Biochemical markers of bone metabolism during distance running in healthy, regularly exercising men and women

An Opinion on the Interpretation of Bone Turnover Markers Following Acute Exercise or Nutrition Intervention and Considerations for Applied Research

It is important for athlete and public health that we continue to develop our understanding of the effects of exercise and nutrition on bone health. Bone turnover markers (BTMs) offer an opportunity to accelerate the progression of bone research by revealing a bone response to exercise and nutrition stimuli far more rapidly than current bone imaging techniques. However, the association between short-term change in the concentration of BTMs and long-term bone health remains ambiguous. Several other limitations also complicate the translation of acute BTM data to applied practice. Importantly, several incongruencies exist between the effects of exercise and nutrition stimuli on short-term change in BTM concentration compared with long-term bone structural outcomes to similar stimuli. There are many potential explanations for these inconsistencies, including that short-term study designs fail to encompass a full remodeling cycle. The current article presents the opinion that data from relatively acute studies measuring BTMs may not be able to reliably inform applied practice aiming to optimize bone health. There are important factors to consider when interpreting or translating BTM data and these are discussed.

Load carriage aerobic exercise stimulates a transient rise in biochemical markers of bone formation and resorption

Exercise can be both anabolic and catabolic for bone tissue. The temporal response of both bone formation and resorption following an acute bout of exercise is not well described. We assayed biochemical markers of bone and calcium metabolism for up to 3 days after military-relevant exercise. In randomized order, male (n = 18) and female (n = 2) Soldiers (means ± SD; 21.2 ± 4.1 years) performed a 60-min bout of load carriage (30% body mass; 22.4 ± 3.7 kg) treadmill exercise (EXER) or a resting control trial (REST). Blood samples were collected following provision of a standardized breakfast before (PRE), after (POST) exercise/rest, 1 h, 2 h, and 4 h into recovery. Fasted samples were also collected at 0630 on EXER and REST and for the next three mornings after EXER. Parathyroid hormone and phosphorus were elevated (208% and 128% of PRE, respectively, P < 0.05), and ionized calcium reduced (88% of PRE, P < 0.05) after EXER. N-terminal propeptide of type 1 collagen was elevated at POST (111% of PRE, P < 0.05), and the resorption marker, C-terminal propeptide of type 1 collagen was elevated at 1 h (153% of PRE, P < 0.05). Osteocalcin was higher than PRE at 1 through 4 h post EXER (119%-120% of PRE, P < 0.05). Sclerostin and Dickkopf-related protein-1 were elevated only at POST (132% and 121% of PRE, respectively, P < 0.05) during EXER. Trivial changes in biomarkers during successive recovery days were observed. These results suggest that 60 min of load carriage exercise elicits transient increases in bone formation and resorption that return to pre-exercise concentrations within 24 h post-exercise.NEW & NOTEWORTHY In this study, we demonstrated evidence for increases in both bone formation and resorption in the first 4 h after a bout of load carriage exercise. However, these changes largely disappear by 24 h after exercise. Acute formation and resorption of bone following exercise may reflect distinct physiological mechanoadaptive responses. Future work is needed to identify ways to promote acute post-exercise bone formation and minimize post-exercise resorption to optimize bone adaptation to exercise.

Sex Differences in Metabolic and Behavioral Responses to Exercise but Not Exogenous Osteocalcin Treatment in Mice Fed a High Fat Diet

Background

Exercise helps improve glucose handling in diabetes and has been shown to improve mood and cognition in other conditions. Osteocalcin, a protein produced by bone osteoblasts, was reported to have endocrine actions to improve both metabolism and also improve age-related cognitive deficits in mice.

Methods

This study was designed to compare the effects of daily treadmill running exercise with injection of osteocalcin in high fat diet (HFD) induced diabetes in male and female C57BL/6J mice. Following established glucose intolerance and treatment for 8 weeks, mice were assessed for anxiety on an elevated plus maze, motivation by tail suspension test and cognition and memory in a puzzle box. Endogenous osteocalcin was measured by ELISA.

Results

Mice on HFD had high weight gain, glucose intolerance and increased white fat. Exercise increased circulating osteocalcin levels in female mice but decreased them in male mice. Exercise also decreased weight gain and improved glucose tolerance in female but not male mice; however, treatment with osteocalcin made no metabolic improvements in either males or females. HFD induced anxiety only in female mice and this was not improved by osteocalcin. Exercise induced anxiety only in male mice. HFD also increased depressive-like behavior in both sexes, and this was improved by either exercise or osteocalcin treatment. Cognitive deficits were seen in both male and female mice on HFD. Exercise improved cognitive performance in female but not male mice, while osteocalcin treatment improved cognitive performance in both sexes.

Conclusion

There were sex differences in the effects of exercise on endogenous osteocalcin regulation that correlated with improvements in cognitive but not metabolic outcomes. Exogenous osteocalcin did not improve metabolism but was effective in improving HFD-induced cognitive deficits. Sex is an important variable in hormonal and cognitive responses to exercise in diabetes.

