The Relationship Between Cardiorespiratory Fitness and Bone Mineral Density in Men: A Cross-sectional Study

Trajectories of osteogenic physical activity in children and adolescents: A 3-year cohort study

OBJECTIVES

We explored the latent profiles based on locomotor skills and cardiorespiratory fitness in Finnish schoolchildren and examined their associations with latent growth curves of osteogenic physical activity (PA) over three years.

DESIGN

Prospective cohort study.

METHODS

Altogether 1147 Finnish adolescents aged 11-13 years participated in the study. Osteogenic PA in terms of osteogenic index (OI) was calculated based on acceleration peak histograms using all of the peaks with acceleration >1.3 g. Locomotor skills were assessed using the five-leap and side-to-side jumping tests and cardiorespiratory fitness (CRF) using 20-metre shuttle run test. The latent growth curve models for the locomotor skills and cardiorespiratory fitness profiles were tested to examine the longitudinal development of OI scores over time three years (from T0 to T3).

RESULTS

OI scores were lower amongst children in the "Low locomotor profile" compared with "Moderate" and "High locomotor" profiles. The OI scores linearly decreased from T0 to T3 in each locomotor profile and the decrease was similar in all the profiles. Moreover, OI scores were lower in the "Low CRF profile" compared with "Moderate" and "High CRF" profiles. The OI scores decreased in each profile over time, but the decrease was steepest in the "Low CRF profile", whereas "Moderate" and "High CRF profiles" had similar developmental trajectories.

CONCLUSIONS

Children with the highest locomotor skills and higher CRF accumulate more osteogenic PA than their least skilful and fit peers, which can have important implications on bone health in this critical period for bone growth.

Link between depression and bone mineral density in Cooper Center Longitudinal Study: Indirect effects of vitamin D, inflammation, and physical activity

BACKGROUND

To examine the effect of depressive symptom severity on bone mineral density (BMD) and the potential mediators of the relationship.

METHOD

This study used data from n = 7273 participants in the Cooper Center Longitudinal Study at the Cooper Clinic in Dallas. Participants were included if they had data for all study variables, including left and right femoral neck (BMD), age, sex, body mass index, smoking status, antidepressant (SSRI/SNRI) use, standard alcoholic drinks consumed per week, and depressive symptom severity as measured with the Center for Epidemiological Studies-Depression (CESD)-10. To evaluate the effect of depressive symptoms on both L/R femur BMD, two multiple linear regression analyses were conducted. To examine effects of vitamin D, high sensitivity C-reactive protein (hs-CRP), and physical activity (MET units) on the relationship between depressive symptom severity and BMD, parallel mediation analyses were conducted.

RESULTS

Depressive symptom severity (CES-D 10 score) significantly predicted both L/R BMD (L: β = -0.048, R: β = -0.047, both p ≤ .001). Only physical activity significantly mediated the relationship between depressive symptom severity and L/R BMD (L: β = -0.008, 95 % CI [-0.011, -0.005]; R: β = -0.007, 95 % CI [-0.010, -0.005]).

LIMITATIONS

The sample may not be generalizable to all patient populations.

CONCLUSION

Depressive symptom severity was inversely related to both L/R femur BMD in a large cohort of relatively healthy adults. Physical activity, but not vitamin D or hs-CRP, mediated this relationship. Future research might examine the effect of physical activity interventions both on depression and BMD.

IMPACT STATEMENT

We certify that this work is both novel and confirmatory of recent clinical research (Lee et al., 2015; Amsterdam and Hooper, 1998; Hlis et al., 2018; Wainstein et al., 2016; Blair et al., 1989; Farrell et al., 2022; Ainsworth et al., 2011). We demonstrated a negative relationship between depression and BMD in a large cohort of adults and expanded on previous findings by demonstrating that physical activity acts as a mediator of this relationship. Physical activity is known to stimulate osteogenesis in osteoporotic patients, and this study further expands on its role in depressive symptoms in this population.

