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Purpose:The purpose of the present controlled cross-sectional study was to investigate proximal femur and whole-body bone mineral density (BMD), as well as bone tover profile, in lifelong trained elderly male football players and young elite football players compared with untrained age-matched men. Methods:One hundred and forty healthy,non-smoking men participated in the study,including lifelong trained football players(FTE,n=35) aged 65-80 years,elite football players(FTY,n=35)aged 18-30 years,as well as untrained age-matched elderly(UE,n=35)and young(UY, n=35) men. All participants underwent a regional dual-energy X-ray Absorptiometry (DXA) scan of the proximal femur and a whole-body DXA scan to determine BMD.From a resting blood sample,the bone tover markers(BTMs)osteocalcin,carboxy-terminal type-1 collagen crosslinks(CTX-1),procollagen type-1 amino-terminal propeptide(P1NP),and sclerostin were measured. Results:FTE had 7.3%-12.9% higher(p<0.05)BMD of the femoral neck,wards,shaft,and total proximal femur in both legs compared to UE, and 9.3%-9.7% higher(p<0.05)BMD in femoral trochanter in both legs compared to UY.FTY had 24.3%-37.4% higher(p<0.001)BMD in all femoral regions and total proximal femur in both legs compared to UY.The whole-body DXA scan confirmed these results,with FTE showing similar whole-body BMD and 7.9% higher(p<0.05)leg BMD compared to UY,and with FTY having 9.6% higher(p<0.001)whole-body BMD and 18.2% higher(p<0.001)leg BMD compared to UY.The plasma concentration of osteocalcin,CTX-1,and P1NP were 29%, 53%,and 52% higher(p<0.01),respectively,in FTY compared to UY. Conclusion:BMD of the proximal femur and whole-body BMD are markedly higher in lifelong trained male football players aged 65-80 years and young elite football players aged 18-30 years compared to age-matched untrained men.Elderly football players even show higher BMD in femoral trochanter and leg BMD than untrained young despite an age difference of 47 years.