Effects of Collagen Peptides on Recovery Following Eccentric Exercise in Resistance-Trained Males-A Pilot Study

The authors sought to determine whether consuming collagen peptides (CP) enhances musculoskeletal recovery of connective tissues following a damaging exercise bout. Resistance-trained males consumed 15 g/day of CP (n = 7) or placebo (n = 8), and after 7 days, maximal voluntary isometric contraction (MVIC), countermovement jump height, soreness, and collagen turnover were examined. Five sets of 20 drop jumps were performed and outcome measures were collected 24, 48, and 120 hr postexercise. Countermovement jump height was maintained in the CP group at 24 hr (PRE = 39.9 ± 8.8 cm vs. 24 hr = 37.9 ± 8.9 cm, p = .102), whereas the CP group experienced a significant decline at 24 hr (PRE = 40.4 ± 7.9 cm vs. 24 hr = 35.5 ± 6.4 cm, p = .001; d = 0.32). In both groups, muscle soreness was significantly higher than PRE at 24 hr (p = .001) and 48 hr (p = .018) but not at 120 hr (p > .05). MVIC in both legs showed a significant time effect (left: p = .007; right: p = .010) over the 5-day postexercise period. Neither collagen biomarker changed significantly at any time point. CP supplementation attenuated performance decline 24 hr following muscle damage. Acute consumption of CP may provide a performance benefit the day following a bout of damaging exercise in resistance-trained males.

The time course and mechanisms of change in biomarkers of joint metabolism in response to acute exercise and chronic training in physiologic and pathological conditions

PURPOSE

The benefits of exercise across the lifespan and for a wide spectrum of health and diseases are well known. However, there remains less clarity as to the effects of both acute and chronic exercise on joint health. Serum biomarkers of joint metabolism are sensitive to change and have the potential to differentiate between normal and adverse adaptations to acute and chronic load. Therefore, the primary objective of this review is to evaluate how serum biomarkers can inform our understanding of how exercise affects joint metabolism.

METHODS

A comprehensive literature search was completed to identify joint biomarkers previously used to investigate acute and chronic exercise training.

RESULTS

Identified biomarkers included those related to joint cartilage, bone, synovium, synovial fluid, and inflammation. However, current research has largely focused on the response of serum cartilage oligomeric matrix protein (COMP) to acute loading in healthy young individuals. Studies demonstrate how acute loading transiently increases serum COMP (i.e., cartilage metabolism), which is mostly dependent on the duration of exercise. This response does not appear to be associated with any lasting deleterious changes, cartilage degradation, or osteoarthritis.

CONCLUSION

Several promising biomarkers for assessing joint metabolism exist and may in future enhance our understanding of the physiological response to acute and chronic exercise. Defining 'normal' and 'abnormal' biomarker responses to exercise and methodological standardisation would greatly improve the potential of research in this area to understand mechanisms and inform practice.

Resistance Training Is Associated With Higher Bone Mineral Density Among Young Adult Male Distance Runners Independent of Physiological Factors

Duplanty, AA, Levitt, DE, Hill, DW, McFarlin, BK, DiMarco, NM, and Vingren, JL. Resistance training is associated with higher bone mineral density among young adult male distance runners independent of physiological factors. J Strength Cond Res 32(6): 1594-1600, 2018-Low bone mineral density (BMD) in male distance runners is common and could be modulated by a host of biomarkers involved in the dynamic balance of bone tissue. In contrast, resistance training can increase BMD; however, the efficacy of resistance training in protecting BMD in distance runners has not been elucidated. The aim of this study was to investigate the relationship between resistance training, testosterone and bone metabolism biomarker concentrations, and BMD in young adult male distance runners. Twenty-five apparently healthy men (23-32 years; mean ± SD: 25.9 ± 2.9 years; 1.77 ± 0.04 m; 75.4 ± 8.5 kg) were categorized into 1 of 3 groups: untrained control participants (CON; n = 8); nonresistance-trained runners (NRT; n = 8); or resistance-trained runners (RT; n = 9). Blood was collected and analyzed for concentrations of free and total testosterone and 14 bone metabolism biomarkers. Bone mineral density was assessed using dual-energy X-ray absorptiometry. At all measured sites, BMD was greater (p ≤ 0.05) for RT compared with NRT and CON. Vitamin D concentration was greater (p ≤ 0.05) in RT and NRT compared with CON. Concentrations of testosterone and remaining bone biomarkers did not differ between groups (p > 0.05). Resistance-trained runners had greater BMD than nonresistance-trained runners and untrained peers. This difference did not seem to be modulated by biomarkers that contribute to bone formation or resorption, indicating that differences in BMD are associated with habitual load-bearing exercise using external resistance. Runners should perform resistance exercise at least once per week because this is associated with greater BMD.