KEY POINTS

Cardiorespiratory Fitness and Bone Turnover Markers in Adults With Metabolic Syndrome: The Mediator Role of Inflammation

The relationship between inflammatory markers and bone turnover in adults is well known, and a negative association between cardiorespiratory fitness (CRF) and inflammatory markers has also been described. Hence, we tested whether the association between CRF and bone turnover markers is mediated by inflammatory markers in adults with metabolic syndrome. A total of 81 adults (58.5 ± 5.0 years, 62.7% women) were included in the analysis. CRF was measured by the 6-min walking test. Serum interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor alpha, high-sensitivity c-reactive protein (hsCRP) and vascular endothelial growth factor, collagen type I cross-linked C-telopeptide, procollagen type I N-terminal propeptide (P1NP), and total osteocalcin were assessed using a sensitive ELISA kit. Body composition was assessed by dual-energy X-ray absorptiometry. Partial correlation was used to test the relationship between CRF, inflammatory markers, and bone turnover markers, controlling for sex, lean mass, and fat mass. Boot-strapped mediation procedures were performed, and indirect effects with confidence intervals not including zero were interpreted as statistically significant. CRF was positively correlated with P1NP levels (r = .228, p = .044) and osteocalcin levels (r = .296, p = .009). Furthermore, CRF was positively correlated with IL-1β levels (r = .340, p = .002) and negatively correlated with hsCRP levels (r = -.335, p = .003), whereas IL-1β levels were positively correlated with P1NP levels (r = .245, p = .030), and hsCRP levels were negatively correlated with P1NP levels (r = -.319, p = .004). Finally, the association between CRF and P1NP levels was totally mediated by hsCRP (percentage of mediation = 39.9). Therefore, CRF benefits on bone formation could be dependent on hsCRP concentrations in this population.

Association of Knee Extensor Muscle Strength and Cardiorespiratory Fitness With Bone Stiffness in Japanese Adults: A Cross-sectional Study

BACKGROUND

Knee extensor muscle strength and cardiorespiratory fitness (CRF) are major components of physical fitness. Because the interactive association of knee extensor muscle strength and CRF with bone health remains unclear, we aimed to investigate such association in Japanese adults.

METHODS

Altogether, 8,829 Japanese adults (3,731 men and 5,098 women) aged ≥45 years completed the maximum voluntary knee extension test, submaximal exercise test, medical examination, and a questionnaire on lifestyle habits. Using an osteo-sono assessment index, low bone stiffness tendency was defined as 80% under the young-adults mean. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated after confounder adjustment.

RESULTS

Overall, 542 men (14.5%) and 978 women (19.2%) had low bone stiffness tendency. We observed an inverse association between muscle strength and low bone stiffness tendency after adjustment for CRF in both sexes (P for linear trend <0.001). Compared with the lowest CRF, the multivariable ORs for low bone stiffness tendency in the highest CRF were 0.47 (95% CI, 0.36-0.62) for men and 1.05 (95% CI, 0.82-1.35) for post-menopausal women (P < 0.001 and P = 0.704, respectively). No interactive association between muscle strength and CRF for low bone stiffness tendency existed in both sexes and irrespective of menopausal status.

CONCLUSION

Knee extensor muscle strength and CRF were associated additively, not synergistically, with bone health. Maintaining high levels of both physical fitness components may improve musculoskeletal health in the cohort. The relationship between physical fitness and bone status should be longitudinally investigated in the future.

Novel nomogram for predicting the 3-year incidence risk of osteoporosis in a Chinese male population

OBJECTIVE

To establish a rapid, cost-effective, accurate, and acceptable osteoporosis (OP) screening model for the Chinese male population (age ≥ 40 years) based on data mining technology.

MATERIALS AND METHODS

This was a 3-year retrospective cohort study, which belonged to the sub-cohort of the Chinese Reaction Study. The research period was from March 2011 to December 2014. A total of 1834 subjects who did not have OP at the baseline and completed a 3-year follow-up were included in this study. All subjects underwent quantitative ultrasound examinations for calcaneus at the baseline and follow-ups that lasted for 3 years. We utilized the least absolute shrinkage and selection operator (LASSO) regression model to select feature variables. The characteristic variables selected in the LASSO regression were analyzed by multivariable logistic regression (MLR) to construct the predictive model. This predictive model was displayed through a nomogram. We used the receiver operating characteristic (ROC) curve, C-index, calibration curve, and clinical decision curve analysis (DCA) to evaluate model performance and the bootstrapping validation to internally validate the model.

