基于应力调控理论的骨质健康促进方法研究

发布时间：2018-06-11 18:12

本文选题：骨质疏松 + 人体成分　；参考：《中国科学技术大学》2017年博士论文

【摘要】：骨质疏松症是一种典型的慢性退行性疾病,是人类共同面临的五大老年病(高血压,心血管,糠尿病,肿瘤和骨质疏松症)之一。我国是世界上老年人口最多的国家之一,老龄化进程快速加剧,随着骨质疏松人群的急剧增加,将给国家和社会医疗资源带来巨大的挑战。中老年人一旦患有骨质疏松,由于影响成骨细胞前体细胞分化的促性激素减少,破骨细胞活性增强,且骨骼所处的内外部环境不易改变,导致其治疗难度非常大。目前虽然部分药物可以通过促进成骨细胞成骨或抑制破骨细胞活性达到干预骨质疏松进程的目的,但药物干预的长期安全性并不确定,现在已知的一些药物已被证明会增加心血管等疾病的风险,因此,美国食品药品管理局(FDA)建议骨质疏松的药物干预需十分谨慎。应对骨质疏松的最佳策略是预防,通过提高成年早期获得的骨量峰值以及降低随增龄引起的骨质下降速率,从而达到防控骨质疏松的目的。在人体骨质的调控方面,一些学者已提出骨应力调控理论(Mechanostat)用来分析骨骼在应力环境下的应变,并探究防治骨质疏松的有效方法。但针对不同种族、性别、不同年龄段的人群,作用于骨骼的人体静态负荷,包括瘦体重和脂肪,以及不同运动产生的运动应力对骨质的影响尚存在诸多争议。本研究基于骨应力调控理论构建系统性的骨质健康促进方法,并以一定样本人群为研究对象跟踪研究,研究运动对骨质促进的作用。本研究将从以下几个方面开展:1.骨静态负荷对人体骨质的影响鉴于作用于骨骼的人体瘦体重、肌肉、脂肪等静态负荷与骨强度的关系在不同种族、性别、年龄段人群中的差异性,获得在我国人群中人体成分与骨质关系有利于为下一步制定科学的干预指导方法提供数据支撑。本研究分别以441名中年男性和女性以及568名老年男性和女性为研究对象,获取研究对象的人体成分数据、骨质数据,分析不同年龄段、不同性别人群的人体成分参数与骨质的关系。研究发现:随着年龄的增加,男性和女性的骨质都呈下降趋势,老年女性的骨质疏松比率要大于老年男性的骨质疏松比率(P0.05),此外,在男性和女性中,瘦体重与骨质呈显著正相关(R=0.271-0.406,P0.001),脂肪与骨质的关系存在性别差异,脂肪与女性的骨质存在弱相关,但在男性中未发现这种关系。2.运动能力与骨质的关系研究为了研究人体运动能力与骨质的关系,本研究分析了 937名20-40岁的青年男性和女性的纵跳水平、下肢肌肉量、握力与跟骨骨质的关系,结果显示人体局部的肌肉量和肌肉力量与局部的骨质显著相关(P0.05),而在男性中更为显著,并且这种关系具有部位特异性。结果也表明了通过提高特定部位的肌肉量和肌肉力量有助于促进该部位的骨质。此外,本研究分析了 945名20-40岁男性的心肺耐力和肺活量与骨质的关系,结果显示人体的运动心肺耐力和肺活量均与骨质呈显著正相关(P0.05),这表明了提高个体的心肺耐力水平有助于促进骨质健康。以上研究为骨质健康促进策略的制定提供了数据支撑。3.骨质健康促进方案推理量表和个性化骨质健康促进服务系统的构建基于骨应力调控理论,本研究建立了骨应力调控模型,提出了骨质健康促进方案推理量表,构建了基于个体体质机能数据的骨质健康促进服务系统。系统对个体骨质状况和影响骨质的风险因素进行分析,并综合个体健康数据推理出针对性的骨质健康促进方案,相关运动处方可推送至个人的手机终端,系统会监测用户运动过程的生理指标变化,监测数据也会传送到健康云数据中心,通过动态监测个体的骨质变化和影响骨质的风险因素的变化,从而实现对骨质健康促进的闭环干预管理系统。此外,本研究设计了一种智能化骨质健康促进干预器械,该器械可执行骨质健康促进服务系统生成的骨质促进方案,该器械可针对身体各个部位进行锻炼,提高身体各部位的肌肉量、肌肉力量和肌肉质量,达到促进骨质健康的目的。4.运动对骨质健康促进作用的人群样本跟踪研究为了研究运动干预对于骨质健康促进的量效关系,验证提出的骨质健康促进方案推理量表的有效性,本研究在普通人群中随机选取了较易发生骨质疏松的中老年人群,最终选取了 81名中老年人,进行了为期6个月的有氧跑和低强度器械锻炼相结合的运动干预,研究结果发现在老年男性和女性中,运动都对其骨质健康具有显著的促进作用(P0.05),研究结果证实了所提出的骨质健康促进推理量表的有效性。同时,本研究也选取了 106名的毒品依赖女性进行骨质评价和干预研究。首先,研究了毒品依赖女性与健康女性之间的骨质差异,并分析了研究组和对照组的骨质影响因素,发现了长期的毒品依赖将导致骨质低下。然后,本研究将毒品依赖女性分为低骨质组和正常骨质组,测定了她们的骨质、人体成分数据,调查了运动和饮食情况,针对这两组人群进行了为期7个月的有氧体操锻炼,结果发现低骨质组的骨质得到了明显改善(P0.05),但正常骨质组骨质并没有显著改善。本研究首次在戒毒人群中进行骨质评价和跟踪研究,国内外类似的研究较为罕见。研究结果证实了运动干预可以促进低骨质女性戒毒人员的骨质健康,但针对不同骨质状况的人群需采取差异化的干预方案。
[Abstract]:Osteoporosis is a typical chronic degenerative disease. It is one of the five major geriatric diseases (hypertension, cardiovascular, furfuronuria, tumor and osteoporosis) common to mankind. China is one of the countries with the largest population in the world. The process of aging is rapidly increasing. With the rapid increase of osteoporosis, it will be given to the state and society. Medical resources are a great challenge. Once the elderly are suffering from osteoporosis, it is difficult to treat the osteoblast as a result of the reduction of the stimulating hormone that affects the differentiation of the osteoblast precursor cells, the enhancement of the osteoclast activity and the internal and external environment in the bone, which can lead to the osteogenesis of osteoblasts. Or inhibition of osteoclast activity to interfere with the process of osteoporosis, but the long-term safety of the drug intervention is not determined. Now some known drugs have been proven to increase the risk of cardiovascular diseases. Therefore, the US Food and Drug Administration (FDA) recommends that the drug intervention for osteoporosis should be very cautious. The best strategy is to prevent and control osteoporosis by increasing the peak bone mass obtained in early adulthood and reducing the rate of osteopenia caused by aging. In the regulation of human bone, some scholars have proposed the theory of bone stress regulation (Mechanostat) to analyze the strain of bone in the stress environment and explore the strain of bone in the stress environment. Effective methods to prevent and cure osteoporosis. However, there are many controversies on the effect of human body static load on bone, including lean body weight and fat, and the effect of exercise stress produced by different movements on bone. This study builds a systematic bone health promotion based on the theory of bone stress regulation. This study will be carried out in the following aspects: 1. the effect of static load on bone in human body in view of the relationship between the body weight, muscle, fat and other static load and bone strength in different races, sex, age The relationship between human body composition and bone in the population of the population in our country is beneficial to provide data support for the next step of formulating scientific intervention guidance. This study took 441 middle-aged men and women and 568 elderly men and women as research subjects to obtain human