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

Turcotte, A.-F.; Kukuljan, S.; Dalla Via, J.; Gagnon, C.; Abbott, G.; Daly, R. M.

Affiliations

¹Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Centre, Québec City, Canada

²Department of Medicine, Laval University, Québec City, Canada

³Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia

⁴Québec Heart and Lung Institute Research Centre, Québec City, Canada

Abstract and keywords

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.

Conclusion: A multi-component exercise program in middle-aged and older men improved spinal BMD and back muscle size but not visceral fat. However, changes in back muscle size and VAT were associated with the changes in spinal BMD, independent of exercise.

Trial registration: ACTRN 12617001224314, 22/08/2017 retrospectively registered

Keywords: Resistance training; Muscle cross-sectional area; Visceral fat; Vertebral bone density; Older men

Links

DOI: 10.1007/s00198-020-05484-z

PubMed: 32500299

WoS: 000538005900001

History

Received: 2020-03-04

Accepted: 2020-05-28

Online: 2020-06-04

Cited Works (5)

Year	Entry
1997	Burr DB. Muscle strength, bone mass, and age‐related bone loss. J Bone Miner Res. 1997;12(10):1547-1551.
2015	Evans AL, Paggiosi MA, Eastell R, Walsh JS. Bone density, microstructure and strength in obese and normal weight men and women in younger and older adulthood. J Bone Miner Res. May 2015;30(5):920-928.
2001	Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E. Risk of new vertebral fracture in the year following a fracture. JAMA. January 17, 2001;285(6):320-323.
2017	Napoli N, Chandran M, Pierroz DD, Abrahamsen B, Schwartz AV, Ferrari SL; IOF Bone and Diabetes Working Group. Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. April 2017;13(4):208-219.
2017	Ballane G, Cauley JA, Luckey MM, Fuleihan GE-H. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int. May 2017;28(5):1531-1542.