RESULTS

The predictive factors included in the prediction model were age, neck circumference, waist-to-height ratio, BMI, triglyceride, impaired fasting glucose, dyslipidemia, osteopenia, smoking history, and strenuous exercise. The area under the ROC (AUC) curve of the risk nomogram was 0.882 (95% CI, 0.858-0.907), exhibiting good predictive ability and performance. The C-index for the risk nomogram was 0.882 in the prediction model, which presented good refinement. In addition, the nomogram calibration curve indicated that the prediction model was consistent. The DCA showed that when the threshold probability was between 1 and 100%, the nomogram had a good clinical application value. More importantly, the internally verified C-index of the nomogram was still very high, at 0.870.

CONCLUSIONS

This novel nomogram can effectively predict the 3-year incidence risk of OP in the male population. It also helps clinicians to identify groups at high risk of OP early and formulate personalized intervention measures.

Cardiorespiratory Fitness is Inversely Associated with Risk of Low Bone Mineral Density in Older Korean Men

Little is known regarding the association between physical fitness and bone health in older Korean men. This study investigated the relationship between estimated cardiorespiratory fitness (eCRF) and bone mineral density (BMD). This cross-sectional study included 2715 Korean men aged 50 years and older selected from those who participated in the 2008–2011 Korea National Health and Nutritional Examination and Survey. eCRF was obtained using a sex-specific algorithm developed on the basis of age, body mass index, resting heart rate, and physical activity and classified into low, middle, and high categories. Femoral neck BMD was assessed by dual X-ray absorptiometry. Odds ratios (OR) and 95% confidence intervals (CI) for osteopenia, osteoporosis, and low BMD were calculated for eCRF categories in models fully adjusted for age, waist circumference, education, income, smoking, heavy alcohol intake, serum vitamin D, serum parathyroid hormone, and dietary intake of energy, protein, calcium, and vitamins A and C. Overall, eCRF levels were positively associated with BMD and negatively with prevalence of osteopenia, osteoporosis, and low BMD. Logistic regression showed inverse trends in the risks of osteopenia (high vs. low: OR = 0.692; 95% CI, 0.328–0.517; p = 0.049) and low BMD (high vs. low: OR = 0.669; 95% CI, 0.497–0.966; p = 0.029) by eCRF category in models fully adjusted for all the measured covariates. The current findings suggest that maintaining high eCRF via regular physical activity may contribute to attenuation of age-related loss of BMD and decreased risk for low BMD in older Korean men.

Impact of an 8-Week Exercise and Sport Intervention on Post-Traumatic Stress Disorder Symptoms, Mental Health, and Physical Fitness among Male Refugees Living in a Greek Refugee Camp

Objective: To explore the potential impact of exercise and sport training on symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, quality of life, pain, and fitness in male refugees living in a Greek refugee camp. Methods: This investigation was designed as a one group pre-test/post-test study. A total of 45 refugees (M_age = 25.6) participated in the data assessment. All participants were invited to engage in an 8-week exercise and sport intervention. Data were analysed with hierarchical regression analyses. Results: Baseline scores significantly predicted post-intervention scores across all study variables. Regression analyses showed that a higher participation rate predicted fewer anxiety symptoms, better health-related quality of life, higher self-perceived fitness, higher handgrip strength, and better cardiovascular fitness at post-intervention. A non-significant trend was also found for PTSD and depressive symptoms, showing that a higher participation rate was associated with fewer complaints at post-intervention. Conclusions: Among male refugees living in precarious conditions in a Greek refugee camp, frequency of participation in an 8-week exercise and sport training program seemed to have the potential to positively impact refugees’ health. Due to the pre-experimental study design, our results must be interpreted with caution.