摘要
目的观察强化运动、不同维生素D制剂和钙剂补充对绝经后骨质疏松高危人群肌力及骨折的影响。方法纳入北京市东城区绝经后女性614名,具有骨质疏松高危因素,随机分为4组:(1)A组(n=173):对照组;(2)B组(n=171):强化运动组;(3)C组(n=139):给予元素钙600 mg/d+普通维生素D 800 U/d;(4)D组(n=131):给予元素钙600 mg/d+25羟基维生素D(25OHD)0.25μg/d。随访2年,测定基线、随访1年及2年肌力,测定基线及随访2年骨转换指标;记录跌倒及新发骨折次数。结果 92.6%的受试者基线血清25OHD<50 nmol/L。与基线水平比较,A组在随访2年时左手握力(t=-3.252,P=0.001)较基线显著降低,B组1年时右手握力明显下降(t=2.460,P=0.015),C组1年时左手握力显著升高(t=-2.051,P=0.043),D组2年随访中双手握力均无统计学变化(P均>0.05)。随访2年时,A(t=-2.962,P=0.004)、B(t=-2.888,P=0.005)、C组(t=-2.441,P=0.016))血清Ⅰ型前胶原氨基末端前肽水平显著高于基线,B(t=2.285,P=0.024)、D组(t=2.596,P=0.011)Ⅰ型胶原交联羧基末端肽水平显著低于基线。结论强化运动及补充钙和25OHD可能有利于维持改善绝经后女性肌力,补充钙和维生素D可能短期内改善绝经后女性肌力。
Objective To observe the effects of enhanced exercise and combined vitamin D and calcium supplementation on muscular strength and fracture occurrence in postmenopausal women with a high risk of osteoporosis. Methods Totally 614 postmenopausal women at high risk factors of osteoporosis were enrolled in Dongcheng district of Beijing and randomized into four groups： group A（control group,n = 173）,group B（regular Tai Chi exercise,n = 171）,group C（calcium 600 mg/d ＋ Vit D3800 U/d,n = 139）,and group D[calcium 600 mg/d ＋ 25 hydroxyl vitamin D（25OHD） 0. 25 μg/d,n = 131]. Muscular strength was measured at baseline and one and two years after intervention. Bone turnover markers were measured at baseline and during the two-year follow-up. Falls and fractures were recorded. Results The incidence of 25 OHD 50 nmol/L was approximately 92. 6%. During the follow-up,the left grip strength decreased significantly two years after intervention（t =-3. 252,P = 0. 001） in group A. Right grip strength decreased significantly in group B（t = 2. 460,P = 0. 015） while left grip strength improved significantly in group C（t =-2. 051,P = 0. 043） one year after intervention. In group D,muscular strength in both 12-month and 24-month did not change compared with baseline（both P〈0. 05）. Furthermore,serum procollagen type I N-terminal propeptide elevated significantly in group A（t =-2. 962,P = 0. 004）,group B（t =-2. 888,P = 0. 005）,and group C（t =-2. 441,P =0. 016）,whereas β-C-terminal telopeptide of type I collagen decreased significantly in group B（t = 2. 285,P = 0. 024） and group D（t = 2. 596,P = 0. 011） two years after intervention. Conclusion Enhanced exercise and combined calcium vitamin D supplementation may help sustain muscle strength in postmenopausal women,while calcium and vitamin D supplementation may improve muscular strength within a short period of time.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2017年第3期345-351,共7页
Acta Academiae Medicinae Sinicae
基金
国家科技支撑计划(2006BAI02B03)
国家自然科学基金青年基金(81100559)
国家自然科学基金面上项目(81270873)
国家临床重点专科建设项目(WBYZ2011-873)~~
关键词
维生素D
绝经后女性
强化运动
肌力
骨折
vitamin D
postmenopausal women
enhanced exercise
muscular strength
fracture
