European Journal of Endocrinology www.eje-online.org © 2016 European Society of Endocrinology Printed in Great Britain Published by Bioscientifica Ltd. DOI: 10.1530/EJE-16-0521 www.eje-online.org © 2016 European Society of Endocrinology 175:6 571–582 V Huovinen and others Effect of exercise on bone strength European Journal of Endocrinology (2016) 175, 571–582 Bone mineral density is increased after a 16-week resistance training intervention in elderly women with decreased muscle strength Ville Huovinen 1,2 , Kaisa K Ivaska 3 , Riku Kiviranta 4,5 , Marco Bucci 1 , Heta Lipponen 1 , Samuel Sandboge 6,7 , Juho Raiko 1 , Johan G Eriksson 6,7,8 , Riitta Parkkola 1,2 , Patricia Iozzo 1,9 and Pirjo Nuutila 1,4 1 Turku PET Centre, University of Turku, Turku, Finland, 2 Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland, 3 Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku, Turku, Finland, 4 Department of Endocrinology, Turku University Hospital, Turku, Finland, 5 Departments of Medicine and Medical Biochemistry and Genetics, University of Turku, Turku, Finland, 6 Folkhälsan Research Centre, Helsinki, Finland, 7 Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, 8 Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland, and 9 Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy Abstract Objective: Non-pharmacological interventions are important in reducing risk for osteoporotic fractures. We investigated the effects of a 16-week individualized resistance training intervention on bone mineral density (BMD), bone turnover markers and 10-year relative risk (RR) for osteoporotic fracture. Design: Interventional study with a follow-up. Methods: In total, 37 elderly women (mean age 71.9 ± 3.1 years) with decreased muscle strength participated in the resistance training intervention three times per week with 60 min per session for 16 weeks under the supervision of a licensed physiotherapist. Total hip BMD with quantitative CT, bone markers (sclerostin, osteocalcin, CTX, PINP, IGF-1, 25(OH)-D) and 10-year RR for osteoporotic fracture were measured at baseline, post-intervention and at 1-year follow-up after the end of the intervention. Eleven age- and sex-matched controls did not participate in the intervention but were studied at baseline and at 1-year follow-up. Results: Resistance training seemed to increase total hip BMD by 6% (P = 0.005). Sclerostin (P < 0.001) and total osteocalcin (P = 0.04) increased while other bone markers remained unchanged. A 10-year RR for major osteoporotic and hip fracture remained unchanged. At follow-up total hip BMD (P < 0.001) decreased back to the baseline level with a simultaneous decrease in serum sclerostin (P = 0.045), CTX (P < 0.001) and an increase in 25(OH)-D (P < 0.001), 10-year RR for major osteoporotic (P = 0.002) and hip fracture (P = 0.01). Conclusions: Our fndings suggest an important role of continuous supervised resistance training for the prevention of osteoporotic fractures in elderly women with decreased muscle strength. Introduction Low bone mineral density (BMD) is a major risk factor for osteoporotic fracture (1). In addition to pharmacological interventions (2), resistance training is an effective method to maintain (3, 4) or even increase BMD and muscle strength (5–12), which together may reduce the risk of fracture through increased balance (13) or an Clinical Study Correspondence should be addressed to P Nuutila Email pirnuu@utu.fi Downloaded from Bioscientifica.com at 06/02/2020 02:39:28PM via free access