Physical Activity Throughout Adolescence and Peak Hip Strength in Young Adults
Physical Activity Throughout Adolescence and Peak Hip Strength in Young Adults
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DOI：
10.1001/jamanetworkopen.2020.13463
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发表时间：
2020-08-17
影响因子：
13.8
通讯作者：
Lawlor, Deborah A.
中科院分区：
文献类型：
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作者：
Elhakeem, Ahmed;Heron, Jon;Lawlor, Deborah A.
问题：在整个青春期，中等强度到高强度和低强度的体力活动所花费的时间是否与年轻成年男性和女性的髋关节力量的临床标志物相关？结果在这项队列研究中，2569名年轻人从12岁开始接受重复的加速计评估，在青春期花费更多的时间在中等到高强度的体力活动与25岁时更大的髋部骨密度相关，而花费更多的时间在轻强度体力活动与25岁时的骨密度无关。研究结果表明，在生命早期高强度的体力活动可能是重要的最大化峰值成人髋关节力量和预防骨质疏松症在以后的生活。重要性峰值骨强度，发生在成年早期，是未来骨质疏松症风险的重要标志。因此，重要的是要确定与达到峰值髋关节力量相关的可改变的早期生活因素。目的探讨青少年期中、高强度和低强度体力活动时间与成年期峰值髋关节力量的关系。设计，设置，和参与者雅芳纵向研究的父母和孩子是一个前瞻性的出生队列研究，最初招募的所有孕妇居住在集水区的3个卫生当局在英格兰西南部谁有一个预期的分娩日期之间的1991年4月1日，1992年12月31日。总共有15 454名合格孕妇入组，分娩了15 589名婴儿。其中，14901名婴儿在1岁时存活。本分析检查了2569名健康后代，这些后代在至少1个年龄（12岁、14岁、16岁和/或25岁）的临床评估期间获得了有效的身体活动测量值，进行了多达4次重复的加速度计评估（每次年龄相关临床访视1次）。数据分析时间为2019年6月至2020年6月。暴露轨迹的加速度计评估的时间花费在中度到剧烈强度和轻强度的体力活动，在12岁，14岁，16岁，和25岁（测量每天分钟）使用潜在轨迹模型进行了识别。使用每分钟加速度计数的既定阈值来确定中等强度到剧烈强度和轻强度的体力活动。主要结果和测量方法通过髋关节双能X线吸收测量扫描评估25岁时股骨颈骨矿物质密度（BMD;以g/cm 2测量）。结果共有2569名参与者（1588名女性参与者[62%]）被纳入分析。男性参与者在每个年龄段都花更多的时间进行中等强度到高强度的活动，并且比女性参与者有更大的成年股骨颈BMD。对于每种性别，确定了3个中度至重度轨迹亚组和3个轻度轨迹亚组。关于中度到剧烈强度的轨迹，大多数男性参与者（85%）处于低青少年亚组，只有6%和9%分别处于高青少年早期和高青少年中期亚组。女性受试者的中度至剧烈强度轨迹分为低血糖-低成人（73%）、低血糖-高成人（8%）和高青少年（19%）亚组。光强度的体力活动轨迹分为低非线性，中度下降，高下降的两种性别的亚组。与低青春期（参考）亚组相比，男性参与者的股骨颈BMD在高青春期早期亚组（0.38 g/cm（2）; 95% CI，0.11 - 0.66 g/cm（2））和高青春期中期亚组（0.33 g/cm（2）; 95% CI，0.07 - 0.60 g/cm（2））中更高。与低血糖-低成人（参考）亚组相比，高血糖青少年亚组中女性受试者的股骨颈BMD更高（0.28 g/cm（2）; 95% CI，0.15 - 0.41 g/cm（2）），但低血糖-高血糖成人亚组中女性受试者的股骨颈BMD不高（-0.12 g/cm（2）; 95% CI，-0.44至0.20 g/cm（2））。一项敏感性分析使用阴性结果控制变量来探索未测量的混杂因素，该分析支持这些发现。例如，股骨颈BMD在高下降和低非线性亚组之间的差异为0.16 g/cm（2）（95% CI，-0.08至0.40 g/cm（2）），女性受试者为0.20 g/cm（2）（95% CI，-0.05至0.44 g/cm（2））。结论和相关性在生命早期支持高强度的体力活动可能有助于最大限度地提高峰值髋关节力量，并预防晚年的骨质疏松症。在独立研究中重复我们的发现将是重要的。这项来自雅芳父母和儿童纵向研究的健康后代的队列研究考察了整个青春期中等强度到高强度和低强度体力活动的时间与成年期峰值髋关节力量的关联。
Question Is the amount of time spent in moderate to vigorous-intensity and light-intensity physical activity throughout adolescence associated with a clinical marker of hip strength in young adult men and women? Findings In this cohort study of 2569 young people who received repeated accelerometer assessments beginning at age 12 years, more time spent in moderate to vigorous-intensity physical activity in adolescence was associated with greater hip bone mineral density at age 25 years, whereas more time spent in light-intensity physical activity was not associated with bone mineral density at age 25 years. Meaning The findings indicate that higher-intensity physical activity in early life may be important for maximizing peak adult hip strength and protecting against osteoporosis in later life.Importance Peak bone strength, which occurs in early adulthood, is an important marker of the future risk of osteoporosis. It is therefore important to identify modifiable early life factors that are associated with the attainment of peak hip strength. Objective To investigate the association of time spent in moderate to vigorous-intensity and light-intensity physical activity throughout adolescence with peak hip strength in adulthood. Design, Setting, and Participants The Avon Longitudinal Study of Parents and Children is a prospective birth cohort study that initially recruited all pregnant women residing within the catchment area of 3 health authorities in southwest