收测定法和外周计算机断层扫描测量）以及身体机能的变化;次要终点是骨转换生化标志物的变化。跳跃运动平均每周进行1.6 +/- 0.9（平均值+/- SD）次。阿仑膦酸钠每日一次可有效增加腰椎（阿仑膦酸钠vs安慰剂3.5%; 95% CI，2.2-4.9%）和股骨颈（1.3%; 95% CI，0.2-2.4%）的骨量，但不影响其他骨部位。单独的运动对腰椎或股骨颈的骨量没有影响;在这些骨骼部位，运动与阿仑膦酸钠既没有叠加作用，也没有相互作用。然而，在胫骨远端，与非运动组相比，运动组的截面模量（即骨强度）平均增加3.6%（0.3-7.1%），皮质骨占总骨面积的比例平均增加3.7%（0.1-7.3%），具有统计学显著性，表明运动诱导的骨皮质增厚。仅阿仑膦酸钠组骨转换率降低。阿仑膦酸钠对身体表现没有影响，而跳跃运动改善了腿部伸肌力量、动态平衡和心肺功能。结论阿仑膦酸钠能有效增加腰椎和股骨颈的骨量，而运动能有效增加某些负荷最大的骨部位的骨力学性能，以及改善参与者的肌肉性能和动态平衡。阿仑膦酸钠和运动可以有效地降低骨质疏松性骨折的风险。(C)2003 Elsevier Science（美国）。All rights reserved.
In this randomized, double-blind, placebo-controlled 12-month trial we evaluated effects of weight- bearing jumping exercise and oral alendronate, alone or in combination, on the mass and structure of bone, risk factors for falling (muscle strength and power, postural sway, and dynamic balance), and cardiorespiratory fitness in postmenopausal women. A total of 164 healthy, sedentary, early postmenopausal women were randomly assigned to one of four experimental groups: (1) 5 mg of alendronate daily plus progressive jumping exercise, (2) 5 mg alendronate, (3) placebo plus progressive jumping exercise, or (4) placebo. The primary endpoint was 12-month change in bone mass and geometry (measured with dual-energy X-ray absorptiometry and peripheral computed tomography at several axial and limb sites) and physical performance; the secondary endpoint was change in biochemical markers of bone turnover. The jumping exercise was conducted an average 1.6 +/- 0.9 (mean +/- SD) times a week. Alendronate daily was effective in increasing bone mass at the lumbar spine (alendronate vs placebo 3.5%; 95% CI, 2.2-4.9%) and femoral neck (1.3%; 95% CI, 0.2-2.4%) but did not affect other bone sites. Exercise alone had no effect on bone mass at the lumbar spine or femoral neck; it had neither an additive nor an interactive effect with alendronate at these bone sites. However, at the distal tibia the mean increase of 3.6% (0.3-7.1%) in the section modulus (that is, bone strength) and 3.7% (0.1-7.3%) increase in the ratio of cortical bone to total bone area were statistically significant in the exercise group compared to the nonexercise group, indicating exercise-induced thickening of the bone cortex. Bone turnover was reduced in alendronate groups only. Alendronate had no effect on physical performance while the jumping exercise improved leg extensor power, dynamic balance, and cardiorespiratory fitness. As conclusion Alendronate is effective in increasing bone mass at the lumbar spine and femoral neck, while exercise is effective in increasing the mechanical properties of bone at some of the most loaded bone sites, as well as improving the participants' muscular performance and dynamic balance. Together alendronate and exercise may effectively decrease the risk of osteoporotic fractures. (C) 2003 Elsevier Science (USA). All rights reserved.