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Ukukhula kwamathambo kugqama kakhulu ngesikhathi sokuthomba.Lolu cwaningo luhlose ukucacisa umphumela wokwakhiwa komzimba osemusha namandla kumakaki wamathambo amaminerali kanye ne-bone metabolism ukusiza ukuthuthukisa ukukhula kwamathambo ngesikhathi sokukhula nokuvimbela ukukhumuzeka kwamathambo esikhathini esizayo.Kusukela ngo-2009 kuya ku-2015, intsha engu-277 (abafana abangu-125 namantombazane angu-152) eneminyaka engu-10/11 no-14/15 yabamba iqhaza kulolu cwaningo.Izilinganiso zibandakanya inkomba yokufaneleka/yesisindo somzimba (isb., isilinganiso semisipha, njll.), amandla okubambelela, ukuminyana kwamaminerali amathambo (inkomba ye-osteosonometry, i-OSI), nomaka be-bone metabolism (uhlobo lwe-alkaline phosphatase yohlobo lwe-bone kanye nohlobo I-collagen exhunywe ngokuphambana N) .- i-terminal peptide).Ukuhlobana okuhle phakathi kosayizi womzimba/amandla okubamba kanye ne-OSI kutholwe emantombazaneni aneminyaka engu-10/11.Ebafaneni abaneminyaka engu-14/15, zonke izici zobukhulu bomzimba/ukubamba zazihlotshaniswa kahle ne-OSI.Izinguquko ezilinganisweni zemisipha yomzimba zazihlotshaniswa kahle nezinguquko ku-OSI kubo bobabili ubulili.Ukuphakama, isilinganiso somzimba wemisipha namandla okubamba eminyakeni engu-10/11 kubo bobabili ubulili kwakuhlotshaniswa kakhulu ne-OSI (positive) kanye nezimpawu ze-bone metabolism (negative) eminyakeni engu-14/15 ubudala.Ukwakheka komzimba okwanele ngemva kweminyaka eyi-10-11 kubafana kuze kufike eminyakeni eyi-10-11 emantombazaneni kungase kuphumelele ekwandiseni ubukhulu bamathambo.
Ubude besikhathi sokuphila okunempilo kwahlongozwa yiNhlangano Yezempilo Yomhlaba (WHO) ngo-2001 njengesilinganiso sobude besikhathi umuntu angakwazi ukuphila impilo enempilo eyedwa ekuphileni kwakhe kwansuku zonke.E-Japan, igebe phakathi kweminyaka yokuphila enempilo kanye nesilinganiso seminyaka yokuphila kulindeleke ukuba lidlule iminyaka eyi-102.Ngakho-ke, i-"National Movement for Health Promotion in the 21st Century (Healthy Japan 21)" yadalwa ukuze kwandiswe iminyaka yokuphila enempilo3,4.Ukufeza lokhu, kuyadingeka ukubambezela isikhathi sokunakekelwa kwabantu.I-Movement syndrome, ubuthakathaka kanye ne-osteoporosis5 yizizathu eziyinhloko zokufuna usizo lwezokwelapha eJapane.Ngaphezu kwalokho, ukulawulwa kwe-metabolic syndrome, ukukhuluphala kwezingane, ubuthakathaka kanye nesifo semoto kuyisinyathelo sokuvimbela isidingo sokunakekelwa6.
Njengoba sonke sazi, ukuvivinya umzimba okusesilinganisweni okuvamile kubalulekile ukuze ube nempilo enhle.Ukuze udlale ezemidlalo, isimiso sezimoto, esihlanganisa amathambo, amalunga nemisipha, kufanele sibe nempilo.Ngenxa yalokho, i-Japan Orthopedic Association ichaze "i-Motion Syndrome" ku-2007 ngokuthi "ukungakwazi ukuhamba ngenxa yezinkinga ze-musculoskeletal kanye [lapho] kunengozi enkulu yokudinga ukunakekelwa isikhathi eside esikhathini esizayo"7, futhi izinyathelo zokuvimbela ziye zafundwa. kusuka lapho.bese.Kodwa-ke, ngokwePhepha Elimhlophe lango-2021, ukuguga, ukuphuka, nokuphazamiseka kwemisipha namathambo8 kusalokhu kuyizimbangela ezivame kakhulu zezidingo zokunakekelwa eJapan, kubalwa ingxenye yesine yazo zonke izidingo zokunakekelwa.