Immediate and short-term effects of exercise on tendon structure: biochemical, biomechanical and imaging responses

Introduction Tendons are metabolically active structures, and their biochemical, biomechanical and structural properties adapt to chronic exercise. However, abnormal adaptations may lead to the development of tendinopathy and pain. Acute and subacute adaptations might contribute to tendon pathology. Sources of data A systematic search of peer-reviewed articles was performed using a wide range of electronic databases. A total of 61 publications were selected. Areas of agreement Exercise induces acute responses in collagen turnover, blood flow, glucose, lactate and other inflammatory products (e.g. prostaglandins and interleukins). Mechanical properties are influenced by activity duration and intensity. Acute bouts of exercise affect tendon structure, with some of the changes resembling those reported in pathological tendons. Areas of controversy Given the variation in study designs, measured parameters and outcomes, it remains debatable how acute exercise influences overall tendon properties. There is discrepancy regarding which investigation modality and settings provide optimal assessment of each parameter. Growing points There is a need for greater homogeneity between study designs, including subject consortium and age, exercise protocols and time frames for parameter assessing. Areas timely for developing research Innovative methods, measuring each parameter simultaneously, would allow a greater understanding of how and when changes occur. This methodology is key to revealing pathological processes and pathways that alter tendon properties according to various activities. Optimal tendon properties differ between activities: more compliant tendons are beneficial for slow stretch shortening cycle (SSC) activities such as countermovement jumps, whereas stiffer tendons are considered beneficial for fast SSC movements such as sprinting.

The effect of 12 weeks of resistance training on hormones of bone formation in young sedentary women

Physical activity has been proposed as one strategy to enhance bone mineral acquisition; however, the basic mechanisms of this effect are not fully understood. The purpose of this study was to investigate the effect of 12 weeks of resistance training on hormones of bone formation in young sedentary women. Twenty sedentary females (aged 25.3 ± 3.2 years; ±SD) volunteered to participate in this study. The subjects were randomly assigned to a training group (n = 10) or control group (n = 10). Subjects executed eight resistance exercises selected to stress the major muscle groups in the following order: chest press, leg extension, shoulder press, leg curls, latissimus pull down, leg press, arm curls, and triceps extension. Resistance training consisted of 50-60 min of circuit weight training per day, 3 days a week, for 12 weeks. This training was circularly performed in eight stations and included two to four sets with 8-12 maximal repetitions at 65-80 % of one-repetition maximum in each station. After 12 weeks, the training group had a significant increase (P < 0.05) in the growth hormone, estrogen, parathyroid hormone and testosterone compared to the control group. The results showed that insulin-like growth factor I levels did not change significantly in response to resistance training. In conclusion, the results suggest that resistance training with specific intensity and duration utilized in this study increases the hormones of bone formation in young sedentary women.

Metabolic markers in sports medicine

Physical exercise induces adaptations in metabolism considered beneficial for health. Athletic performance is linked to adaptations, training, and correct nutrition in individuals with genetic traits that can facilitate such adaptations. Intense and continuous exercise, training, and competitions, however, can induce changes in the serum concentrations of numerous laboratory parameters. When these modifications, especially elevated laboratory levels, result outside the reference range, further examinations are ordered or participation in training and competition is discontinued or sports practice loses its appeal. In order to correctly interpret commonly used laboratory data, laboratory professionals and sport physicians need to know the behavior of laboratory parameters during and after practice and competition. We reviewed the literature on liver, kidney, muscle, heart, energy, and bone parameters in athletes with a view to increase the knowledge about clinical chemistry applied to sport and to stimulate studies in this field. In liver metabolism, the interpretation of serum aminotransferases concentration in athletes should consider the release of aspartate aminotransferase (AST) from muscle and of alanine aminotransferase (ALT) mainly from the liver, when bilirubin can be elevated because of continuous hemolysis, which is typical of exercise. Muscle metabolism parameters such as creatine kinase (CK) are typically increased after exercise. This parameter can be used to interpret the physiological release of CK from muscle, its altered release due to rhabdomyolysis, or incomplete recovery due to overreaching or trauma. Cardiac markers are released during exercise, and especially endurance training. Increases in these markers should not simply be interpreted as a signal of cardiac damage or wall stress but rather as a sign of regulation of myocardial adaptation. Renal function can be followed in athletes by measuring serum creatinine concentration, but it should be interpreted considering the athlete's body-mass index (BMI) and phase of the competitive season; use of cystatin C could be a reliable alternative to creatinine. Exercise and training induce adaptations in glucose metabolism which improve glucose utilization in athletes and are beneficial for reducing insulin insensitivity in nonathletes. Glucose metabolism differs slightly for different sports disciplines, as revealed in laboratory levels. Sport activities induce a blood lipid profile superior to that of sedentary subjects. There are few reports for a definitive conclusion, however. The differences between athletes and sedentary subjects are mainly due to high-density lipoprotein cholesterol (HDLC) concentrations in physically active individuals, although some differences among sport disciplines exist. The effect of sports on serum and urinary markers for bone metabolism is not univocal; further studies are needed to establish the real and effective influence of sport on bone turnover and especially to establish its beneficial effect.

