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Ukukhula kwamathambo kubonakala kakhulu ngexesha lokufikisa.Olu pho nonongo lujolise ekucaciseni umphumo wokwakhiwa komzimba ofikisayo kunye namandla kwiimpawu ze-bone mineral density and bone metabolism ukunceda ukuphucula ukukhula kwamathambo ngexesha lokufikisa kunye nokuthintela i-osteoporosis yexesha elizayo.Ukususela ngo-2009 ukuya ku-2015, ulutsha lwe-277 (amakhwenkwe angama-125 kunye namantombazana angama-152) abaneminyaka eyi-10/11 kunye ne-14/15 bathathe inxaxheba kwisaveyi.Imilinganiselo ibandakanya ukufaneleka/ubunzima bomzimba (umzekelo, umlinganiselo wezihlunu, njl. njl.), amandla okubamba, ukuxinana kweeminerali (i-osteosonometry index, i-OSI), kunye neziphawuli zemetabolism yamathambo (ithambo-uhlobo lwe-alkaline phosphatase kunye nohlobo lwe-collagen oludityanisiweyo olunqamlezileyo lwe-N) .-i-terminal peptide).Ulungelelwaniso oluhle phakathi kobukhulu bomzimba / amandla okubamba kunye ne-OSI yafunyanwa kumantombazana aneminyaka eyi-10 / 11 iminyaka.Kumakhwenkwe aneminyaka eyi-14/15 iminyaka, bonke ubukhulu bomzimba / amandla okubamba adityaniswa ngokufanelekileyo ne-OSI.Utshintsho kwi-muscle ye-muscle ye-muscle yahambelana ngokufanelekileyo kunye neenguqu kwi-OSI kuzo zombini izini.Ukuphakama, umlinganiselo we-muscle we-muscle kunye namandla okubamba kwi-10 / 11 iminyaka yobudala kuzo zombini izini zidibene kakhulu ne-OSI (i-positive) kunye namanqaku e-bone metabolism (negative) kwi-14 / 15 ubudala.Umzimba owaneleyo emva kweminyaka eyi-10-11 ubudala kubafana kunye ukuya kuthi ga kwi-10-11 yeminyaka ubudala kumantombazana inokusebenza ekwandiseni ubunzima bethambo.
Ukuphila ubomi obunempilo kwacetywa nguMbutho wezeMpilo weHlabathi (World Health Organization) (WHO) ngo-2001 njenge-avareji yobude bexesha umntu anokuphila ubomi obunempilo eyedwa kubomi bakhe bemihla ngemihla.EJapan, umsantsa phakathi kwexesha lokuphila ubomi obusempilweni kunye nomndilili wobomi obulindelekileyo kulindeleke ukuba udlule kwiminyaka eyi-102.Ngaloo ndlela, i-"National Movement for Health Promotion kwi-21st Century (i-Healthy Japan 21)" yadalwa ukwandisa ixesha lokuphila okunempilo3,4.Ukuphumeza oku, kuyimfuneko ukulibazisa ixesha labantu lokunyamekela.I-Movement syndrome, ubuthathaka kunye ne-osteoporosis5 zezona zizathu zokufuna unyango eJapan.Ukongeza, ulawulo lwe-metabolic syndrome, ukutyeba kwabantwana, ubuthathaka kunye nesifo semoto ngumlinganiselo wokuthintela isidingo sokhathalelo6.
Njengoko sonke sisazi, ukwenza umthambo ngokuthe rhoqo kubalulekile kwimpilo entle.Ukudlala imidlalo, inkqubo yeemoto, equkethe amathambo, amalungu kunye nezihlunu, kufuneka ibe nempilo.Ngenxa yoko, i-Japan Orthopedic Association ichaze "i-Motion Syndrome" kwi-2007 "njengokungashukumi ngenxa yokuphazamiseka kwe-musculoskeletal disorders kwaye [apho] kukho umngcipheko omkhulu wokufuna ukunakekelwa kwexesha elide kwixesha elizayo"7, kunye neendlela zokuthintela ziye zafundwa. ukusukela ngoko.ngoko.Nangona kunjalo, ngokutsho kwePhepha leNgcaciso ye-2021, ukuguga, ukuphuka, kunye nokuphazamiseka kwe-musculoskeletal disorders8 zihlala ziyizizathu eziqhelekileyo zokunyamekela iimfuno eJapan, zibalwa kwikota yazo zonke iimfuno zokunyamekela.