England who had an expected delivery date between April 1, 1991, and December 31, 1992. In total, 15 454 eligible pregnant women were enrolled, and 15 589 infants were delivered. Of those, 14 901 infants were alive at age 1 year. The present analysis examined 2569 healthy offspring who had valid physical activity measurements obtained during a clinical assessment for at least 1 age (12, 14, 16, and/or 25 years), with up to 4 repeated accelerometer assessments performed (1 per age-associated clinical visit). Data were analyzed from June 2019 to June 2020. Exposures Trajectories of accelerometer-assessed time spent in moderate to vigorous-intensity and light-intensity physical activity at ages 12, 14, 16, and 25 years (measured in minutes per day) were identified using latent trajectory modeling. Moderate to vigorous-intensity and light-intensity physical activity were determined using established thresholds of acceleration counts per minute. Main Outcomes and Measures Femur neck bone mineral density (BMD; measured in g/cm(2)) at age 25 years assessed by dual-energy radiography absorptiometry scans of the hip. Results A total of 2569 participants (1588 female participants [62%]) were included in the analysis. Male participants spent more time in moderate to vigorous-intensity activity at each age and had greater adult femur neck BMD than female participants. For each sex, 3 moderate to vigorous-intensity trajectory subgroups and 3 light-intensity trajectory subgroups were identified. With regard to the moderate to vigorous-intensity trajectories, most male participants (85%) were in the low adolescent subgroup, with only 6% and 9% in the high early-adolescent and high mid-adolescent subgroups, respectively. Moderate to vigorous-intensity trajectories in female participants were divided into low adolescent-low adult (73%), low adolescent-high adult (8%), and high adolescent (19%) subgroups. Light-intensity physical activity trajectories were classified into low nonlinear, moderate decreasing, and high decreasing subgroups for both sexes. Femur neck BMD in male participants was greater in the high early-adolescent subgroup (0.38 g/cm(2); 95% CI, 0.11-0.66 g/cm(2)) and the high mid-adolescent subgroup (0.33 g/cm(2); 95% CI, 0.07-0.60 g/cm(2)) compared with the low adolescent (reference) subgroup. Femur neck BMD in female participants was greater in the high adolescent subgroup (0.28 g/cm(2); 95% CI, 0.15-0.41 g/cm(2)) but not in the low adolescent-high adult subgroup (-0.12 g/cm(2); 95% CI, -0.44 to 0.20 g/cm(2)) compared with the low adolescent-low adult (reference) subgroup. A sensitivity analysis using a negative-outcome control variable to explore unmeasured confounding supported these findings.The light-intensity trajectories were not associated with femur neck BMD; for example, differences in femur neck BMD between the high decreasing and low nonlinear subgroups were 0.16 g/cm(2)(95% CI, -0.08 to 0.40 g/cm(2)) in male participants and 0.20 g/cm(2)(95% CI, -0.05 to 0.44 g/cm(2)) in female participants. Conclusions and Relevance Supporting high-intensity physical activity throughout early life may help to maximize peak hip strength and prevent osteoporosis in later life. Replication of our findings in independent studies will be important.This cohort study of healthy offspring from the Avon Longitudinal Study of Parents and Children examines the association of time spent in moderate to vigorous-intensity and light-intensity physical activity throughout adolescence with peak hip strength in adulthood.