The Association Between Walking Speed and Bone Turnover Markers in Older Adults

Objective: To examine the associations between bone turnover markers (BTMs) and bone mineral density (BMD) in older adults aged 60–85 years. Methods: A total of 1124 men (mean age, 69.1 years) and 1203 women (mean age, 70.7 years) from the National Health and Nutrition Examination Survey 1999–2002 were included in this cross-sectional analysis. Independent variables were serum bone-specific alkaline phosphatase (sBAP) and urinary N-telopeptide (uNTx), which are biomarkers of bone formation and resorption, respectively. Outcome variable was lumbar BMD. The associations of sBAP and uNTx levels with lumbar BMD was examined using multivariable linear regression models. Results: sBAP was negatively associated with lumbar BMD in each multivariable linear regression model, and this negative association was stable in both men and women men (men: β = −0.0028, 95% CI: −0.0046 to −0.0010; women: β = −0.0039, 95% CI: −0.0054 to −0.0023). On the other hand, uNTx was negatively associated with lumbar BMD after adjustment of relevant covariables (β = −0.0328, 95% CI: −0.0523 to −0.0133). However, in the subgroup analysis stratified by gender, this negative association remained only in older women (β = −0.0491, 95% CI: −0.0751 to −0.0231). Conclusion: Our study suggested that elevated sBAP and uNTX levels correlated with decreased lumbar BMD, especially in older women. This finding indicated that maintaining BTMs at low levels may be beneficial to bone health for older adults.

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A Combined Nutrition and Exercise Intervention Influences Serum Vitamin B-12 and 25-Hydroxyvitamin D and Bone Turnover of Healthy Chinese Middle-Aged and Older Adults

Journal of Nutrition ◽

10.1093/jn/nxaa149 ◽

2020 ◽

Vol 150 (8) ◽

pp. 2112-2119

Author(s):

Inge Groenendijk ◽

Ruth Chan ◽

Jean Woo ◽

Sherlin Ong ◽

Panam Parikh ◽

...

Keyword(s):

Older Adults ◽

Bone Turnover ◽

Bone Turnover Markers ◽

Exercise Intervention ◽

Intervention Group ◽

Serum Vitamin ◽

Vitamin B ◽

Middle Aged ◽

Vitamin B 12 ◽

Turnover Markers

ABSTRACT Background Hong Kong faces several public health problems including malnutrition and osteoporosis. Considering the typical Chinese diet and overall low physical activity levels of Chinese adults, timely interventions to improve nutritional status and bone health are needed. Objectives We examined the effects of a nutrition plus exercise intervention on serum vitamin B-12 and 25-hydroxyvitamin D [25(OH)D], bone turnover markers, and parathyroid hormone (PTH) concentrations in apparently healthy Chinese middle-aged and older adults. Methods In this 24-wk randomized controlled trial, 180 Chinese adults (85 women, mean ± SD age: 61 ± 6 y) were randomly assigned to receive a fortified milk supplement (2 × 30 g/d) and an exercise program (2 × 1 h/wk including resistance, balance, and aerobic training) or no intervention. The primary outcome was physical performance. In this article we analyzed the secondary outcomes serum vitamin B-12 and 25(OH)D concentrations, assessed at baseline, 12 wk, and 24 wk. Also, bone turnover markers and PTH concentrations were studied. Linear mixed models evaluated group differences over time. Results A significant time × group interaction (P < 0.001) was found for serum vitamin B-12 and 25(OH)D concentrations and the bone turnover markers, but not for serum PTH concentrations (P = 0.09). The intervention increased mean ± SD vitamin B-12 concentrations from baseline (345 ± 119 pmol/L) to 24 wk (484 ± 136 pmol/L), whereas concentrations remained stable within the control. For 25(OH)D concentrations, the intervention group had a greater increase from baseline (54.7 ± 14.2 nmol/L) to 24 wk (80.1 ± 19.2 nmol/L) than the control (60.6 ± 15.2 compared with 65.6 ± 14.6 nmol/L). The ratio of the net effect of bone formation and resorption was greater in the intervention group, suggesting less bone remodeling, irrespective of sex. Conclusions A fortified milk supplement and exercise intervention successfully improved vitamin B-12 and 25(OH)D concentrations as well as the balance of bone turnover markers of Chinese middle-aged and older adults. This trial was registered at trialregister.nl as NTR6214.

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