Ngokukodwa, i-osteoporosis ebangela i-fracture ixelwe ukuba ichaphazele i-7.9% yamadoda kunye ne-22.9% yabasetyhini abangaphezu kwe-40 eJapan9,10.Ukufunyaniswa kwangoko kunye nonyango kubonakala kuyeyona ndlela ibalulekileyo yokuthintela i-osteoporosis.Uvavanyo lwe-bone mineral density (BMD) lubalulekile ekubhaqweni kwangaphambili kunye nonyango.I-Dual energy X-ray absorption (DXA) isetyenziswe ngokwesiko njengesalathisi sovavanyo lwamathambo kwiindlela ezahlukeneyo ze-radiological.Nangona kunjalo, iifractures ziye zaxelwa ukuba zenzeke nakwi-BMD ephezulu, kwaye kwi-2000 intlanganiso ye-National Institutes of Health (NIH) ye-11 yokuvumelana yacebisa ukunyuka kwamathambo njengomlinganiselo wovavanyo lwamathambo.Nangona kunjalo, ukuvavanya umgangatho wamathambo kuhlala kungumngeni.
Enye indlela yokuvavanya i-BMD yi-ultrasound (quantitative ultrasound, QUS)12,13,14,15.Ucwaningo luye lwabonisa ukuba iziphumo ze-QUS kunye ne-DXA zihambelana16,17,18,19,20,21,22,23,24,25,26,27.Nangona kunjalo, i-QUS ayihlaseli, ayisebenzisi imitha, kwaye ingasetyenziselwa ukuhlola abafazi abakhulelweyo kunye nabantwana.Ukongeza, inenzuzo ecacileyo ngaphezu kweDXA, oko kukuthi, iyasuswa.
Ithambo lithathwa yi-osteoclasts kwaye lenziwe ngama-osteoblasts.Ukuxinana kwamathambo kugcinwa ukuba i-metabolism yamathambo iyinto eqhelekileyo kwaye kukho ulungelelwano phakathi kwe-bone resorption kunye nokubunjwa kwamathambo.
Ngokwahlukileyo, i-metabolism yamathambo engaqhelekanga iphumela ekunciphiseni kwe-BMD.Ngoko ke, ukufumanisa kwangaphambili i-osteoporosis, iimpawu ze-metabolism yamathambo, ezizikhombisi ezizimeleyo ezinxulumene ne-BMD, kubandakanywa iimpawu zokubunjwa kwamathambo kunye ne-bone resorption, zisetyenziselwa ukuvavanya i-bone metabolism eJapan.Uvavanyo lwe-FIT (FIT) olunesiphelo sokuthintela ukuphuka lubonise ukuba i-BMD ngumqondiso wokwakheka kwamathambo kunokuba i-bone resorption16,28.Kolu phononongo, abamakishi be-metabolism yamathambo baye balinganiswa ukuba bafunde ngokufanelekileyo ukuguqulwa kwamathambo.Ezi ziquka iimpawu zokubunjwa kwamathambo (ithambo-uhlobo lwe-alkaline phosphatase, i-BAP) kunye nabamakishi be-bone resorption (i-cross-linked N-terminal type I collagen peptide, NTX).
Ubufikisa bubudala benqanaba lokukhula kwencopho (PHVA), xa ukukhula kwamathambo kukhawuleza kwaye ukuxinana kwamathambo kuphezulu (ipeak bone mass, PBM) malunga neminyaka engama-20 eyadlulayo.
Enye indlela yokuthintela i-osteoporosis kukwandisa i-PBM.Nangona kunjalo, ekubeni iinkcukacha ze-metabolism yamathambo kubantwana abafikisayo ayaziwa, akukho ngenelelo oluthile olunokucetyiswa ukuba lonyuse i-BMD.