The role of exercise intensity in the bone metabolic response to an acute bout of weight-bearing exercise

We compared the effects of exercise intensity (EI) on bone metabolism during and for 4 days after acute, weight-bearing endurance exercise. Ten males [mean ± SD maximum oxygen uptake (Vo(2max)): 56.2 ± 8.1 ml·min(-1)·kg(-1)] completed three counterbalanced 8-day trials. Following three control days, on day 4, subjects completed 60 min of running at 55%, 65%, and 75% Vo(2max). Markers of bone resorption [COOH-terminal telopeptide region of collagen type 1 (β-CTX)] and formation [NH(2)-terminal propeptides of procollagen type 1 (P1NP), osteocalcin (OC), bone-alkaline phosphatase (ALP)], osteoprotegerin (OPG), parathyroid hormone (PTH), albumin-adjusted calcium (ACa), phosphate (PO(4)), and cortisol were measured during and for 3 h after exercise and on four follow-up days (FU1-FU4). At 75% Vo(2max), β-CTX was not significantly increased from baseline by exercise but was higher compared with 55% (17-19%, P < 0.01) and 65% (11-13%, P < 0.05) Vo(2max) in the first hour postexercise. Concentrations were decreased from baseline in all three groups by 39-42% (P < 0.001) at 3 h postexercise but not thereafter. P1NP increased (P < 0.001) during exercise only, while bone-ALP was increased (P < 0.01) at FU3 and FU4, but neither were affected by EI. PTH and cortisol increased (P < 0.001) with exercise at 75% Vo(2max) only and were higher (P < 0.05) than at 55% and 65% Vo(2max) during and immediately after exercise. The increases (P < 0.001) in OPG, ACa, and PO(4) with exercise were not affected by EI. Increasing EI from 55% to 75% Vo(2max) during 60 min of running resulted in higher β-CTX concentrations in the first hour postexercise but had no effect on bone formation markers. Increased bone-ALP concentrations at 3 and 4 days postexercise suggest a beneficial effect of this type of exercise on bone mineralization. The increase in OPG was not influenced by exercise intensity, whereas PTH was increased at 75% Vo(2max) only, which cannot be fully explained by changes in serum calcium or PO(4) concentrations.

Bone metabolism markers in sports medicine

Bone mass can be viewed as the net product of two counteracting metabolic processes, bone formation and bone resorption, which allow the skeleton to carry out its principal functions: mechanical support of the body, calcium dynamic deposition and haemopoiesis. Besides radiological methods, several blood and urinary molecules have been identified as markers of bone metabolic activity for estimating the rates and direction of the biological activities governing bone turnover. The advantages for the use of bone metabolism markers are that they are potentially less dangerous than radiological determinations, are more sensitive to changes in bone metabolism than radiological methods and are easily collected and analysed. The disadvantages are that they have high biological variability. Physical exercise is a known source of bone turnover and is recommended for preventing osteoporosis and bone metabolism problems. There are numerous experiments on bone metabolism markers after acute exercise, but not after long-term training and during or after a whole competition season. Moreover, few studies on bone metabolism markers have evaluated their performance in elite and top-level athletes, who have a higher bone turnover than sedentary individuals. Despite discrepant results among studies, most have shown that short exercise is insufficient for modifying serum concentrations of bone metabolism markers. Marker variations are more evident after several hours or days after exercise, bone formation markers are more sensitive than bone resorption markers, and stimulation of osteoblast and/or osteoclast functions is exercise dependent but the response is not immediate. The response depends on the type of exercise; the markers seem to be less sensitive to resistance exercise and the intensity of exercise is not discriminate. Comparisons between trained subjects and untrained controls have demonstrated the influence of exercise on bone turnover. During training, carboxy-terminal collagen cross-links (CTx), a bone resorption marker, was shown to be less sensitive than amino-terminal cross-linking telopeptide of type I collagen (NTx) and urinary pyridinolines, which were sensitive to anaerobic exercise. Whereas, the bone formation markers, bone alkaline phosphatase (BAP) and osteocalcin (OC) changed after 1 month and 2 months of an exercise programme, respectively. After 2 months, while BAP normalized, it was found to be sensitive to aerobic exercise and OC was found to be sensitive to anaerobic exercise. After prolonged training and competition, bone formation markers are found to change in sedentary subjects enrolled in a physical activity programme. Professional athletes show changes in bone formation markers depending on programme intensity, whereas bone resorption appears to stabilize. Crucial for long-term training, are the characteristics of exercise (e.g. weight-bearing, impact).

Bone formation is increased to a greater extent than bone resorption during a cycling stage race

This study examined the effects of participation in the Tour of Southland, a 6-day bicycle race, on serum markers of bone turnover in 5 elite male cyclists. During the race, energy intake matched expenditure. Osteocalcin was increased approximately 300% on days 1-5; and C-terminal telopeptide of type I collagen was elevated (43%) on day 3. Participation in a cycling stage race does not appear to have deleterious effects on bone turnover.

