Exercise builds bone strength during menopause
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Postmenopausal women with low bone mass saw greater gains in spine bone mineral density and less bone turnover when assigned monthly risedronate therapy compared with a 12-month regimen of impact and resistance exercises, study data show.
Researchers also showed that an exercise regimen led to increased bone strength compared with either bisphosphonate therapy or a control arm assigned calcium and vitamin D alone.
“For postmenopausal women with early bone loss, exercise may improve strength of bones by changing structure, not bone density,” Laura D. Bilek, PhD, PT, associate dean for research at the University of Nebraska College of Allied Health Professionals, told Healio. “Risedronate was effective at improving bone density of the spine, and current guidelines recommend giving risedronate after a woman becomes osteoporatic.”
Bilek and colleagues analyzed data from 276 healthy, postmenopausal women with low bone mass but not osteoporosis who were randomly assigned to one of three groups for 12 months: calcium and vitamin D supplementation alone (controls), 150 mg monthly oral risedronate plus calcium and vitamin D, or bone-building exercise three times weekly plus calcium and vitamin D. The mean age of participants was 55 years; 83.3% were white. The exercise regimen included impact exercises with timed jogging using a weighted vest and resistance exercises of major muscle groups, guided by trainers. Researchers measured BMD and body composition; conducted hip structural analysis via DXA; assessed serum bone turnover biomarkers at baseline and 6 and 12 months; and compared measurements between groups and over time using hierarchical linear modeling. The data were presented at the American Society for Bone and Mineral Research annual meeting.
At 12 months, women assigned risedronate experienced mean BMD increases of 1.9% at the spine, 0.9% at the total hip and .09% at the femoral neck. Women in the exercise group saw mean BMD increases of 0.9% at the spine and 0.5% at the hip, whereas femoral neck BMD decreased by mean 0.4%.
Researchers observed greater reductions in bone resorption (serum Ntx; P < .004) and formation (bone-specific alkphase B; P < .001) among the risedronate group vs. the exercise group.
Hip structure analysis measures showed a significant difference between the exercise group and the control group; there were no differences between the risedronate group and exercise or controls, Bilek said.
In a Q&A session after the presentation, Bilek said researchers also observed positive hip structural analysis effects at the shaft and the proximal femoral, suggesting that a regular exercise regimen for postmenopausal women is good for bone strength despite only modest changes in BMD.
“Clinicians should realize the goal is to prevent bone loss, not to see an improvement in bone density in postmenopausal women who exercise,” Bilek told Healio. “Additionally, the structural changes we reported are not typically evaluated clinically, so they may not detect structural changes in bone with a typical DXA scan.”
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Bilek L, et al. Abstract 1035. Presented at: ASBMR Annual Meeting; Oct. 1-4, 2021; San Diego (hybrid meeting).
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