Ngoko ke, olu phononongo lujolise ekucaciseni umphumo wokwakheka komzimba kunye namandla omzimba kwi-bone mineral density and skeletal markers ngexesha lokufikisa, xa ukukhula kwamathambo kusebenza kakhulu.
Esi sisifundo seminyaka emine samaqela ukusuka kwibanga lesihlanu kwisikolo samabanga aphantsi ukuya kwibanga lesithathu kwisikolo samabanga aphakamileyo.
Abathathi-nxaxheba baquka amakhwenkwe namantombazana afikisayo athathe inxaxheba kwiProjekthi ye-Iwaki Health Promotion Primary kunye neSekondari yoPhando lwezeMpilo kwibakala lesihlanu lesikolo samabanga aphantsi kunye nebanga lesithathu lesikolo samabanga aphakamileyo samabanga aphakamileyo.
Kwakhethwa izikolo ezine zamabanga aphantsi nezamabanga aphakamileyo, ezikwisithili sase-Iwaki kwisiXeko saseHirosaki kumantla eJapan.Uvavanyo lwenziwe ekwindla.
Ukususela ngo-2009 ukuya ku-2011, abafundi bebanga lesi-5 abavumayo (abaneminyaka eyi-10/11 ubudala) kunye nabazali babo badliwano-ndlebe baza balinganiswa.Kwizifundo ezingama-395, abantu abangama-361 bathathe inxaxheba kwisaveyi, eyi-91.4%.
Ukususela ngo-2013 ukuya ku-2015, abafundi bezikolo zasesekondari abavumayo abakunyaka wesithathu (abaneminyaka eyi-14/15 ubudala) kunye nabazali babo badliwano-ndlebe baze balinganiswe.Kwizifundo ezingama-415, abantu abangama-380 bathathe inxaxheba kwisaveyi, eyi-84.3%.
Abathathi-nxaxheba be-323 baquka abantu abanembali yesifo senhliziyo, isifo seswekile, i-dyslipidemia, okanye i-hypertension, abantu abasebenzisa amayeza, abantu abanembali yokwaphuka, abantu abanembali yokuphuka kwe-calcaneus, kunye nabantu abanamaxabiso alahlekileyo kwizinto zokuhlalutya.Akubandakanywanga.Itotali yolutsha lwe-277 (amakhwenkwe angama-125 kunye namantombazana angama-152) afakiwe kuhlalutyo.
Amacandelo ophando aquka amaphepha-mibuzo, imilinganiselo yoxinaniso lwamathambo, iimvavanyo zegazi (abamakishi bemetabolism yamathambo), kunye nemilinganiselo yokufaneleka.Uphando lwenziwe ngosuku olu-1 lwesikolo samabanga aphantsi kunye neentsuku ezi-1-2 zesikolo sasesekondari.Uphando lwathatha iintsuku ezi-5.
Ikhweshine yanikwa kwangethuba ukuze izaliswe ngokwayo.Abathathi-nxaxheba bacelwa ukuba bazalise iikhweshine nabazali babo okanye nabagcini babo, kwaye iikhweshine zaqokelelwa ngosuku lokulinganisa.Iingcali ezine zempilo yoluntu ziye zaphonononga iimpendulo kwaye zabonisana nabantwana okanye abazali babo ukuba banayo nayiphi na imibuzo.Izinto zemibuzo zibandakanya iminyaka, isini, imbali yonyango, imbali yangoku yonyango, kunye nesimo samayeza.
Njengenxalenye yovavanyo lomzimba ngomhla wokufunda, imilinganiselo yobude kunye nokwakheka komzimba kwathathwa.
Imilinganiselo yokwakheka komzimba ibandakanya ubunzima bomzimba, ipesenti yamafutha omzimba (% fat), kunye nepesenti yobunzima bomzimba (% muscle).Imilinganiselo yathathwa kusetyenziswa i-analyzer yokwakheka komzimba ngokusekelwe kwindlela ye-bioimpedance (TBF-110; Tanita Corporation, Tokyo).Isixhobo sisebenzisa ii-frequencies ezininzi 5 kHz, 50 kHz, 250 kHz kunye ne-500 kHz kwaye isetyenziswe kwizifundo ezininzi zabantu abadala29,30,31.Isixhobo senzelwe ukulinganisa abathathi-nxaxheba ubuncinane ubuncinane be-110 cm ubude kunye neminyaka eyi-6 ubudala okanye ngaphezulu.
