Anabolic Versus Catabolic Skeletal Effects of Endurance or Resistance Exercise in Older Veterans

老年退伍军人耐力或抗阻运动的合成代谢与分解代谢骨骼效应

• 批准号: 10420843
• 负责人: Sarah J Wherry
• 金额: --
• 依托单位: VA EASTERN COLORADO HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10420843
• 关键词: Acute; Address; Adult; Aging; Award; Biological Markers; Blood specimen; Bone Density; Bone Resorption; C-telopeptide; Calcium; Calcium ion; Chronic; Collagen Type I; Cyclophosphamide; Data; Disabled Persons; Dose; Elderly; Exercise; Exercise Test; Forteo; Frequencies; Future; Glean; Health; Hip Fractures; Homeostasis; Hormones; Hour; Intervention; Knowledge; Lead; Measures; Mentors; N-terminal; Osteogenesis; Osteoporosis; Outcome; PTH gene; Participant; Physical Performance; Population; Procollagen; Public Health; Quality of life; Randomized; Research; Resistance; Risk; Role; Sampling; Serum; Shapes; Stimulus; Stress; Supervision; Testing; Time; TimeLine; Type I Procollagen; Veterans; Visit; Walking; Woman; aged; appropriate dose; bone; bone health; bone loss; bone mass; bone preservation; bone quality; cardiometabolism; design; disability; endurance exercise; exercise intervention; exercise prescription; exercise training; experimental study; fitness; fracture risk; functional independence; functional outcomes; functional status; hormone analog; improved; innovation; lifestyle intervention; men; military veteran; mode of exercise; mortality; novel; older men; older women; osteoporosis with pathological fracture; preservation; resistance exercise; response; response biomarker; sex; skeletal; strength training; young adult

Exercise is frequently recommended to reduce the risk of osteoporotic fracture. However, bone does not always result in the expected improvements in bone mass, and there is evidence that endurance exercise may lead to bone loss under certain conditions. It is our contention that disruptions in calcium homeostasis during exercise, resulting in a decrease in serum ionized calcium (iCa) and increases in parathyroid hormone (PTH) and c-telopeptide of type I collagen (CTX; a marker of bone resorption) that occur shortly after the start of exercise, may be responsible for the lack of the expected improvements in bone mineral density. The iCa, PTH, and CTX responses to exercise have been well-characterized for both young and older adults in response to a single endurance exercise bout, but it is unclear if resistance training (e.g., weightlifting) results in the same exercise-induced disruption in calcium homeostasis. Further, it is unclear how the iCa, PTH, and CTX response to exercise may change with exercise training, and if a bone anabolic response to exercise can be detected after repeat exercise bouts. The bone anabolic response to exercise (assessed by procollagen of type I terminal propeptide, P1NP; a marker of bone formation) has yet to be fully characterized, but that may be due to the testing of single exercise bouts and the short sampling timeline following exercise. To address these gaps in knowledge, up to 60 Veterans (30 men, 30 women), aged 60-80 years, will be randomized to 1) stationary cycling; or 2) resistance training and will complete 10 weeks of supervised exercise training 3x/week (30 total exercise training sessions). This number of exercise visits was due to the demonstrated increase in P1NP after 28 doses of teriparatide, a PTH analog, that results in bone formation. During the 1st, 15th, and 30th exercise training session, participants will undergo an acute exercise testing bout with pre- and post-exercise sampling up to 48 hours after exercise. Blood samples will be collected to measure iCa, PTH, CTX and P1NP. The primary aims are 1) to determine if resistance exercise results in a different bone biomarker response compared to what we have observed during endurance exercise in older adults; 2) determine if resistance and/or endurance exercise result in an increase in P1NP over 10 weeks of exercise training. Exploratory outcomes related to changes in fitness and functional status will address how Veteran health is impacted by each exercise type, which will be used to inform future applications. The biomarker and functional outcomes information are the next step in determining the appropriate “dose” of exercise, consisting of factors such as exercise type, frequency, duration, and intensity (which will be explored in future research), can be used to enhance Veteran health. Exercise should continue to be recommended for overall health, but future interventions could incorporate what is known about the dose of exercise that is needed for cardiometabolic health and the emerging data on the dose of exercise needed to preserve bone health to create personalized exercise prescriptions to improve multiple components of Veteran health. The proposed research is significant because it is investigating several knowledge gaps that need to be addressed to design future, larger exercise and lifestyle interventions aimed at preserving multiple components of Veteran health, which could have a lasting impact on Veteran quality of life and functional independence. The proposed research is innovative because it is testing novel hypotheses, the mode of exercise on the disruption in calcium homeostasis and the role of exercise training, in a population that could greatly benefit from the knowledge to be gained. Long-term, information gleaned from this research will help to define personalized exercise prescriptions to improve cardiometabolic health without compromising bone health in aging Veterans.

