中老年人高強度阻力運動訓練與血清骨鈣素變化、動脈硬化指標及骨密度變化之探討

The Impact of High-intensity Resistance Training on Serum Osteocalcin, Arterial Stiffness and Bone Mineral Density in Middle-aged to Older Adults

蘇羿蓁(I-Chen Su)

指導教授 ： 林信甫

國立臺灣大學/共同教育中心/運動設施與健康管理碩士學位學程/碩士(2021年)

https://doi.org/10.6342/NTU202102034

摘要

背景:近年研究發現骨骼分泌之骨鈣素 (osteocalcin) 具有似荷爾蒙的功能，其中未羧 化骨鈣素 (undercarboxylated osteocalcin, ucOC) 可能與運動能力和動脈硬化有關。中高齡者 規律從事阻力訓練能預防骨質疏鬆和肌少症，不過有文獻指出阻力訓練對心血管系統會造成 負面的影響。目的:探討中老年人規律高強度阻力訓練介入後，對不同結構骨鈣素和血管硬 化指標與骨密度的影響，以及骨鈣素和血管硬化指標、骨密度是否具有相關性。方法:受試 者為 28 位無規律運動習慣的健康中老年人(年齡 64.0±5.8 歲，身高 164.5±8.4 公分，體重 64.5±11.2 公斤)，分為規律運動組 (N=14) 和控制組 (N=14)，進行 8 週，每週 3 次，80% 1RM (one repetition maximum, 1RM) 之全身高強度機械式阻力訓練，測量訓練前、後及停止 訓練 4 週後的骨鈣素濃度、血管硬化指標及骨密度。結果:高強度阻力訓練介入對血管硬化 指標肱踝脈波傳導速度(brachial-ankle pulse wave velocity, baPWV)、頸股脈波傳導速度 (carotid-femoral PWV, cfPWV)、頸動脈脈波傳導速度(local pulse wave velocity, local PWV) 和 血清總骨鈣素(total osteocalcin, tOC)、ucOC 濃度及骨密度皆無顯著影響;tOC、ucOC 和血 管硬化指標也不具有相關性。不過在骨密度變化量方面，運動組整體和控制組有顯著差異 (p=0.01)，運動組在訓練後和四周停止訓練的變化量皆是些微增加 (訓練後 0.005±0.012 g/cm2，停止訓練 0.006±0.011 g/cm2)，而控制組則皆是些微下降 (訓練後−0.004±0.009 g/cm2，停止訓練−0.005±0.008 g/cm2);而 tOC 和骨密度在訓練後和停止訓練 2 個時間點， 呈現顯著負相關 (訓練後 r = −0.48，p=0.01;停止訓練 r = −0.43，p=0.02)。結論:健康中老 年人規律進行高強度阻力訓練 8 週後，動脈硬化指標 PWV、骨鈣素和骨密度皆未有顯著改 變，不過可能有維持骨密度的效果。中老年人從事短期高強度阻力訓練，並未影響骨鈣素及 動脈硬化指標，但對骨質密度可能有正面影響;骨鈣素和動脈硬化指標及骨密度變化之間的 相關性，未來還需更多研究證實。

關鍵字

未羧化骨鈣素 ； 動脈硬化 ； 高強度阻力訓練 ； 骨密度 ； 脈波傳導速度

並列摘要

Background: Recent studies have found that bones secret hormone-like osteocalcin. One of the forms, undercarboxylated osteocalcin (ucOC), may be related to exercise capacity and arteriosclerosis. On the other hand, regular resistance training is demonstrated to prevent middle- aged and elderly adults from osteoporosis and sarcopenia. However, some research demonstrated that resistance training could have negative impacts on the cardiovascular system. Purpose: To explore the effects of regular high-intensity resistance training for middle-aged and elderly adults on different structures of osteocalcin, vascular stiffness indexes, and bone mineral density. Furthermore, to investigate the relationships between osteocalcin and vascular sclerosis indexes and bone density. Methods: 28 healthy middle-aged and elderly sedentary adults (age 64.0±5.8 years old, height 164.5±8.4 cm, weight 64.5±11.2 kg) were recruited and assigned to the regular exercise group (N=14) and control group (N=14). The exercise group performed whole body high-intensity, 80% one-repetition maximum (1RM), resistance training 3 times a week for 8 weeks. Serum osteocalcin, vascular stiffness indexes, and bone mineral density were analyzed before, after the intervention, and detraining. Results: High-intensity resistance training had no significant influences on vascular stiffness indexes brachial-ankle pulse wave velocity (baPWV), carotid- femoral PWV (cfPWV), carotid local pulse wave velocity (local PWV), total osteocalcin (tOC), ucOC concentration, and bone density. The tOC, ucOC, and vascular stiffness indexes were not related either. However, the amount of change in bone density had a significant difference between the exercise group and the control group (p=0.01). The change at the post-intervention and detraining of the exercise group were slightly increased (∆bone mineral density of post- intervention: 0.005±0.012 g /cm2, detraining: 0.006±0.011 g/cm2), while the control group had a slight decrease (post-intervention: −0.004±0.009 g/cm2, detraining: −0.005 ±0.008 g/cm2). tOC and bone mineral density showed a significant negative correlation at post-intervention and detraining (post-intervention: r = −0.48, p=0.01; detraining: r = −0.43, p= 0.02). Conclusion: After 8 weeks of regular high-intensity resistance training in healthy middle-aged adults and elderlies, there were no significant changes in PWV, osteocalcin, and bone mineral density, but might favor maintaining bone density. Osteocalcin was not associated with vascular stiffness indexes; tOC might negatively affect bone mineral density. High-intensity resistance training may maintain bone mineral density without eliciting negative effects on the cardiovascular system. Future research regarding the relationship between vascular function, osteocalcin secretion, and bone mineral density is warranted.

並列關鍵字

undercarboxylated osteocalcin ； atherosclerosis ； high-intensity resistance training ； bone mineral density ； pulse wave velocity

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