I-BMD yeyona nto iphambili yokomelela kwamathambo.Uvavanyo lwe-BMD lwenziwa yi-ECUS isebenzisa isixhobo se-ultrasound yamathambo (AOS-100NW; Aloka Co., Ltd., Tokyo, Japan).Indawo yokulinganisa yayiyi-calcaneus, eyavavanywa kusetyenziswa i-Osteo Sono-Assessment Index (OSI).Esi sixhobo silinganisa isantya sesandi (SOS) kunye ne-transmission index (TI), ezithi zisetyenziswe ukubala i-OSI.I-SOS isetyenziselwa ukulinganisa i-calcification kunye ne-bone mineral density34,35 kunye ne-TI isetyenziselwa ukulinganisa i-attenuation ye-broadband ultrasound, isalathisi sovavanyo lomgangatho wethambo12,15.I-OSI ibalwa kusetyenziswa le fomyula ilandelayo:
Ngaloo ndlela ibonisa iimpawu ze-SOS kunye ne-TI.Ke ngoko, i-OSI ithathwa njengelinye lamaxabiso esalathisi sehlabathi kuvavanyo lwethambo le-acoustic.
Ukuvavanya amandla emisipha, sasebenzisa amandla okubamba, okucingelwa ukuba kubonakalisa amandla omzimba omzimba wonke37,38.Silandela indlela yokusebenza “yoVavanyo olutsha lokuPhila ngokwasemzimbeni”39 lweZiko lezeMidlalo leSebe lezeMfundo, iNkcubeko, iMidlalo, iSayensi nobuChwepheshe.
I-Dynamometer yokubamba i-Smedley (TKK 5401; Takei Scientific Instruments Co., Ltd., Niigata, Japan).Isetyenziselwa ukulinganisa amandla okubamba kunye nokulungelelanisa ububanzi bokubamba ukuze i-proximal interphalangeal joint of the ring finger is flexed 90 °.Xa ulinganisa, indawo yelungu imile ngemilenze eyoluliweyo, utolo lwegeyiji yesandla lugcinwe lujonge ngaphandle, amagxa atshintshe kancinci emacaleni, angawuchukumisi umzimba.Abathathi-nxaxheba bacelwa ukuba babambe i-dynamometer ngamandla apheleleyo njengoko bekhupha.Ngexesha lokulinganisa, abathathi-nxaxheba bacelwa ukuba bagcine isibambo se-dynamometer sisekhona ngelixa begcina i-posture esisiseko.Isandla ngasinye silinganiswa kabini, kwaye isandla sasekhohlo nesokunene silinganiswa ngokutshintshanayo ukufumana elona xabiso lihle.
Ngentsasa kusasa kwisisu esingenalutho, igazi laqokelelwa kubantwana bebanga lesithathu bebanga eliphakamileyo, kwaye uvavanyo lwegazi lwathunyelwa kwi-LSI Medience Co., Ltd. Inkampani nayo yalinganisa ukubunjwa kwamathambo (BAP) kunye nobunzima bamathambo usebenzisa i-CLEIA (i-CLEIA) i-enzymatic immunochemiluminescent assay) indlela.yeresorption marker (NTX).
Amanyathelo afunyenwe kwibanga lesihlanu kwisikolo samabanga aphantsi nakwibanga lesithathu kwisikolo samabanga aphakamileyo esiphantsi athelekiswe kusetyenziswa iimvavanyo ezidityanisiweyo.
Ukuphonononga izinto ezinokuthi zidibanise, ulungelelwaniso phakathi kwe-OSI kwiklasi nganye kunye nokuphakama, ipesenti yamafutha omzimba, ipesenti yemisipha, kunye namandla okubamba aqinisekisiwe ngokusebenzisa i-coefficients yokulungelelanisa inxalenye.Kubafundi bebanga lesithathu bezikolo eziphakamileyo, ulungelelwaniso phakathi kwe-OSI, i-BAP, kunye ne-NTX ziqinisekisiwe kusetyenziswa i-coefficients yokulungelelaniswa kwenxalenye.