Ikakhulukazi, i-osteoporosis ebangela ukuphuka kubikwa ukuthi ithinta i-7.9% yamadoda kanye ne-22.9% yabesifazane abangaphezu kuka-40 e-Japan9,10.Ukutholwa kusenesikhathi nokwelashwa kubonakala kuyindlela ebaluleke kakhulu yokuvimbela ukukhumuzeka kwamathambo.Ukuhlolwa kokuqina kwamaminerali amathambo (BMD) kubalulekile ukuze kutholakale ngokushesha kanye nokwelashwa.I-Dual energy X-ray absorption (DXA) ijwayele ukusetshenziswa njengenkomba yokuhlolwa kwamathambo ezindleleni ezihlukahlukene ze-radiological.Kodwa-ke, ukuphuka kuye kwabikwa ukuthi kwenzeka ngisho ne-BMD ephezulu, futhi ngo-2000 umhlangano we-National Institutes of Health (NIH)11 wokuvumelana wancoma ukwanda kwamathambo njengesilinganiso sokuhlola amathambo.Nokho, ukuhlola ikhwalithi yamathambo kusalokhu kuyinselele.
Enye indlela yokuhlola i-BMD nge-ultrasound (quantitative ultrasound, QUS)12,13,14,15.Ucwaningo luphinde lwabonisa ukuthi imiphumela ye-QUS ne-DXA ihlobene16,17,18,19,20,21,22,23,24,25,26,27.Kodwa-ke, i-QUS ayihlaseli, ayisebenzisi imisebe, futhi ingasetshenziswa ukuhlola abesifazane abakhulelwe nezingane.Ngaphezu kwalokho, inenzuzo ecacile ngaphezu kwe-DXA, okungukuthi iyakhipheka.
Ithambo lithathwa ama-osteoclast futhi lakhiwe ama-osteoblasts.Ukuqina kwamathambo kugcinwa uma i-metabolism yamathambo ijwayelekile futhi kukhona ibhalansi phakathi kwe-bone resorption kanye nokwakheka kwamathambo.
Ngokuphambene, i-metabolism yamathambo engavamile iholela ekwehleni kwe-BMD.Ngakho-ke, ukuze kutholakale ngokushesha i-osteoporosis, izimpawu ze-bone metabolism, okuyizinkomba ezizimele ezihlotshaniswa ne-BMD, kuhlanganise nezimpawu zokwakheka kwamathambo kanye nokuvuselelwa kwamathambo, zisetshenziselwa ukuhlola umzimba wethambo eJapane.Ukuhlolwa kwe-Fracture Intervention Trial (FIT) nge-endpoint yokuvimbela ukuphuka kubonise ukuthi i-BMD iwuphawu lokwakheka kwamathambo kunokuba i-bone resorption16,28.Kulolu cwaningo, izimpawu zemetabolism yamathambo nazo zikalwa ukuze kufundwe ngokunembile ukuguquguquka kwe-bone metabolism.Lokhu kufaka phakathi izimpawu zokwakheka kwamathambo (ithambo lohlobo lwe-alkaline phosphatase, i-BAP) kanye nezimpawu ze-bone resorption (uhlobo oluxhunywe ngokuphambano lwe-N-terminal I collagen peptide, NTX).
Ubusha yinkathi yezinga eliphezulu lokukhula (PHVA), lapho ukukhula kwamathambo kushesha futhi ukuminyana kwamathambo kuphakama (isiqongo samathambo, i-PBM) cishe eminyakeni engama-20 edlule.
Enye indlela yokuvimbela i-osteoporosis ukwandisa i-PBM.Kodwa-ke, njengoba imininingwane ye-bone metabolism entsheni ingaziwa, akukho ukungenelela okuqondile okungaphakanyiswa ukuze kwandiswe i-BMD.
