論文

© 2018, The Author(s). Stress fractures are a limitation for athletes not only in sports performance but in activities of daily living. Thus, preventing them is crucial. In female athletes, a triad of symptoms including low energy availability, functional hypothalamic amenorrhea and osteoporosis are considered risk factors for stress injuries, but biomarkers predictive of these outcomes are not available. Here, we evaluated 56 female university athletes and found that 13 had a history of stress bone injuries. Logistic regression analysis demonstrated that dysmenorrhea including amenorrhea, but not reduced food intake or body weight loss, was significantly associated with stress injuries. When we subdivided subjects into stress fracture and non-fracture groups, we found that serum levels of creatine kinase (CK) and lactic acid dehydrogenase (LDH) were significantly higher in the fracture group, while osteocalcin and uncarboxylated osteocalcin (ucOC), which are bone forming parameters, significantly decreased. Low vitamin D levels are associated with stress fractures, but serum vitamin D levels were higher in fracture compared to non-fracture subjects. We followed up 32 subjects for one year, and three exhibited new stress injuries during that period. A history of stress fracture history is significantly associated with experiencing a new stress fracture. We also found that subjects with new fracture performed significantly greater exercise activity than did non-fracture subjects. Taken together, our data indicate that increased serum CK and LDH and decreased serum osteocalcin and ucOC are biomarkers of stress injuries, and evaluating these markers along with dysmenorrhea, stress fracture history or high sports activity could predict future stress fractures in female athletes.

本研究の目的は、日本人高齢者を対象に「アクティガイド」や「プラス・テン」などの身体活動プロモーションの認知と身体活動時間、座位行動時間の関連について検討することである。我々は2013年より神奈川県藤沢市において身体活動促進のためのコミュニティワイドキャンペーンを実施している。この取り組みの成果評価及び2015年度以降に行う全市的な介入の事前評価の位置づけで、2015年6月に20歳以上の藤沢市民3,000名を無作為抽出して質問紙調査を実施した。本研究ではその質問紙調査を用い、65歳以上の高齢者874名を対象者とした。このうち550名から返答があり、データに欠損のない373名を解析に用いた。48%(179/373名)が「アクティブガイド」や「プラス・テン」などの身体活動プロモーションを認知していた。身体活動時間(運動を行っている時間と歩行またはそれと同等以上の強度の生活活動を行っている時間の総和)の中央値は100分/日、座位行動時間の中央値は300分/日であった

© 2017 Elsevier Inc. Very few community intervention studies that promote physical activity (PA) using guidelines and its dissemination and implementation have been conducted. Consequently, we evaluated the effectiveness of a community-wide intervention (CWI) of PA with adults based on the Japanese guidelines for promoting PA. This was a non-randomized controlled trial, with four administrative districts in Fujisawa city assigned to the intervention group and nine to the control group. The CWI, conducted from 2013 to 2015, comprised information dissemination, education, and community support. The primary outcome was change in PA participation. Secondary outcomes were CWI awareness and PA guideline knowledge. Outcomes were assessed using questionnaires distributed to two independent, random samples of 3000 community-based adults (aged ≥ 20 years). Two separate samples—1230 adults at baseline and 1393 at the two-year follow-up—responded to the survey. The median time spent in PA did not differ between intervention and control groups after adjusting for potential confounders (adjusted difference between groups = − 0.02 min/day [95% confidence interval (CI): − 0.11, 0.10]). However, intervention group participants were more aware of the CWI (33.8%) than were control group participants (25.2%) at the two-year follow-up (odds ratio = 1.44 [95% CI: 1.06, 1.95]). A significant difference was also observed in participants’ PA guideline knowledge (adjusted difference between groups = 0.82% [95% CI: 0.33, 1.31]). Although significant differences in awareness and knowledge were observed between groups, this CWI did not change PA levels over two years. Future studies should investigate the long-term effects of CWIs beyond two years. Trial registration number: UMIN-CTR UMIN000018389.