Ukuphanda umphumo wokutshintsha komzimba kunye namandla ukusuka kwibanga lesihlanu kwisikolo samabanga aphantsi ukuya kwibanga lesithathu lesikolo samabanga aphakamileyo kwi-OSI, utshintsho kwipesenti yamafutha omzimba, ubunzima be-muscle, kunye namandla okubamba ahambelana notshintsho kwi-OSI.Sebenzisa uhlalutyo lokuhlehla kaninzi.Kolu hlalutyo, utshintsho kwi-OSI lusetyenziswe njengento ekujoliswe kuyo kwaye utshintsho kwinto nganye isetyenziswe njengenkcazo echazayo.
Uhlalutyo lwe-Logistic regression analysis lusetyenziselwe ukubala i-odds ratios kunye ne-95% yamathuba okuzithemba ukuqikelela ubudlelwane phakathi kwemilinganiselo yokufaneleka kwibakala lesihlanu lesikolo samabanga aphantsi kunye ne-bone metabolism (OSI, BAP kunye ne-NTX) kwibakala lesithathu lesikolo esiphakamileyo.
Ubude, ipesenti yamafutha omzimba, ipesenti yemisipha, kunye namandla okubamba zisetyenziswe njengezibonakaliso zokufaneleka / ukufaneleka kwabafundi bebanga lesihlanu lokuqala, nganye kuzo yayisetyenziselwa ukuhlula abafundi kumaqela aphantsi, aphakathi, kunye naphezulu.
Isoftware ye-SPSS 16.0J (SPSS Inc., Chicago, IL, USA) yayisetyenziselwa uhlalutyo lwamanani kunye nexabiso le-p <0.05 lithathwa njengelibalulekileyo.
Injongo yesifundo, ilungelo lokurhoxa kuphononongo nangaliphi na ixesha, kunye neendlela zolawulo lwedatha (kubandakanywa ubumfihlo bedatha kunye nokungaziwa kwedatha) zichazwe ngokweenkcukacha kubo bonke abathathi-nxaxheba, kwaye imvume ebhaliweyo yafunyanwa kubathathi-nxaxheba ngokwabo okanye kubazali babo. ./ abagcini.
IProjekthi yokuKhuthaza iMpilo ye-Iwaki ePrayimari kunye neSifundo seSekondari yezeMpilo yavunywa yi-Hirosaki University Graduate School of Medicine Institutional Review Board (inombolo yokuvunywa kwe-2009-048, 2010-084, 2011-111, 2013-339, 2014-060 kunye ne-2015).-075).
Olu phononongo lubhaliswe ne-University Hospitals Medical Information Network (UMIN-CTR, https://www.umin.ac.jp; igama loviwo: Iwaki Health Promotion Project yoviwo lwezonyango; kunye ne-UMIN yoviwo ID: UMIN000040459).
Kumakhwenkwe, zonke izikhombisi zanda kakhulu, ngaphandle kwe-% fat, kwaye kumantombazana, zonke izikhombisi zanda kakhulu.Kunyaka wesithathu wesikolo esiphakamileyo samabanga aphakamileyo, amaxabiso esalathiso semetabolism yamathambo kumakhwenkwe ayephezulu kakhulu kunamantombazana, nto leyo ebonisa ukuba i-metabolism yamathambo kumakhwenkwe ngeli xesha yayisebenza ngakumbi kunamantombazana.
Kumantombazana ebanga lesihlanu, ulungelelwaniso oluhle lufunyenwe phakathi kobukhulu bomzimba / amandla okubamba kunye ne-OSI.Noko ke, olu tyekelo alubonwa emakhwenkweni.
Kumakhwenkwe ebanga lesithathu, zonke izinto zobungakanani bomzimba/ukubamba amandla zinxulunyaniswe kakuhle ne-OSI kwaye zinxibelelene kakubi ne-NTX kunye / ne-BAP.Ngokwahlukileyo koko, lo mkhwa wawungavakaliswa kangako kumantombazana.