Ngakho-ke, lolu cwaningo luhlose ukucacisa umphumela wokwakheka komzimba namandla angokomzimba emathanjeni amaminerali kanye nezimpawu zamathambo ngesikhathi sobusha, lapho ukukhula kwamathambo kusebenza kakhulu.
Lolu wucwaningo lweminyaka emine lweqembu kusukela ebangeni lesihlanu lesikole samabanga aphansi kuya ebangeni lesithathu lesikole samabanga aphezulu.
Abahlanganyeli bahlanganisa abafana namantombazane abasakhula ababambe iqhaza ku-Iwaki Health Promotion Project Primary and Secondary Health Survey ebangeni lesihlanu lesikole samabanga aphansi kanye nebanga lesithathu lesikole samabanga aphezulu.
Kwakhethwa izikole ezine zamabanga aphansi nezincane, ezisesifundeni sase-Iwaki eDolobheni laseHirosaki enyakatho yeJapane.Ucwaningo lwenziwe ekwindla.
Kusukela ngo-2009 kuya ku-2011, abafundi abavumayo bebanga lesi-5 (abaneminyaka engu-10/11 ubudala) nabazali babo kwaxoxwa nabo futhi balinganiswa.Ezifundweni ezingama-395, bangu-361 abantu ababambe iqhaza kulolu cwaningo, okungama-91.4%.
Kusukela ngo-2013 kuya ku-2015, kwaxoxwa nabafundi besikole samabanga aphakeme abenza unyaka wesithathu (abaneminyaka engu-14/15 ubudala) nabazali babo futhi balinganiswa.Ezifundweni ezingu-415, bangu-380 abantu ababambe iqhaza kulolu cwaningo, okungama-84.3%.
Abahlanganyeli abangu-323 bahlanganisa abantu abanomlando wesifo senhliziyo, isifo sikashukela, i-dyslipidemia, noma i-hypertension, abantu abaphuza imithi, abantu abanomlando wokuphuka, abantu abanomlando wokuphuka kwe-calcaneus, nabantu abanamanani ashodayo ezintweni zokuhlaziya.Akufakiwe.Ingqikithi yentsha engama-277 (abafana abangu-125 namantombazane angu-152) ifakiwe ekuhlaziyeni.
Izingxenye zocwaningo zazihlanganisa imibuzo, izilinganiso zokuminyana kwamathambo, ukuhlolwa kwegazi (omaka be-bone metabolism), nezilinganiso zokufaneleka.Ucwaningo lwenziwe phakathi nosuku olungu-1 lwesikole samabanga aphansi kanye no-1-2 wesikole samabanga aphezulu.Uphenyo lwathatha izinsuku ezingu-5.
Uhlu lwemibuzo lwanikezwa kusenesikhathi ukuze uzigcwalise ngokwalo.Abahlanganyeli bacelwa ukuba bagcwalise uhlu lwemibuzo nabazali babo noma ababheki babo, futhi uhlu lwemibuzo lwaqoqwa ngosuku lokulinganisa.Ochwepheshe abane bezempilo yomphakathi babuyekeze izimpendulo futhi baxoxisana nezingane noma abazali bazo uma benemibuzo.Izinto zohlu lwemibuzo zazihlanganisa iminyaka, ubulili, umlando wezokwelapha, umlando wamanje wezokwelapha, nesimo somuthi.
Njengengxenye yokuhlolwa komzimba ngosuku locwaningo, kwathathwa izilinganiso zobude nokwakheka komzimba.
Izilinganiso zokwakheka komzimba zihlanganisa isisindo somzimba, iphesenti lamafutha omzimba (% fat), kanye nephesenti lesisindo somzimba (% muscle).Izilinganiso zithathwe kusetshenziswa ukuhlaziya ukwakheka komzimba okusekelwe endleleni ye-bioimpedance (TBF-110; Tanita Corporation, Tokyo).Idivayisi isebenzisa amafrikhwensi amaningi 5 kHz, 50 kHz, 250 kHz kanye no-500 kHz futhi isetshenziswe ezifundweni eziningi zabantu abadala29,30,31.Idivayisi yakhelwe ukukala ababambiqhaza okungenani abangu-110 cm ubude nabaneminyaka engu-6 ubudala noma ngaphezulu.