Bone metabolism markers in sports medicine

Bone mass can be viewed as the net product of two counteracting metabolic processes, bone formation and bone resorption, which allow the skeleton to carry out its principal functions: mechanical support of the body, calcium dynamic deposition and haemopoiesis. Besides radiological methods, several blood and urinary molecules have been identified as markers of bone metabolic activity for estimating the rates and direction of the biological activities governing bone turnover. The advantages for the use of bone metabolism markers are that they are potentially less dangerous than radiological determinations, are more sensitive to changes in bone metabolism than radiological methods and are easily collected and analysed. The disadvantages are that they have high biological variability. Physical exercise is a known source of bone turnover and is recommended for preventing osteoporosis and bone metabolism problems. There are numerous experiments on bone metabolism markers after acute exercise, but not after long-term training and during or after a whole competition season. Moreover, few studies on bone metabolism markers have evaluated their performance in elite and top-level athletes, who have a higher bone turnover than sedentary individuals. Despite discrepant results among studies, most have shown that short exercise is insufficient for modifying serum concentrations of bone metabolism markers. Marker variations are more evident after several hours or days after exercise, bone formation markers are more sensitive than bone resorption markers, and stimulation of osteoblast and/or osteoclast functions is exercise dependent but the response is not immediate. The response depends on the type of exercise; the markers seem to be less sensitive to resistance exercise and the intensity of exercise is not discriminate. Comparisons between trained subjects and untrained controls have demonstrated the influence of exercise on bone turnover. During training, carboxy-terminal collagen cross-links (CTx), a bone resorption marker, was shown to be less sensitive than amino-terminal cross-linking telopeptide of type I collagen (NTx) and urinary pyridinolines, which were sensitive to anaerobic exercise. Whereas, the bone formation markers, bone alkaline phosphatase (BAP) and osteocalcin (OC) changed after 1 month and 2 months of an exercise programme, respectively. After 2 months, while BAP normalized, it was found to be sensitive to aerobic exercise and OC was found to be sensitive to anaerobic exercise. After prolonged training and competition, bone formation markers are found to change in sedentary subjects enrolled in a physical activity programme. Professional athletes show changes in bone formation markers depending on programme intensity, whereas bone resorption appears to stabilize. Crucial for long-term training, are the characteristics of exercise (e.g. weight-bearing, impact).

Effects of a 4-month recruit training program on markers of bone metabolism

Stress fracture susceptibility results from accelerated bone remodeling after onset of novel exercise and may be reflected in bone turnover changes. It is unknown if the bone turnover response to exercise is different between sexes.

PURPOSE

To assess disparity between sexes in bone metabolism markers during military recruit training and to evaluate relationships between bone turnover markers and factors that may affect bone metabolism.

METHODS

Volunteers were age-matched men (n = 58) and women (n = 199), 19 yr old, entering gender-integrated combat training. Blood was collected at 0, 2, and 4 months and anthropometric and fitness measures at 0 and 4 months. Serum was analyzed for biomarkers reflecting bone formation (bone alkaline phosphatase and procollagen I N-terminal peptide), bone resorption (C-telopeptide cross-links of type I collagen and tartrate-resistant acid phosphatase), endocrine regulation (parathyroid hormone, calcium, and 25(OH)D), and inflammation (interleukin 1B, interleukin 6, and tumor necrosis factor alpha). Data were analyzed using ANOVA, correlation, and regression analyses.

RESULTS

Bone turnover markers were higher in men (P < 0.01) and increased similarly for both sexes from 0 to 2 months (P < 0.01). Independent of gender, VO2max (R = 0.477) and serum calcium (R = 0.252) predicted bone formation activity (bone alkaline phosphatase) at baseline (P < 0.01). Serum calcium and parathyroid hormone decreased (2.0 and 6.4%, respectively) from 0 to 2 months (P < 0.001), returning to baseline at 4 months for both sexes. Men exhibited a decrease in 25(OH)D from 0 to 4 months (P = 0.007). Changes in endocrine regulators were significantly correlated with changes in bone turnover markers. Inflammatory markers did not differ between sexes and did not increase.

CONCLUSION

Military training increased bone formation and resorption markers in 2 months, suggesting rapid onset of strenuous exercise accelerates bone turnover similarly in men and women. Although bone turnover markers were higher in men than women, bone formation status may be related to aerobic fitness and serum calcium independent of gender and may be affected by small changes in endocrine regulators related to nutrition.

Participation in road cycling vs running is associated with lower bone mineral density in men

The effects of regular non-weight-bearing (NWB) exercise on bone health are largely unknown. The objective of the study was to determine the effects of participation in NWB sports on bone health in adult male recreational athletes. Male cyclists (NWB; n = 27) and runners (weight-bearing [WB]; n = 16) aged 20 to 59 years were recruited from the community. Whole-body and regional bone mineral content and bone mineral density (BMD), and body composition were assessed using dual x-ray absorptiometry. Bone formation and resorption markers, and hormones were measured in serum. Bone-loading history was estimated from a sports participation history questionnaire. Nutrient intake and current physical activity were estimated from 7-day written logs. The NWB athletes had significantly lower BMD of the whole body and spine than the WB athletes, despite having similar age, weight, body mass index, body composition, hormonal status, current activity level, and nutrient intakes. Sixty-three percent of NWB athletes had osteopenia of the spine or hip, compared with 19% of WB athletes. Cyclists were 7 times more likely to have osteopenia of the spine than runners, controlling for age, body weight, and bone-loading history. There were no group differences in serum markers of bone turnover. Based on the results of this study, current bone loading is an important determinant of whole-body and lumbar spine BMD. Therefore, bone-loading activity should be sustained during adulthood to maintain bone mass.

