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.

人们经常建议进行锻炼来降低骨质疏松性骨折的风险，但骨骼却不能。 总是会导致骨量的预期改善，并且有证据表明耐力运动可能会 我们认为，在某些情况下，钙稳态会被破坏。 运动，导致血清离子钙 (iCa) 减少和甲状旁腺激素 (PTH) 增加 和 I 型胶原蛋白的 c 端肽（CTX；骨吸收标志物），在骨吸收开始后不久出现 运动可能是导致骨矿物质密度未达到预期改善的原因。 年轻人和老年人对运动的 PTH 和 CTX 反应已得到充分表征 对单次耐力运动的反应，但尚不清楚阻力训练（例如举重）是否有效 此外，尚不清楚 iCa、PTH 和钙稳态的破坏是如何发生的。 CTX 对运动的反应可能会随着运动训练而改变，并且骨合成代谢对运动的反应是否可以改变 重复运动后检测骨合成代谢反应（通过前胶原评估）。 I 型末端前肽，P1NP；骨形成的标志物）尚未完全表征，但这可能 这是由于单次练习的测试和练习后的采样时间很短。 这些知识差距，最多 60 名年龄在 60-80 岁的退伍军人（30 名男性，30 名女性）将被随机分配到 1) 固定自行车；或 2) 阻力训练，并完成 10 周的监督运动训练，每周 3 次 （总共 30 次运动训练）。 服用 28 剂特立帕肽（一种 PTH 类似物）后出现 P1NP，导致第 1、15 和 30 日骨形成。 运动训练课程中，参与者将在运动前和运动后进行剧烈的运动测试 运动后 48 小时内采集血样以测量 iCa、PTH、CTX 和 P1NP。 主要目标是 1) 确定抗阻运动是否会导致不同的骨生物标志物反应 与我们在老年人运动耐力中观察到的结果进行比较2) 确定阻力是否存在； 和/或耐力运动导致 P1NP 在 10 周的探索性运动训练中增加。 与健康和功能状态变化相关的结果将解决退伍军人健康如何受到影响 每种运动类型，这将用于为未来的应用提供信息。 信息是确定适当运动“剂量”的下一步，包括以下因素： 运动类型、频率、持续时间和强度（将在未来的研究中探讨）可用于 为了整体健康，应继续建议退伍军人进行锻炼，但未来仍应如此。 干预措施可以结合心脏代谢所需的运动剂量的已知信息 健康和关于保持骨骼健康所需的运动剂量的新数据，以创建个性化的 改善退伍军人健康多个方面的运动处方这项研究意义重大。 因为它正在调查一些需要解决的知识差距，以设计未来更大规模的练习 旨在保护退伍军人健康的多个组成部分的生活方式干预措施，这可能会产生 所提出的研究具有创新性，对退伍军人的生活质量和功能独立性产生持久影响。 因为它正在测试新的假设、运动模式对钙稳态破坏的影响以及 运动训练在人群中的作用可以从长期获得的知识中受益匪浅。 从这项研究中收集的信息将有助于确定个性化的运动处方，以改善 心脏代谢健康而不损害老年退伍军人的骨骼健康。