I-BMD iyingxenye eyinhloko yamandla amathambo.Ukuhlolwa kwe-BMD kwenziwa yi-ECUS isebenzisa idivayisi ye-bone ultrasound (AOS-100NW; Aloka Co., Ltd., Tokyo, Japan).Indawo yokulinganisa bekuyi-calcaneus, eyahlolwa kusetshenziswa i-Osteo Sono-Assessment Index (OSI).Le divayisi ikala isivinini somsindo (SOS) kanye ne-transmission index (TI), bese isetshenziselwa ukubala i-OSI.I-SOS isetshenziselwa ukukala i-calcification kanye ne-bone mineral density34,35 futhi i-TI isetshenziselwa ukukala ukuncishiswa kwe-broadband ultrasound, inkomba yokuhlolwa kwekhwalithi yamathambo12,15.I-OSI ibalwa kusetshenziswa ifomula elandelayo:
Ngakho kubonisa izici ze-SOS ne-TI.Ngakho-ke, i-OSI ibhekwa njengenye yamanani wenkomba yomhlaba wonke ekuhlolweni kwethambo le-acoustic.
Ukuhlola amandla emisipha, sasebenzisa amandla okubamba, okucatshangwa ukuthi abonisa amandla emisipha yomzimba wonke37,38.Silandela indlela yokusebenza “Yokuhlolwa Okusha Kokufaneleka Komzimba”39 Yehhovisi Lezemidlalo Lomnyango Wezemfundo, Amasiko, Ezemidlalo, Isayensi Nobuchwepheshe.
I-Smedley gripping dynamometer (TKK 5401; Takei Scientific Instruments Co., Ltd., Niigata, Japan).Isetshenziselwa ukukala amandla okubambelela futhi ulungise ububanzi bokubamba ukuze i-proximal interphalangeal joint yomunwe wendandatho igobe ngo-90°.Uma kulinganiswa, ukuma kwesitho kumile ngemilenze eyeluliwe, umcibisholo wegeji yesandla ugcinwa ubheke ngaphandle, amahlombe ashintshela kancane emaceleni, angawuthinti umzimba.Abahlanganyeli babe sebecelwa ukuthi babambe i-dynamometer ngamandla aphelele njengoba bekhipha umoya.Ngesikhathi sokulinganisa, ababambiqhaza bacelwe ukuthi bagcine isibambo se-dynamometer singanyakazi ngenkathi begcina ukuma okuyisisekelo.Isandla ngasinye silinganiswa kabili, futhi izandla kwesokunxele nesokudla kukalwa ngokushintshana ukuze uthole inani elingcono kakhulu.
Ekuseni ngovivi esiswini esingenalutho, kwaqoqwa igazi ezinganeni zebanga lesithathu zesikole samabanga aphakeme, futhi ukuhlolwa kwegazi kwathunyelwa kwa-LSI Medience Co., Ltd. Le nkampani iphinde yakala ukwakheka kwamathambo (BAP) nesisindo samathambo isebenzisa i-CLEIA ( indlela ye-enzymatic immunochemiluminescent assay).umaka we-resorption (NTX).
Izinyathelo ezitholwe ebangeni lesihlanu lesikole samabanga aphansi kanye nebanga lesithathu lesikole samabanga aphakeme esincane ziqhathaniswe kusetshenziswa izivivinyo zika-t ezibhangqiwe.
Ukuze uhlole izici ezingase zidideke, ukuhlobana phakathi kwe-OSI yekilasi ngalinye nobude, amaphesenti wamafutha omzimba, amaphesenti emisipha, namandla okubambelela kwaqinisekiswa kusetshenziswa ama-coefficients wokuhlanganisa ingxenye.Kubafundi bebanga lesithathu besikole samabanga aphezulu, ukuhlobana phakathi kwe-OSI, i-BAP, ne-NTX kwaqinisekiswa kusetshenziswa ama-coefficients wokuhlanganisa ingxenye.
