Changes in spinal bone density, back muscle size, and visceral adipose tissue and their interaction following a multi-co
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ORIGINAL ARTICLE
Changes in spinal bone density, back muscle size, and visceral adipose tissue and their interaction following a multi-component exercise program in older men: secondary analysis of an 18-month randomized controlled trial A.-F. Turcotte 1,2 & S. Kukuljan 3 & J. Dalla Via 3 & C. Gagnon 1,2,4 & G. Abbott 3 & R.M. Daly 3 Received: 4 March 2020 / Accepted: 28 May 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary In middle-aged and older men, an 18-month multi-component exercise program improved spinal trabecular BMD, paraspinal, and psoas muscle cross-sectional area (CSA) but not visceral adipose tissue (VAT). However, changes in both muscle and VAT CSA were associated with changes in spinal BMD, independent of the exercise intervention. Introduction In older men, we previously reported that a multi-component exercise program improved lumbar spine (LS) trabecular volumetric BMD (Tb.vBMD) compared with no exercise. This study aimed to investigate the following: (1) the effect of the exercise program on paraspinal and psoas (back) muscle CSA and VAT, and 2) if any exercise-related changes in muscle CSA and/or VAT were associated with changes in spinal BMD. Methods Men (n = 180) aged 50–79 years were randomized to an exercise or no-exercise group. Exercise involved high-intensity progressive resistance training (60–85% max) with weight-bearing impact exercise (3 days/week) for 18 months. Quantitative computed tomography was used to assess L1–L3 Tb.vBMD, paraspinal, and psoas muscle CSA and VAT. Results Exercise resulted in a 2.6% ((95% CI, 1.1, 4.1), P < 0.01) net gain in back muscle CSA, but no effect on VAT (−1.6% (95% CI, −7.3, 4.2)) relative to no exercise. Robust regression indicated that percentage changes in Tb.vBMD were positively associated with changes (expressed as z-scores) in back muscle CSA in both the exercise (beta (β)-coefficient = 1.9, 95% CI 0.5, 3.2, P = 0.007) and no-exercise (β = 2.6, 95% CI, 1.1, 4.1, P = 0.001) group, and negatively with the changes in VAT (β = −2.0, 95% CI −3.3, −0.7, P = 0.003) in the exercise only group. There were no group differences in the slopes for the muscle-bone or VAT-bone relationships. Regression analysis (pooled data) revealed that back muscle CSA and VAT were independent predictors of the change in Tb.vBMD, explaining 14% of the variance.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00198-020-05484-z) contains supplementary material, which is available to authorized users. * R.M. Daly [email protected] 1
Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Centre, Québec City, Canada
2
Department of Medicine, Laval University, Québec City, Canada
3
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3128, VIC, Australia
4
Québec Heart and Lung Institute Research Centre, Québec City, Canada
Osteoporos Int
Conclusion A multi-component exercise progra
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