TY - JOUR
T1 - The effects of improved metabolic risk factors on bone turnover markers after 12 weeks of simvastatin treatment with or without exercise
AU - Jiang, Jun
AU - Boyle, Leryn J.
AU - Mikus, Catherine R.
AU - Oberlin, Douglas J.
AU - Fletcher, Justin A.
AU - Thyfault, John P.
AU - Hinton, Pamela S.
N1 - Funding Information:
Funding was provided by the University of Missouri Research Board Grant (JPT), VA Career Development Award (JPT), and American Heart Association Midwest Affiliate Clinical Research Award - #09CRP2260136 (JPT), and NIH grant T32 AR048523 (CRM).
Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective. Emerging evidence supports an association between metabolic risk factors and bone turnover. Statins and exercise independently improve metabolic risk factors; however whether improvements in metabolic risk factor affects bone turnover is unknown. The purpose of the present study was to: 1) evaluate the relationship between metabolic risk factors and bone turnover; and 2) determine if improvements in metabolic risk factors after 12 weeks of statin treatment, exercise or the combination affect bone turnover.Methods. Fifty participants with ≥2 metabolic syndrome defining characteristics were randomly assigned to one of three groups: statin (STAT: simvastatin, 40 mg/day), exercise (EX: brisk walking and/or slow jogging, 45 minutes/day, 5 days/week), or the combination (STAT + EX). Body composition and whole body bone mineral density were measured with dual energy X-ray absorptiometry. Serum markers of bone formation (bone specific alkaline phosphatase, BAP; osteocalcin, OC), resorption (C-terminal peptide of type I collagen, CTX) and metabolic risk factors were determined. Two-factor (time, group) repeated-measures ANCOVA was used to examine changes of metabolic risk factors and bone turnover. General linear models were used to determine the effect of pre-treatment metabolic risk factors on post-treatment bone turnover marker outcomes.Results. Participants with ≥4 metabolic syndrome defining characteristics had lower pretreatment OC than those with 3 or fewer. OC was negatively correlated with glucose, and CTX was positively correlated with cholesterol. STAT or STAT + EX lowered total and LDL cholesterol. The OC to CTX ratio decreased in all groups with no other significant changes in bone turnover. Higher pre-treatment insulin or body fat predicted a greater CTX reduction and a greater BAP/CTX increase. Conclusion. Metabolic risk factors were negatively associated with bone turnover markers. Short-term statin treatment with orwithout exercise lowered cholesterol and all treatmentshad a small effect on bone turnover.
AB - Objective. Emerging evidence supports an association between metabolic risk factors and bone turnover. Statins and exercise independently improve metabolic risk factors; however whether improvements in metabolic risk factor affects bone turnover is unknown. The purpose of the present study was to: 1) evaluate the relationship between metabolic risk factors and bone turnover; and 2) determine if improvements in metabolic risk factors after 12 weeks of statin treatment, exercise or the combination affect bone turnover.Methods. Fifty participants with ≥2 metabolic syndrome defining characteristics were randomly assigned to one of three groups: statin (STAT: simvastatin, 40 mg/day), exercise (EX: brisk walking and/or slow jogging, 45 minutes/day, 5 days/week), or the combination (STAT + EX). Body composition and whole body bone mineral density were measured with dual energy X-ray absorptiometry. Serum markers of bone formation (bone specific alkaline phosphatase, BAP; osteocalcin, OC), resorption (C-terminal peptide of type I collagen, CTX) and metabolic risk factors were determined. Two-factor (time, group) repeated-measures ANCOVA was used to examine changes of metabolic risk factors and bone turnover. General linear models were used to determine the effect of pre-treatment metabolic risk factors on post-treatment bone turnover marker outcomes.Results. Participants with ≥4 metabolic syndrome defining characteristics had lower pretreatment OC than those with 3 or fewer. OC was negatively correlated with glucose, and CTX was positively correlated with cholesterol. STAT or STAT + EX lowered total and LDL cholesterol. The OC to CTX ratio decreased in all groups with no other significant changes in bone turnover. Higher pre-treatment insulin or body fat predicted a greater CTX reduction and a greater BAP/CTX increase. Conclusion. Metabolic risk factors were negatively associated with bone turnover markers. Short-term statin treatment with orwithout exercise lowered cholesterol and all treatmentshad a small effect on bone turnover.
KW - Aerobic exercise
KW - Bone turnover markers
KW - Metabolic risk factors
KW - Simvastatin
KW - The metabolic syndrome
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U2 - 10.1016/j.metabol.2014.07.011
DO - 10.1016/j.metabol.2014.07.011
M3 - Article
C2 - 25151031
AN - SCOPUS:84908025246
SN - 0026-0495
VL - 63
SP - 1398
EP - 1408
JO - Metabolism: Clinical and Experimental
JF - Metabolism: Clinical and Experimental
IS - 11
ER -