Ukuze kuphenywe umphumela wezinguquko zomzimba namandla kusukela ebangeni lesihlanu lesikole samabanga aphansi kuya ebangeni lesithathu lesikole samabanga aphakeme esiphansi ku-OSI, izinguquko kumaphesenti wamafutha omzimba, ubunzima bemisipha, namandla okubamba okuhambisana nezinguquko ku-OSI kwahlolwa.Sebenzisa ukuhlaziywa kokuhlehla okuningi.Kulokhu kuhlaziya, uguquko ku-OSI lusetshenziswe njengokuguquguquka okuhlosiwe futhi uguquko lwento ngayinye lusetshenziswe njengokuguquguquka okuchazayo.
Ukuhlaziywa kokuhlehliswa kokuhleleka kwasetshenziswa ukubala izilinganiso zezingqinamba nezikhawu zokuzethemba ezingu-95% ukuze kulinganiswe ubudlelwano phakathi kwamapharamitha wokufaneleka ebangeni lesihlanu lesikole samabanga aphansi kanye ne-bone metabolism (OSI, BAP ne-NTX) ebangeni lesithathu lesikole esiphakeme.
Ubude, iphesenti lamafutha omzimba, amaphesenti emisipha, namandla okubambelela kwasetshenziswa njengezinkomba zokufaneleka/ukufaneleka kwabafundi bebanga lesihlanu aphansi, ngayinye eyasetshenziswa ukuhlukanisa abafundi ngamaqembu aphansi, aphakathi nendawo naphezulu.
Isofthiwe ye-SPSS 16.0J (SPSS Inc., Chicago, IL, USA) isetshenziselwe ukuhlaziywa kwezibalo futhi amanani we-p <0.05 abhekwa njengebalulekile ngokwezibalo.
Injongo yocwaningo, ilungelo lokuhoxa ocwaningweni nganoma yisiphi isikhathi, kanye nezinqubo zokuphatha idatha (okuhlanganisa ubumfihlo bedatha nokwenza kungaziwa ukuthi ungubani) kwachazwa ngokuningiliziwe kubo bonke ababambiqhaza, futhi imvume ebhaliwe yatholwa kubahlanganyeli ngokwabo noma kubazali babo. ./ ababheki.
I-Iwaki Health Promotion Project Primary kanye ne-Secondary School Health Study yavunywa yi-Hirosaki University Graduate School of Medicine Institutional Review Board (inombolo yokugunyaza 2009-048, 2010-084, 2011-111, 2013-339, 2014-060 kanye no-2015).-075).
Lolu cwaningo lubhaliswe ne-University Hospitals Medical Information Network (UMIN-CTR, https://www.umin.ac.jp; igama lesivivinyo: ukuhlolwa kwezokwelapha kwephrojekthi ye-Iwaki Health Promotion; kanye ne-ID yokuhlolwa kwe-UMIN: UMIN000040459).
Kubafana, zonke izinkomba zanda kakhulu, ngaphandle kwamafutha angu-%, futhi emantombazaneni, zonke izinkomba zanda kakhulu.Ngonyaka wesithathu wesikole samabanga aphezulu, amanani we-bone metabolism index kubafana nawo ayephezulu kakhulu kunamantombazane, okukhombisa ukuthi i-metabolism yamathambo kubafana ngalesi sikhathi yayisebenza kakhulu kunamantombazane.
Emantombazaneni ebanga lesihlanu, kutholwe ukuhlobana okuhle phakathi kosayizi womzimba/amandla okubamba kanye ne-OSI.Nokho, lo mkhuba awuzange ubonwe kubafana.
Ebafaneni bebanga lesithathu, zonke izici zobukhulu bomzimba/ukubamba kwamandla zazihlotshaniswa kahle ne-OSI futhi zihlotshaniswa kabi ne-NTX kanye //BAP.Ngokuphambene, lo mkhuba wawungagqami kahle emantombazaneni.
