This study investigated the short-term effects of the intensity level of physical exercise on bone metabolism and related hormones. The responses of calciotropic hormones and bone biochemical markers were evaluated in seven male cyclists (mean age 24.4 years, range 20-39) during two 50-min cycling tests performed 15% below (-VT) and 15% above (+VT) the ventilatory threshold. In each test, venous blood samples were drawn at rest, at the 30th and 50th min of exercise, and after 15 min of recovery. For both intensity levels, no significant variation in calcium, 25-hydroxyvitamin D, 1.25-dihydroxyvitamin D, or cortisol level was observed. Intact parathyroid hormone (iPTH) level increased significantly after the last minute of the test (41%, p < 0.05) and peaked during the recovery (80%, p < 0.05) only in response to exercise performed at +VT. Serum phosphorus concentration rose during both tests, while albumin levels increased only at +VT. Concerning bone cell activity, osteocalcin, and type I-C telopeptide breakdown products transiently increased only in response to exercise performed at +VT (11% and 16.8%, respectively; p < 0.05). Bone alkaline phosphatase increased similarly for both intensity levels after 30 min (12%, p < 0.05) and 50 min (12% for -VT vs. 14% for +VT, p < 0.05). All markers of bone turnover returned to initial values during the recovery. In conclusion, a no-impact but intense and sustained exercise performed at +VT transiently stimulated bone turnover and iPTH secretion, suggesting the existence of a bone stimulation threshold. In addition to the well known effect of mechanical constraints, both the duration and intensity of exercise may induce changes in bone turnover.
This study analyzed the temporal and regional variations in bone loss and explored bone cell activities via biochemical markers during an extended follow-up in patients with spinal cord injury (SCI). In parallel, the possible role of the osteoprotegerin (OPG)/RANKL system in disuse osteoporosis was investigated. Seven male patients with acute and complete SCI (31.3 +/- 9.5 years) and 12 able-bodied (AB) men (26.9 +/- 4.2 years) participated in the study. Measurements were performed 16, 24, 36, 48, and 71 weeks after injury. At week 16, marked calcium homeostasis disturbance and a concomitant increase in bone resorption markers were observed, reflecting an intense bone degradation process. Resorption activity decreased continuously with time. Contrasting with the great rise in the resorption markers, the bone formation markers showed little variation. During the period of investigation, a loss in bone mineral density (BMD) was demonstrated for the total body (-4.3%), pelvis (-15.7%) and lower limbs (-15.2%), whereas BMD did not change at the lumbar spine, upper limbs, or skull. At all stages, SCI patients had lower serum RANKL levels and higher serum OPG levels than did AB controls, but no significant variation with time was observed for either cytokine. These findings suggest that bone resorption persisted long after SCI and specifically affected BMD at sublesional sites. The marked modification of serum OPG/RANKL levels in SCI patients suggests that this system is affected, in disuse osteoporosis. However, the precise biologic role of the OPG/RANKL system in the bone tissue of SCI patients has yet to be determined.
Sports characterized by little or moderate weight bearing or impact have a low osteogenic effect. However, the action of such sports on bone turnover remains unclear. The objective of this study was to determine the effect on bone remodelling of physical activities that induce moderate external loading on the skeleton. Thirty-eight male athletes aged 18-39 years (cyclists, n = 11; swimmers, n = 13; triathletes, n = 14) and 10 age-matched sedentary controls aged 22-35 years participated in the study. The study combined measurement of bone mineral density by dual-energy X-ray absorptiometry and bone turnover assessment from specific biochemical markers: serum bone-specific alkaline phosphatase, osteocalcin, urinary type I collagen C-telopeptide and calcium. Compared with the controls and swimmers, adjusted bone mineral density was higher (P < 0.05) in triathletes at the total proximal femur and lower limbs. No differences in bone mineral density were found between cyclists, swimmers and controls. Compared with controls, osteocalcin was higher (P < 0.05) in triathletes and swimmers and urinary type I collagen C-telopeptide was higher in swimmers only. Serum bone-specific alkaline phosphatase was lower (P < 0.05) in cyclists than in all other groups. In conclusion, an osteogenic effect was found only in triathletes, mainly at bone sites under high mechanical stress. Bone turnover differed in athletes compared with controls, suggesting that bone turnover may be sport-practice dependent. Despite some encouraging observations, it was not possible to show that changes in the bone remodelling process were sport-discipline dependent.
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