Acute effects of a single session of aerobic exercise with or without weight-lifting on bone turnover in healthy young women

This study aimed to investigate the acute effects of exercise on bone turnover and to determine whether brisk walking with or without weight-lifting makes a difference on bone metabolism. Nine healthy women performed two exercise bouts: brisk walking on a treadmill for 30 min (E), and similar exercise carrying 5 kg of weight in a backpack (WE). Serum parathyroid hormone (PTH), osteocalcin (OC), calcitonin (CT), procollagen type 1 carboxy terminal propeptide (PICP), procollagen type 1 amino terminal propeptide (PINP), type 1 collagen carboxy terminal telopeptide (ICTP), total alkaline phosphatase (ALP), and urine deoxypyridinoline (D-Pyr) levels were studied. Resting values served as control. Significant variances were observed only in serum ALP and PTH values. Variances in ALP values within subjects after exercise were statistically significant (analysis of variance in repeated measurements [AVRM], P=0.000). E caused a significant decrease, while WE caused a significant increase in ALP values at the 24th h (Bonferroni pairwise comparisons tests [BPC t-test]: P=0.028, P=0.000, respectively). Variances in PTH values within subjects after exercise were statistically significant (AVRM, P=0.029), while diurnal variation was not significant (P=0.981). E caused significant alterations in PTH levels (an increase at the 30th min, turned towards baseline at the 45th min) (BPC t-test, P=0.007). WE also caused alterations in PTH levels, though insignificant (BPC t-test, P=1.00). Brisk walking for 30 min has stimulating effects on bone turnover by various mechanisms without any additive effect of weight bearing.

Serum osteocalcin and CTX-MMP concentration in young exercising thoroughbred racehorses

Bone responds to exercise with changes in bone (re-)modelling, which might be monitored non-invasively with biochemical bone markers. The aim of this study was to evaluate the influence of exercise on serum osteocalcin and serum carboxy-terminal cross-linked telopeptide of type I collagen generated by matrix metalloproteinases (CTX-MMP) concentration in young racehorses. Seventy-one 2 to 4-year-old Thoroughbreds were included in this prospective infield study. Blood sampling was performed six times (i.e. six sampling cycles) during a 9-month period. Serum samples were analysed with commercial osteocalcin and CTX-MMP radioimmunoassays. Two-year-old racehorses had higher serum osteocalcin and CTX-MMP values than 3-year-old horses. Gender and training amplitude did not significantly influence serum osteocalcin and CTX-MMP values. Two-year-old horses showed an increase in osteocalcin values between cycles 2 and 3 and an increase in serum CTX-MMP values between cycles 1 and 2. Serum osteocalcin and CTX-MMP concentrations decreased between cycles 4 and 5, and 5 and 6. Three-year-old horses showed an increase in serum osteocalcin levels between cycles 3 and 4 and an increase in serum CTX-MMP concentrations between cycles 1 and 2, and 3 and 4. Serum osteocalcin levels decreased between cycles 5 and 6, whereas serum CTX-MMP levels decreased between cycles 4 and 5, and 5 and 6. Two- and three-year-old horses showed a decreased osteocalcin/CTX-MMP ratio between cycles 1 and 2. Moreover, 2-year-old horses showed an increase in the osteocalcin/CTX-MMP ratio between cycles 2 and 3. Sore shin formation did not significantly influence serum osteocalcin and CTX-MMP values. Serum osteocalcin and CTX-MMP are promising bone markers for monitoring exercise induced changes in equine bone metabolism.

Evaluation of treadmill exercise in a lower body negative pressure chamber as a countermeasure for weightlessness-induced bone loss: a bed rest study with identical twins

Counteracting bone loss is required for future space exploration. We evaluated the ability of treadmill exercise in a LBNP chamber to counteract bone loss in a 30-day bed rest study. Eight pairs of identical twins were randomly assigned to sedentary control or exercise groups. Exercise within LBNP decreased the bone resorption caused by bed rest and may provide a countermeasure for spaceflight.

INTRODUCTION

Bone loss is one of the greatest physiological challenges for extended-duration space missions. The ability of exercise to counteract weightlessness-induced bone loss has been studied extensively, but to date, it has proven ineffective. We evaluated the effectiveness of a combination of two countermeasures-treadmill exercise while inside a lower body negative pressure (LBNP) chamber-on bone loss during a 30-day bed rest study.

MATERIALS AND METHODS

Eight pairs of identical twins were randomized into sedentary (SED) or exercise/LBNP (EX/LBNP) groups. Blood and urine samples were collected before, several times during, and after the 30-day bed rest period. These samples were analyzed for markers of bone and calcium metabolism. Repeated measures ANOVA was used to determine statistical significance. Because identical twins were used, both time and group were treated as repeated variables.