Kube nokuthambekela okubalulekile kumathuba e-OSI ephakeme kubafundi bebanga lesithathu nelesihlanu ekuphakameni okuphezulu, amaphesenti amafutha, amaphesenti emisipha, namaqembu amandla okubambelela.
Ngaphezu kwalokho, ukuphakama okuphezulu, iphesenti lamafutha omzimba, amaphesenti emisipha, namandla okubambelela ebangeni lesihlanu abesilisa nabesifazane bathambekele ekwehliseni ngokuphawulekayo isilinganiso sezinkinga ze-BAP ne-NTX ebangeni lesishiyagalolunye.
Ukwakheka kabusha kanye nokufakwa kabusha kwethambo kwenzeka impilo yonke.Le misebenzi ye-bone metabolic ilawulwa amahomoni ahlukahlukene40,41,42,43,44,45,46 nama-cytokines.Kuneziqongo ezimbili ekukhuleni kwamathambo: ukukhula okuyinhloko ngaphambi kweminyaka emi-5 kanye nokukhula kwesibili ngesikhathi sokuthomba.Esigabeni sesibili sokukhula, ukukhula kwe-axis ende yethambo kuqedwa, umugqa we-epiphyseal uvala, ithambo le-trabecular liba likhulu, futhi i-BMD iyathuthuka.Abahlanganyeli kulolu cwaningo babesesikhathini sokuthuthuka kwezici zocansi zesibili, lapho ukukhishwa kwamahomoni ocansi kusebenza futhi izici ezithinta umzimba wethambo zihlangene.U-Rauchenzauner et al.[47] ibike ukuthi i-metabolism yamathambo ebusheni iyashintshashintsha kakhulu ngokweminyaka nobulili, nokuthi kokubili i-BAP kanye ne-phosphatase engamelana ne-tartrate, umaka wokuqina kwamathambo, yehla ngemva kweminyaka engu-15 ubudala.Kodwa-ke, azikho izifundo ezenziwe ukuze kuphenywe lezi zici entsheni yaseJapane.Kukhona nemibiko elinganiselwe kakhulu mayelana nezitayela kumaka ahlobene ne-DXA nezici ze-bone metabolism entsheni yase-Japan.Esinye isizathu salokhu ukungabaza kwabazali nabanakekeli ukuvumela ukuhlolwa okuhlaselayo ezinganeni zabo, njengokuqoqwa kwegazi nemisebe, ngaphandle kokuxilongwa noma ukwelashwa.
Emantombazaneni ebanga lesihlanu, kutholwe ukuhlobana okuhle phakathi kosayizi womzimba/amandla okubamba kanye ne-OSI.Nokho, lo mkhuba awuzange ubonwe kubafana.Lokhu kuphakamisa ukuthi ukukhula kosayizi womzimba ngesikhathi sokuthomba kusenesikhathi kuthonya i-OSI emantombazaneni.
Zonke izici zokuma komzimba/ukubamba kwamandla zazihlotshaniswa kahle ne-OSI ebafaneni bebanga lesithathu.Ngokuphambene, lo mkhuba wawungacacisi kangako emantombazaneni, lapho izinguquko kuphela kumaphesenti emisipha namandla okubambelela zazihlotshaniswa kahle ne-OSI.Izinguquko ekulinganiseni kwemisipha yomzimba zazihlotshaniswa kahle nezinguquko ku-OSI phakathi kobulili.Le miphumela iphakamisa ukuthi kubafana, ukwanda kosayizi womzimba/amandla emisipha kusuka kumabanga 5 kuya ku-3 kuthinta i-OSI.
Ubude, isilinganiso somzimba nemisipha, namandla okubambelela ebangeni lesihlanu lesikole samabanga aphansi kwakuhlotshaniswa kahle kakhulu nenkomba ye-OSI futhi kuhlotshaniswa kakhulu kabi nezinyathelo ze-bone metabolism ebangeni lesithathu lesikole esiphakeme.Le datha iphakamisa ukuthi ukuthuthukiswa kosayizi womzimba (ubude kanye nesilinganiso somzimba nomzimba) namandla okubambelela ekuqaleni kokuthomba kuthinta i-OSI kanye ne-bone metabolism.