Bekukho izinto ezibalulekileyo kumathuba okufumana i-OSI ephezulu kubafundi bebanga lesithathu nelesihlanu kumphakamo ophakamileyo, ipesenti yamafutha, ipesenti yemisipha, kunye namaqela amandla okubambelela.
Ukongeza, ukuphakama okuphezulu, ipesenti yamafutha omzimba, ipesenti yezihlunu, kunye namandla okubamba kwibanga lesihlanu amadoda nabasetyhini bathande ukuthoba kakhulu umlinganiselo wezinto ezingathandekiyo kumanqaku e-BAP kunye ne-NTX kwibakala lesithoba.
Ukubunjwa kwakhona kunye nokuhlaziywa kwethambo kwenzeka ebomini bonke.Le misebenzi ye-bone metabolic ilawulwa ngamahomoni ahlukeneyo40,41,42,43,44,45,46 kunye ne-cytokines.Kukho iincopho ezimbini ekukhuleni kwamathambo: ukukhula okuphambili ngaphambi kweminyaka eyi-5 kunye nokukhula kwesibini ngexesha lokufikisa.Kwinqanaba lesibini lokukhula, ukukhula kwe-axis ende yethambo kugqityiwe, umgca we-epiphyseal uvala, ithambo le-trabecular liba likhulu, kwaye i-BMD iphucula.Abathathi-nxaxheba kolu phononongo babekwixesha lophuhliso lweempawu zesini zesibini, xa ukukhutshwa kwehomoni yesini kwakusebenza kwaye izinto ezichaphazela i-metabolism yamathambo zadityaniswa.URauchenzauner et al.[47] yabika ukuba i-metabolism yamathambo ebusheni iguquguquka kakhulu kunye nobudala kunye nesini, kwaye zombini i-BAP kunye ne-tartrate-resistant phosphatase, i-marker of bone resorption, iyancipha emva kweminyaka eyi-15 ubudala.Nangona kunjalo, akukho zifundo zenziweyo ukuphanda ezi zinto kulutsha lwaseJapan.Kukwakho neengxelo ezinqongopheleyo kwiintsingiselo ezinxulumene ne-DXA kunye nezinto zemetabolism yamathambo kulutsha lwaseJapan.Esinye isizathu soku kukungafuni kwabazali nabanyamekeli ukuvumela uvavanyo oluyingozi ebantwaneni babo, njengokuqokelelwa kwegazi kunye nemitha, ngaphandle kokuxilongwa okanye unyango.
Kumantombazana ebanga lesihlanu, ulungelelwaniso oluhle lufunyenwe phakathi kobukhulu bomzimba / amandla okubamba kunye ne-OSI.Noko ke, olu tyekelo alubonwa emakhwenkweni.Oku kuphakamisa ukuba ukukhula kobungakanani bomzimba ngexesha lokufikisa kwangoko kunefuthe kwi-OSI kumantombazana.
Zonke izinto zokumila komzimba/ukubamba amandla zazinxulunyaniswa ngokuqinisekileyo ne-OSI kumakhwenkwe ebanga lesithathu.Ngokwahlukileyo, lo mkhwa wawungabonakali kakhulu kumantombazana, apho kuphela utshintsho kwipesenti ye-muscle kunye namandla okubamba kwakudityaniswa ngokuqinisekileyo ne-OSI.Utshintsho kwi-muscle ye-muscle ye-muscle yahambelana ngokufanelekileyo kunye neenguqu kwi-OSI phakathi kwesondo.Ezi ziphumo zibonisa ukuba kumakhwenkwe, ukwanda kobukhulu bomzimba / amandla emisipha ukusuka kumabakala 5 ukuya ku-3 kuchaphazela i-OSI.