RESULTS

Markers of bone resorption were increased during bed rest in samples from sedentary subjects, including the collagen cross-links and serum and urinary calcium concentrations. For N-telopeptide and deoxypyridinoline, there were significant (p < 0.05) interactions between group (SED versus EX/LBNP) and phase of the study (sample collection point). Pyridinium cross-links were increased above pre-bed rest levels in both groups, but the EX/LBNP group had a smaller increase than the SED group. Markers of bone formation were unchanged by bed rest in both groups.

CONCLUSIONS

These data show that this weight-bearing exercise combined with LBNP ameliorates some of the negative effects of simulated weightlessness on bone metabolism. This protocol may pave the way to counteracting bone loss during spaceflight and may provide valuable information about normal and abnormal bone physiology here on Earth.

Significant exercise-related changes in the serum levels of two biomarkers of collagen metabolism in young horses

OBJECTIVE

To identify metabolic biomarkers that can be evaluated in serum for monitoring the effects of exercise on skeletal development in mammals.

DESIGN

Sera of foals from three groups (box-stall rest, pasture and training) were serially collected over the first 5 months of life and assayed for eight biomarkers of cartilage and bone metabolism. Sub-populations from each group were sampled for an additional 6 months of identical exercise.

RESULTS

When expressed as a percentage of baseline values, lower serum levels of the carboxy-terminal propeptides of type II collagen (CPII), and higher serum levels of the cross-linked telopeptide fragments of degraded type I collagen (CTx1) were found in the trained foals compared to the other groups. Significant differences disappeared in those foals sampled during an additional 6 months of identical exercise. The most significant correlations were between serum biomarkers of bone metabolism, being positive between anabolic markers and negative between anabolic and catabolic markers. Serum levels of CTx1 and CPII significantly increased with age in all groups throughout the study.

CONCLUSIONS

We have identified two markers of collagen metabolism, CPII and CTx1, as potential serum indicators of the exercise effects on the developing skeletal system in horses. Forced exercise during the first months postpartum appeared to have a negative effect on collagen turnover when compared to levels in pastured foals. Routine monitoring of collagen biomarkers in sera of exercising young mammals may allow for the early detection of abnormalities in skeletal tissue metabolism and for subsequent intervention before permanent damage occurs.

Biochemical markers of bone activity in young standardbred horses during different types of exercise and training

Seven untrained Standardbred horses were used in a training programme of 6 weeks to evaluate the effects of exercise and training on bone metabolism. The horses were exercised on a treadmill according to a standardized exercise test (SET 1: six incremental steps, 5 min duration each; start 5 m/s, increase 1 m/s). SET 1 was followed by a training programme of 6 weeks. In alternating order: high-speed exercise (HSE): 15 min duration, start at VLa4, continuous increase in speed every 60 s by 0.3 m/s (14 incremental steps); low-speed exercise (LSE): constant velocity at VLa2.5, duration: approximately 60-90 min (total training programme: eight HSE and eight LSE sessions). SET 2 finished the training programme and a deconditioning period of 12 weeks followed. Blood samples for lactate, total plasma protein (TPP), osteocalcin, and ICTP (cross-linked C-telopeptide of type I collagen) were collected. ICTP increased during SET 1 and SET 2, whereas osteocalcin decreased to below resting concentration 24 h after SET 1. A rise in ICTP was observed during LSE 1 and LSE 8, which was followed by a drop 24 h after exercise. No changes in osteocalcin were noted during LSE 1, but 24 h after LSE 1 osteocalcin dropped to below pre-exercise levels. LSE 8 resulted in an increase in osteocalcin, followed by a drop 24 h after LSE 8. Osteocalcin and ICTP were not affected by HSE. Baseline osteocalcin levels dropped during the course of training. The acute response of biochemical bone markers indicates a direct influence of a single bout of exercise on bone metabolism.

Training-induced changes in peritendinous type I collagen turnover determined by microdialysis in humans

1. Acute exercise is found to increase collagen type I formation locally in peritendinous connective tissue of the Achilles' tendon in humans, as determined from changes in interstitial concentrations of collagen propeptide (PICP) and a collagen degradation product (ICTP) by the use of microdialysis catheters. However, the local collagen type I turnover response to training is unknown. 2. Nineteen young males were studied before and after 4 and 11 weeks of physical training. Microdialysis catheters with a high molecular mass cut-off value (3000 kDa), allowing the determination of PICP and ICTP, were placed in the peritendinous space ventral to the Achilles' tendon, under ultrasound guidance, in both legs. The catheters were perfused with a Ringer-acetate solution containing (3)H-labelled human type IV collagen for in vivo recovery determination (relative recovery: 79 +/- 2 %, mean +/- S.E.M.). 3. The PICP concentration in the peritendinous tissue increased in response to training (from 5 +/- 1 to 35 +/- 5 microg l(-1) (4 weeks), P < 0.05) and remained elevated throughout the training period (28 +/- 6 microg l(-1), 11 weeks). Tissue ICTP only rose transiently with training (from 2.2 +/- 0.1 to 2.8 +/- 0.2 microg l(-1) (4 weeks), P < 0.05, and 2.5 +/- 0.2 microg l(-1) (11 weeks), P > 0.05 vs. basal). Plasma PICP was unchanged whereas plasma ICTP declined by 17 % in response to training. 4. The findings indicate that physical training results in an increased turnover of collagen type I in local connective tissue of the peritendinous Achilles' region. Early in the process both synthesis and degradation are elevated, whereas later, the anabolic processes are dominating causing a net synthesis of type I collagen in tendon-related tissue in humans.