Iminyaka yesibili yezinga eliphezulu lokukhula (PHVA) ngesi-Japanese yabonwa eminyakeni engu-13 kubafana kanye neminyaka engu-11 emantombazaneni, ngokukhula ngokushesha kubafana49.Lapho eneminyaka engu-17 kubafana kanye neminyaka engu-15 emantombazaneni, umugqa we-epiphyseal uqala ukuvala, futhi i-BMD iyanda ibheke ku-BMD.Uma kubhekwa lesi sizinda kanye nemiphumela yalolu cwaningo, sicabanga ukuthi ukukhula kobude, imisipha, namandla emisipha emantombazaneni afika ebangeni lesihlanu kubalulekile ekwandiseni i-BMD.
Ucwaningo lwangaphambilini lwezingane ezikhulayo kanye nentsha lubonise ukuthi izimpawu zokubuyiswa kwamathambo kanye nokwakheka kwamathambo ekugcineni zanda ama-50.Lokhu kungase kubonise umzimba wethambo osebenzayo.
Ubudlelwano phakathi kwe-bone metabolism kanye ne-BMD kube yisihloko sezifundo eziningi kubantu abadala51,52.Nakuba eminye imibiko53, 54, 55, 56 ibonisa ukuthambekela okuhluke kancane emadodeni, ukubuyekezwa kokutholwe kwangaphambilini kungafingqwa ngale ndlela elandelayo: "Izimpawu ze-bone metabolism zanda ngesikhathi sokukhula, bese ziyancipha futhi zihlala zingashintshi kuze kube yilapho iminyaka engu-40, ubudala. ”.
E-Japan, amanani ereferensi ye-BAP angu-3.7–20.9 µg/L kwabesilisa abanempilo kanye no-2.9–14.5 µg/L kwabesifazane abanempilo abangaphambi kokuya esikhathini.Amanani okuyisethenjwa e-NTX angu-9.5-17.7 nmol BCE/L kwabesilisa abanempilo kanye no-7.5-16.5 nmol BCE/L kwabesifazane abanempilo ngaphambi kokuya esikhathini.Uma kuqhathaniswa nalawa manani ereferensi ocwaningweni lwethu, zombili izinkomba zithuthuke kubafundi bebanga lesithathu besikole samabanga aphansi, obekugqame kakhulu kubafana.Lokhu kubonisa umsebenzi we-bone metabolism kubafundi bebanga lesithathu, ikakhulukazi abafana.Isizathu sokuhlukana kobulili kungase kube ukuthi abafana bebanga lesi-3 basesesigabeni sokukhula futhi umugqa we-epiphyseal awukavaliwe, kuyilapho emantombazaneni kule nkathi umugqa we-epiphyseal useduze nokuvalwa.Okungukuthi, abafana bebanga lesithathu basathuthuka futhi banokukhula okusebenzayo kwamathambo, kuyilapho amantombazane esekupheleni kwesikhathi sokukhula kwamathambo futhi afinyelela esigabeni sokuvuthwa kwamathambo.Amathrendi kumaka we-bone metabolism atholwe kulolu cwaningo ahambisana neminyaka yezinga eliphezulu lokukhula kwenani labantu baseJapane.
Ukwengeza, imiphumela yalolu cwaningo ibonise ukuthi abafundi besikole samabanga aphansi bebanga lesihlanu abanomzimba oqinile namandla angokomzimba babebancane kakhulu ekuphakameni kwamathambo.
Kodwa-ke, umkhawulo walolu cwaningo ukuthi umphumela wokuya esikhathini awuzange ucatshangelwe.Ngenxa yokuthi i-bone metabolism ithonywa ama-hormone ocansi, izifundo zesikhathi esizayo zidinga ukuphenya umphumela wokuya esikhathini.