Ukuphakama, umlinganiselo wemisipha yomzimba, kunye namandla okubamba kwibanga lesihlanu lesikolo samabanga aphantsi kwakuhambelana ngokufanelekileyo kunye ne-OSI index kwaye ihambelana kakhulu nemilinganiselo ye-bone metabolism kwibakala lesithathu lesikolo esiphakamileyo.Ezi nkcukacha zibonisa ukuba ukuphuhliswa kobukhulu bomzimba (ubude kunye nomlinganiselo womzimba ukuya kumzimba) kunye namandla okubamba ebusheni bokuqala buchaphazela i-OSI kunye ne-bone metabolism.
Ubudala besibini benqanaba lokukhula kwencopho (PHVA) kwisiJapani yabonwa kwiminyaka eyi-13 kumakhwenkwe kunye ne-11 leminyaka kumantombazana, ngokukhula ngokukhawuleza kumakhwenkwe49.Kwiminyaka eyi-17 kumakhwenkwe kunye neminyaka eyi-15 kumantombazana, umgca we-epiphyseal uqala ukuvala, kwaye i-BMD iyanda kwi-BMD.Ngenxa yale mvelaphi kunye neziphumo zolu phononongo, sicinga ukuba ukuphakama, ubunzima bemisipha, kunye namandla emisipha kumantombazana ukuya kwibanga lesihlanu kubalulekile ekunyuseni i-BMD.
Uphononongo lwangaphambili lwabantwana abakhulayo kunye nabakwishumi elivisayo lubonise ukuba abamakishi be-bone resorption kunye nokwakheka kwamathambo ekugqibeleni banda i50.Oku kunokubonakalisa i-metabolism yamathambo esebenzayo.
Ubudlelwane phakathi kwe-bone metabolism kunye ne-BMD ibe ngumxholo wezifundo ezininzi kubantu abadala51,52.Nangona ezinye iingxelo53, i-54, i-55, i-56 ibonisa iindlela ezihluke kancinci kumadoda, ukuphononongwa kweziphumo zangaphambili kunokushwankathelwa ngolu hlobo lulandelayo: "Amanqaku e-bone metabolism ayanda ngexesha lokukhula, aze anciphise kwaye ahlale engatshintshi kude kube yi-40 yobudala, ubudala. ”.
EJapan, amaxabiso esalathiso se-BAP yi-3.7–20.9 µg/L kumadoda asempilweni kunye ne-2.9–14.5 µg/L yabasetyhini abasempilweni abangaphambi kokuya esikhathini.Amaxabiso okubhekisela kwi-NTX yi-9.5-17.7 nmol BCE/L yamadoda asempilweni kunye ne-7.5-16.5 nmol BCE/L yabasetyhini abasempilweni ngaphambi kokuya esikhathini.Xa kuthelekiswa nala maxabiso ereferensi kwisifundo sethu, zombini izikhombisi ziphuculwe kumabanga esithathu kwisikolo samabanga aphantsi, ebesichazwa ngakumbi kumakhwenkwe.Oku kubonisa umsebenzi we-metabolism yamathambo kubantwana besithathu, ngakumbi abafana.Isizathu sokwahlukana ngokwesini sinokuthi abafana bebanga le-3 basesesigaba sokukhula kwaye umgca we-epiphyseal awukavalwa, ngelixa kumantombazana ngeli xesha umgca we-epiphyseal usondele ekuvaleni.Oko kukuthi, abafana bebanga lesithathu basaphuhlisa kwaye banokukhula okusebenzayo kwamathambo, ngelixa amantombazana esekupheleni kwexesha lokukhula kwamathambo kwaye afikelela kwinqanaba lokukhula kwamathambo.Iimpawu kwiimpawu zemetabolism zamathambo ezifunyenwe kolu phononongo zihambelana nobudala bezinga eliphezulu lokukhula kubemi baseJapan.
Ukongezelela, iziphumo zolu phando zibonise ukuba abafundi bebanga lesihlanu besikolo samabanga aphantsi abanomzimba oqinileyo kunye namandla omzimba babeneminyaka emincinci kwincopho ye-bone metabolism.
Nangona kunjalo, umda wolu phononongo kukuba umphumo wokuya esikhathini awuzange uthathelwe ingqalelo.Ngenxa yokuba i-metabolism yamathambo iphenjelelwa yi-hormone yesini, izifundo ezizayo kufuneka ziphande umphumo wokuya esikhathini.