The Impact of Nordic Walking on Bone Properties in Postmenopausal Women with Pre-Diabetes and Non-Alcohol Fatty Liver Disease

Xiaming Du,Zhen Qi,Chao Zhang,Xiangqi Zhang,Sulin Cheng,Shenglong Le

doi:10.3390/ijerph18147570

Abstract

This study investigated the impact of Nordic walking on bone properties in postmenopausal women with pre-diabetes and non-alcohol fatty liver disease (NAFLD). A total of 63 eligible women randomly participated in the Nordic walking training (AEx, n = 33), or maintained their daily lifestyle (Con, n = 30) during intervention. Bone mineral content (BMC) and density (BMD) of whole body (WB), total femur (TF), femoral neck (FN), and lumbar spine (L2-4) were assessed by dual-energy X-ray absorptiometry. Serum osteocalcin, pentosidine, receptor activator of nuclear factor kappa-B ligand (RANKL) levels were analyzed by ELISA assay. After an 8.6-month intervention, the AEx group maintained their BMCTF, BMDTF, BMCL2−4, and BMDL2−4, and increased their BMCFN (p = 0.016), while the Con group decreased their BMCTF (p = 0.008), BMDTF (p = 0.001), and BMDL2−4 (p = 0.002). However, no significant group × time interaction was observed, except for BMDL2−4 (p = 0.013). Decreased pentosidine was correlated with increased BMCWB(r = −0.352, p = 0.019). The intervention has no significant effect on osteocalcin and RANKL. Changing of bone mass was associated with changing of pentosidine, but not with osteocalcin and RANKL. Our results suggest that Nordic walking is effective in preventing bone loss among postmenopausal women with pre-diabetes and NAFLD.

Highlights

Type 2 diabetes (T2DM) is a widely prevalent chronic disease that affects bone health.Individuals with T2DM are known to have a higher risk for fractures with no change in or higher bone mineral density (BMD) than normal individuals [1]
Studies have shown that non-alcoholic fatty liver disease (NAFLD) is related to decreased BMD
Previous after studies8.6 havemonths shown that exercise training in 1-yearwhen blocks (4–6conserved ofperiodic the exercise intervention compared week blocks of high-intensity bone-specific exercise with intermittent moderate-intensity decrease in the control group, indicating that the osteogenic effects were sig metabolism-specific exercise for 10–12 weeks) positively affected BMD at the lumbar positive adaptation in regionscomputed where tomography a large portion of the po spine that was assessed byoccurred peripheral quantitative in early postmenopausal women with metabolicor syndrome

Summary

Introduction

Type 2 diabetes (T2DM) is a widely prevalent chronic disease that affects bone health. Individuals with T2DM are known to have a higher risk for fractures with no change in or higher bone mineral density (BMD) than normal individuals [1]. One- to two-thirds of diabetic patients have NAFLD [5], and both diseases are known to be related to insulin resistance and bone metabolism. No studies have assessed bone properties in patients with comorbidities; it is important to assess how bone properties would change after exercise intervention. Food records were collected to estimate the participant’s energy intake and intake of different nutrients during the study. Dual-energy X-ray absorptiometry (DXA Prodigy, GE Lunar Corp., Madison, WI, USA) was used to assess whole-body lean mass and fat mass, as well as bone mineral content (BMC) and areal BMD of the whole body (WB), total femur (TF), femoral neck (FN), and lumbar spine (L2-4)

Methods

Discussion

Conclusion