Protein and amino acid metabolism during and after exercise and the effects of nutrition

Sustained dynamic exercise stimulates amino acid oxidation, chiefly of the branched-chain amino acids, and ammonia production in proportion to exercise intensity; if the exercise is intense enough, there is a net loss of muscle protein (as a result of decreased protein synthesis, increased breakdown, or both); some of the amino acids are oxidized as fuel, whereas the rest provide substrates for gluconeogenesis and possibly for acid-based regulation. Protein balance is restored after exercise, but no hypertrophy occurs with habitual dynamic exercise. Resistance exercise causes little change in amino acid oxidation but probably depresses protein synthesis and elevates breakdown acutely. After exercise, protein synthesis rebounds for </=48 h, but breakdown remains elevated, and net positive balance is achieved only if amino acid availability is increased. There is no evidence that habitual exercise increases protein requirements; indeed protein metabolism may become more efficient as a result of training.

Responses of markers of bone and collagen turnover to exercise, growth hormone (GH) administration, and GH withdrawal in trained adult males

To examine the interactions between acute exercise and GH on markers of bone and collagen turnover and to assess the potential for detecting GH abuse in athletes using these markers, we studied 17 aerobically trained males (age, 26.9+/-1.5 yr). Sequential studies of exercise, GH administration, and GH withdrawal were undertaken. A randomized, controlled study of rest vs. exercise showed that exercise did not change serum osteocalcin; other markers of formation increased transiently (each P<0.001): bone-specific alkaline phosphatase (+16.1%), carboxyterminal propeptide of type I procollagen (+14.1%), and procollagen III N-terminal extension peptide (+5.0%). The carboxyterminal cross-linked telopeptide of type I collagen, a bone resorption marker, increased 9.7% (P = 0.018) in response to exercise. A randomized, double blind, placebo-controlled, parallel study of recombinant human GH treatment (0.15 IU/kg x day) for 1 week increased serum osteocalcin (net increase preexercise, +/-10.0%; P = 0.017), carboxyterminal propeptide of type I procollagen (+17.6%; P = 0.002), procollagen III N-terminal extension peptide (+48.4%; P = 0.001), and carboxyterminal cross-linked telopeptide of type I collagen (53.3%; P = 0.009). Disappearance half-times after cessation of recombinant human GH for pre- and postexercise markers ranged from 248-770 h. We conclude 1) endurance exercise transiently activates bone and collagen turnover; 2) brief GH administration results in similar but quantitatively greater augmentation; and 3) these data will assist in designing a GH detection strategy.

Type I collagen synthesis and degradation in peritendinous tissue after exercise determined by microdialysis in humans

1. Physical activity is known to increase type I collagen synthesis measured as the concentration of biomarkers in plasma. By the use of microdialysis catheters with a very high molecular mass cut-off value (3000 kDa) we aimed to determine local type I collagen synthesis and degradation in the peritendinous region by measuring interstitial concentrations of a collagen propeptide (PICP; 100 kDa) and a collagen degradation product (ICTP; 9 kDa) as well as an inflammatory mediator (PGE2). 2. Seven trained human runners were studied before and after (2 and 72 h) 3 h of running (36 km). Two microdialysis catheters were placed in the peritendinous space ventral to the Achilles' tendon under ultrasound guidance and perfused with a Ringer-acetate solution containing 3H-labelled human type IV collagen and [15-3H(N)]PGE2 for in vivo recovery determination. Relative recovery was 37-59 % (range of the s.e.m. values) for both radioactively labelled substances. 3. PICP concentration decreased in both interstitial peritendinous tissue and arterial blood immediately after exercise, but rose 3-fold from basal 72 h after exercise in the peritendinous tissue (55 +/- 10 microg l-1, mean +/- s.e.m. (rest) to 165 +/- 40 microg l-1 (72 h), P < 0.05) and by 25 % in circulating blood (160 +/- 10 microg l-1 (rest) to 200 +/- 12 microg l-1 (72 h), P < 0.05). ICTP concentration did not change in blood, but decreased transiently in tendon-related tissue during early recovery after exercise only. PGE2 concentration increased in blood during running, and returned to baseline in the recovery period, whereas interstitial PGE2 concentration was elevated in the early recovery phase. 4. The findings of the present study indicate that acute exercise induces increased formation of type I collagen in peritendinous tissue as determined with microdialysis and using dialysate fibre with a very high molecular mass cut-off. This suggests an adaptation to acute physical loading also in non-bone-related collagen in humans.