body composition data, bone data, and bone data. The study found that the bone of men and women decreased with age, and the ratio of osteoporosis in older women was greater than that of older men (P0.05), and in males and females, thin body weight and bone were significantly positive. R=0.271-0.406 (P0.001), there was a gender difference in the relationship between fat and bone. Fat was weakly related to the existence of bone in women, but the relationship between.2. exercise and bone was not found in men. In order to study the relationship between human exercise ability and bone, this study analyzed 937 young male and female 20-40 year old men and women. The relationship between jumping level, lower limb muscle volume, grip strength and calcaneus bone, results show that local muscle volume and muscle strength are significantly associated with local bone (P0.05), but more significant in men, and the relationship is specific. In addition, the study analyzed the relationship between cardiopulmonary endurance and lung capacity and bone mass in 945 20-40 year old men. The results showed a significant positive correlation between exercise cardiopulmonary endurance and vital capacity (P0.05). This showed that improving the individual's cardiopulmonary endurance was helpful to promote bone health. The formulation of health promotion strategy provides data support.3. bone health promotion scheme reasoning scale and personalized bone health promotion service system construction based on bone stress regulation theory. This study established bone stress regulation model, proposed a bone health promotion scheme reasoning scale, and constructed bone based on individual physical function data. The health promotion service system. The system analyzes the individual bone status and the risk factors affecting the bone, and combines the individual health data to deduce the targeted bone health promotion program. The related exercise prescriptions can be pushed to the individual mobile terminal. The system will monitor the changes in the physiological indexes of the user's movement process and the monitoring data will be transmitted. To the health cloud data center, a closed loop intervention management system for bone health promotion is achieved by dynamically monitoring the changes in the bone and the risk factors affecting the bone. In addition, this study designed an intelligent bone health promotion intervention device that can perform bone health promotion service system generated bone. To promote the program, the apparatus can be exercised at various parts of the body to improve the muscle volume, muscle strength and quality of all parts of the body, to achieve the purpose of promoting bone health to promote bone health. The sample tracking study on the effect of.4. exercise on bone health is designed to study the quantitative relationship between exercise intervention and bone health promotion. The effectiveness of the bone health promotion program reasoning scale was selected in this study. In this study, 81 middle-aged and elderly people were selected randomly in the general population. Finally, 81 middle-aged and elderly people were selected for a 6 month combination of aerobic and low intensity exercise. The results were found in old men and women. Exercise has a significant promoting effect on bone health (P0.05). The results confirmed the effectiveness of the proposed bone health promotion scale. At the same time, 106 drug dependent women were selected to conduct bone evaluation and intervention study. First, the bone differences between drug dependent women and healthy women were studied. In the study group and the control group, the bone influence factors were analyzed, and the long-term drug dependence was found to lead to bone loss. Then, this study divided drug dependent women into low bone groups and normal bone groups, measured their bone, body composition data, investigated exercise and diet, and lasted for 7 months for these two groups. It was found that bone in the low bone group improved significantly (P0.05), but the bone in the normal bone group did not improve significantly. This study was the first to conduct bone evaluation and follow up research in the detoxification population. Similar studies were rare both at home and abroad. The study confirmed that exercise intervention could promote low bone female ring. The bone health of the drug users is different, but different groups of people need to adopt a differentiated intervention plan.
【学位授予单位】：中国科学技术大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R580

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