通常建议进行运动以降低骨质疏松骨折的风险。但是，骨头没有 始终导致骨骼质量的预期改善，有证据表明耐力运动可能 在某些条件下导致骨质流失。正是我们的内容破坏了钙稳态的破坏 运动，导致血清离子化钙（ICA）降低，甲状旁腺激素（PTH）增加 I型胶原蛋白（CTX；骨骼分辨率的标记）的C- telopectide发生在开始之后不久 运动可能是由于缺乏骨矿物质密度的预期改善而导致的。 ICA， PTH和CTX对运动的反应已针对年轻人和老年人进行了很好的表征 对单次耐力运动的反应，但尚不清楚抵抗训练（例如，举重）是否结果 在相同的运动引起的钙稳态中的破坏中。此外，目前尚不清楚ICA，PTH和 CTX对运动的反应可能会随着运动训练而改变，如果对运动的骨合成代谢反应， 重复锻炼后被检测到。骨合成代谢对运动的反应（由Procollagen评估 I型末端丙肽，P1NP；骨形成的标记）尚未完全表征，但可能 由于测试了单次锻炼和锻炼后简短的采样时间表。解决 这些知识差距，最多60名退伍军人（30名男性，30名女性），年龄在60-80岁，将随机分为1） 固定骑自行车；或2）抵抗训练，并将完成10周的监督运动训练3倍/周 （总共30次运动训练）。这一数量的锻炼是由于证明的增加 28剂Teriparatide（一种PTH类似物）后，P1NP导致骨形成。在第1，第15和30位 锻炼训练课程，参与者将接受急性锻炼测试 锻炼后最多48小时采样。将收集血液样本以测量ICA，PTH，CTX和P1NP。 主要目的是1）确定抗性运动是否导致不同的骨生物标志物反应 与我们在老年人耐力运动中观察到的相比； 2）确定电阻是否 和/或耐力运动导致在运动训练10周内P1NP增加。探索性 与健身和功能状况变化有关的结果将解决资深健康如何受到的影响 每种运动类型，将用于告知未来的应用。生物标志物和功能结果 信息是确定锻炼的适当“剂量”的下一步，包括 运动类型，频率，持续时间和强度（将在以后的研究中探讨），可用于 增强退伍军人健康。应继续推荐运动以进行整体健康，但未来 干预措施可以纳入心脏代谢所需的运动剂量 健康和有关维护骨骼健康所需锻炼剂量的新兴数据以创建个性化 锻炼处方，以改善退伍军人健康的多个组成部分。拟议的研究很重要 因为它正在调查需要解决的几个知识差距，以设计未来，更大的练习 以及旨在保留退伍军人健康组成部分的生活方式干预措施，这可能具有 对退伍军人生活质量和功能独立性的持久影响。拟议的研究是创新的 因为它正在测试新的假设，所以钙稳态中断的运动方式和 运动训练的作用，在可以从知识中受益匪浅的人群中。长期， 从这项研究中收集的信息将有助于定义个性化的锻炼处方以改进 衰老的退伍军人中没有损害骨骼健康的心脏代谢健康。