运动对青少年骨量和骨代谢的影响:系统回顾和荟萃分析。

IF 3.2 3区 医学 Q2 PHYSIOLOGY
Frontiers in Physiology Pub Date : 2024-12-24 eCollection Date: 2024-01-01 DOI:10.3389/fphys.2024.1512822
Wenhua Zhang, Xiaoqiang Wang, Yurong Liu, Qiang He, Qixin Ding, Jingqi Mei, Xun Li
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引用次数: 0

摘要

目的:采用荟萃分析评价运动干预对青少年骨矿物质含量(BMC)、骨矿物质密度(BMD)和骨代谢的影响。方法:系统检索PubMed、Embase、Cochrane Library和Web of Science,检索截至2024年9月10日关于“运动、青少年、骨密度、骨代谢”的随机对照试验。纳入的rct主要关注运动对10-19岁人群BMC、BMD和骨代谢的影响,以体育活动组为运动组,日常生活/原始运动组为对照组。结局指标包括腰椎、股骨颈、全身BMC和BMD、骨碱性磷酸酶(BALP)、前胶原1n型末端前肽(PINP)、骨钙素(OC)和I型胶原羧基末端肽(CTX)。排除标准包括重复、非随机对照试验、非青少年研究和不符合指标。meta分析采用RevMan 5.4进行,质量评价采用Cochrane工具。使用标准化平均差异(SMDs)和95%置信区间(ci)估计效应大小,并使用i2统计量评估异质性以确定固定或随机效应模型。结果:纳入文献15篇,共723名受试者。荟萃分析显示,与对照组相比,(i)运动能有效提高青少年的整体BMC (SMD = 0.16, 95% CI: 0.06-0.27, p = 0.003)和BMD (SMD = 0.26, 95% CI: 0.13-0.40, p = 0.0001)。(ii)亚组分析显示,运动显著增加青少年腰椎BMC (SMD = 0.17, 95% CI: 0.01 ~ 0.34, p = 0.04)、股骨颈BMC (SMD = 0.23, 95% CI: 0.05 ~ 0.42, p = 0.01)、腰椎BMD (SMD = 0.34, 95% CI: 0.12 ~ 0.56, p = 0.003)、股骨颈BMD (SMD = 0.31, 95% CI: 0.09 ~ 0.53, p = 0.007),而对全身BMC和BMD的影响无统计学意义(p < 0.05)。(iii)运动增加青少年BALP,降低PINP、OC和CTX。但运动组与对照组之间的差异均无统计学意义(p < 0.05)。结论:运动能有效改善青少年整体BMC和骨密度,提高腰椎和股骨颈的BMC和骨密度。由于纳入研究数量和质量的限制,上述结论有待更多高质量实证研究的验证。系统综述注册:https://www.crd.york.ac.uk/,标识符CRD42024593399。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of exercise on bone mass and bone metabolism in adolescents: a systematic review and meta-analysis.

Objective: Meta-analysis was used to evaluate the effects of an exercise intervention on bone mineral content (BMC), bone mineral density (BMD), and bone metabolism in adolescents.

Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science for RCTs on "exercise, adolescents, BMD, bone metabolism" up to 10 September 2024. Included RCTs focused on effects of exercise on BMC, BMD, and bone metabolism in 10-19 years old, with physical activity as exercise group and daily living/primal exercise as control group. Outcome metrics included lumbar spine, femoral neck, whole body BMC and BMD, bone alkaline phosphatase (BALP), procollagen type 1N-terminal propeptide (PINP), osteocalcin (OC), and type I collagen carboxy-terminal peptide (CTX). Exclusion criteria included duplicates, non-RCTs, non-adolescent studies, and non-compliance with indicators. Meta-analyses were performed using RevMan 5.4, and quality assessed by Cochrane's tool. Effect sizes were estimated using standardized mean differences (SMDs) and 95% confidence intervals (CIs), and heterogeneity was assessed using the I 2 statistic to determine fixed or random effects models.

Results: Fifteen articles with a total of 723 subjects were included. The meta-analysis showed that, compared to the control group, (i) exercise was effective in increasing adolescents' overall BMC (SMD = 0.16, 95% CI: 0.06-0.27, p = 0.003) and BMD (SMD = 0.26, 95% CI: 0.13-0.40, p = 0.0001). (ii) Subgroup analyses showed that exercise significantly increased adolescents' lumbar spine BMC (SMD = 0.17, 95% CI: 0.01-0.34, p = 0.04), femoral neck BMC (SMD = 0.23, 95% CI: 0.05-0.42, p = 0.01), lumbar spine BMD (SMD = 0.34, 95% CI: 0.12-0.56, p = 0.003) and femoral neck BMD (SMD = 0.31, 95% CI: 0.09-0.53, p = 0.007), whereas there was no statistically significant effect on whole body BMC and BMD (p > 0.05). (iii) Exercise increased BALP, and decreased PINP, OC and CTX in adolescents. but none of the differences between the exercise groups and the control group were significant (p > 0.05).

Conclusion: Exercise is effective in improving overall BMC and BMD in adolescents and elevating BMC and BMD of the lumbar spine and femoral neck. Due to the limitation of the number and quality of the included studies, the above conclusions are yet to be validated by more high-quality empirical studies.

Systematic review registration: https://www.crd.york.ac.uk/, identifier CRD42024593399.

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来源期刊
CiteScore
6.50
自引率
5.00%
发文量
2608
审稿时长
14 weeks
期刊介绍: Frontiers in Physiology is a leading journal in its field, publishing rigorously peer-reviewed research on the physiology of living systems, from the subcellular and molecular domains to the intact organism, and its interaction with the environment. Field Chief Editor George E. Billman at the Ohio State University Columbus is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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