Effects of physical activity on bone remodeling
Introduction
The influence of exercise on bone mineral density (BMD) has been extensively evaluated by both cross-sectional [1], [2], [3] and intervention studies in young [4] and elderly subjects [5]. Nevertheless, the specific mechanisms by which physical activity influences bone metabolism are still not thoroughly understood. It is widely acknowledged that the bone mass gain from exercise is principally a response to an increase in mechanical strain [6], but other parameters like endocrine changes [7], [8], [9] are likely to contribute to the skeletal adaptations. In particular, little is known about the changes in bone turnover induced by various forms of systematic exercise. Because changes in bone mass result from slow-acting metabolic processes, bone biochemical markers should be useful for investigating the acute effects of exercise on bone remodeling. The objective of this work is to focus on the effect of physical activity on bone turnover. For the past 20 years, many studies have investigated these biological parameters. Unfortunately, the conclusions are confounded, probably because no standardized procedures were used. Several factors related to exercise (duration, intensity, or type of exercise), population (young or elderly subjects), and protocol (time points for blood sampling or the use of bone biochemical markers with various specificities and sensitivities) may explain the divergent results. Moreover, it is not clear whether the variation in bone remodeling is an adaptive change associated with long-term training or whether it is an acute effect of a recent exercise bout. Despite the shortcomings of many of the studies to date, this original approach of using bone biochemical markers and calciotropic hormones may elucidate the acute effect of exercise on bone metabolism, which in turn would provide useful information for the design of standardized and adapted therapeutic programs to optimize bone accretion in children and to improve bone health in the elderly.
Section snippets
Part 1: bone biochemical markers
By consensus, BMD measurement is used to estimate bone strength and is taken as the primary indicator of a risk of osteoporotic fracture [10]. However, the BMD value provides a static representation of bone metabolism; and changes in its value occur at a slow rate. Bone mineral density measurement is thus inadequate to detect slight and acute changes in bone metabolism, such as might occur after a single bout of physical exercise or a training program. Moreover, in confirmed athletes, the
In athletes
In parallel to the higher BMD in athletes, higher values for bone formation markers have been found in subjects involved in long-term training in comparison with age-matched controls [7], [24], [25] (Table 2). Bell et al [7] reported higher OC levels in young men participating in regular muscle-building activity. Similar results were reported in other sports that generate high mechanical strain, such as weight-lifting [25] and volleyball [24]. However, because bone resorption markers were not
Conclusion
Bone biochemical markers may become very attractive tools for investigating the immediate response of bone cells to exercise, particularly in the aim of individualizing exercise programs to improve bone health. However, typical responses to different types of exercise have been difficult to obtain up to now, probably because many factors like sex and physical fitness modify the responses. Moreover, it is currently unknown whether the variations measured in these markers were partially due to
Acknowledgment
The authors would like to express their thanks to Prof Patrick Garnero for his helpful remarks on the construction of this manuscript. No funding was available for the project.
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