Labarai

Na gode da ziyartar Nature.com.Sigar burauzar da kuke amfani da ita tana da iyakacin tallafin CSS.Don ƙwarewa mafi kyau, muna ba da shawarar ku yi amfani da sabuntar burauza (ko kuma musaki Yanayin dacewa a cikin Internet Explorer).A halin yanzu, don tabbatar da ci gaba da goyan baya, za mu sanya rukunin yanar gizon ba tare da salo da JavaScript ba.
Girman kashi ya fi bayyana a lokacin samartaka.Wannan binciken ya yi niyya don bayyana tasirin gina jiki na samari da ƙarfi akan alamomin ma'adinai na kasusuwa da haɓakar ƙashi don taimakawa haɓaka haɓakar ƙashi yayin samartaka da hana osteoporosis na gaba.Daga 2009 zuwa 2015, matasa 277 (maza 125 da mata 152) masu shekaru 10/11 da 14/15 sun shiga cikin binciken.Ma'aunai sun haɗa da dacewa / ma'auni na jiki (misali, rabon tsoka, da dai sauransu), ƙarfin riko, ƙananan ma'adinai na kashi (osteosonometry index, OSI), da alamomi na metabolism na kashi (nau'in nau'in alkaline phosphatase da nau'in I collagen cross-linked N) .- peptide m).An sami kyakkyawar alaƙa tsakanin girman jiki/ƙarfin ƙarfi da OSI a cikin 'yan mata masu shekaru 10/11.A cikin yara maza masu shekaru 14/15, duk girman girman jiki / ƙarfin ƙarfi yana da alaƙa da OSI.Canje-canje a cikin ma'auni na tsoka na jiki sun kasance daidai da daidaituwa tare da canje-canje a cikin OSI a cikin jinsin biyu.Tsawon tsayi, ƙwayar tsoka na jiki da ƙarfin ƙarfi a 10 / 11 shekaru a cikin jinsin biyu sun kasance masu mahimmanci tare da OSI (tabbatacce) da alamomin metabolism na kashi (mara kyau) a 14 / 15 shekaru.Ingantacciyar jiki bayan shekaru 10-11 a cikin yara maza da kuma shekaru 10-11 a cikin 'yan mata na iya yin tasiri wajen haɓaka ƙwayar ƙashi.
Hukumar Lafiya ta Duniya (WHO) ta ba da shawarar tsawon rai na koshin lafiya a shekara ta 2001 a matsayin matsakaicin tsawon lokacin da mutum zai iya gudanar da rayuwa mai lafiya da kansa a rayuwarsa ta yau da kullun.A Japan, ana sa ran tazarar da ke tsakanin tsawon rai mai lafiya da matsakaicin tsawon rayuwa zai wuce shekaru 102.Don haka, "Ƙungiyar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙarni na 21 (Healthy Japan 21)" an halicce shi don ƙara yawan tsawon rai na lafiya3,4.Don cimma wannan, wajibi ne a jinkirta lokacin kulawa da mutane.Ciwon motsi, rauni da osteoporosis5 sune manyan dalilan neman magani a Japan.Bugu da ƙari, kula da ciwo na rayuwa, kiba na yara, rashin ƙarfi da ciwon motsa jiki shine ma'auni don hana buƙatar kulawa6.
Kamar yadda muka sani, motsa jiki na yau da kullun yana da mahimmanci don lafiya mai kyau.Don yin wasanni, tsarin motar, wanda ya ƙunshi kasusuwa, haɗin gwiwa da tsokoki, dole ne ya kasance lafiya.A sakamakon haka, Ƙungiyar Orthopedic ta Japan ta bayyana "Motion Syndrome" a cikin 2007 a matsayin "rashin motsi saboda cututtuka na musculoskeletal da kuma [a cikinsa] akwai babban haɗari na buƙatar kulawa na dogon lokaci a nan gaba"7, kuma an yi nazarin matakan kariya. tun daga nan.sannan.Koyaya, bisa ga White Paper na 2021, tsufa, karaya, da cututtukan musculoskeletal8 sun kasance mafi yawan abubuwan da ke haifar da buƙatun kulawa a Japan, suna lissafin kashi ɗaya cikin huɗu na duk buƙatun kulawa.
Musamman, an ba da rahoton karaya da ke haifar da osteoporosis yana shafar 7.9% na maza da 22.9% na mata sama da 40 a Japan9,10.Ganowa da wuri da jiyya ya bayyana shine hanya mafi mahimmanci don hana osteoporosis.Ƙimar ma'adinan kashi (BMD) yana da mahimmanci don ganowa da wuri da magani.Dual energy X-ray absorption (DXA) an yi amfani da shi a al'ada azaman mai nuna alamar ƙima ta kashi ta hanyoyi daban-daban na rediyo.Duk da haka, an bayar da rahoton raunin da ya faru har ma da babban BMD, kuma a cikin 2000 Cibiyar Harkokin Kiwon Lafiya ta Kasa (NIH) 11 taron yarjejeniya ta ba da shawarar karuwar kashi kashi a matsayin ma'auni na ƙididdigar kashi.Duk da haka, tantance ingancin kashi ya kasance mai ƙalubale.
Hanya ɗaya don tantance BMD ita ce ta duban dan tayi (yawan duban dan tayi, QUS)12,13,14,15.Nazarin kuma ya nuna cewa sakamakon QUS da DXA suna da alaƙa16,17,18,19,20,21,22,23,24,25,26,27.Duk da haka, QUS ba mai cin zali ba ne, mara rediyo, kuma ana iya amfani dashi don tantance mata masu juna biyu da yara.Bugu da ƙari, yana da fa'ida bayyananne akan DXA, wato cewa ana iya cirewa.
Kashi yana ɗauka ta osteoclasts kuma an kafa shi ta hanyar osteoblasts.Ana kiyaye yawan ƙasusuwan kasusuwa idan ƙasusuwan kasusuwa ya kasance na al'ada kuma akwai ma'auni tsakanin haɓakar kashi da samuwar kashi.
Sabanin haka, rashin daidaituwar ƙasusuwan ƙashi yana haifar da raguwar BMD.Sabili da haka, don gano farkon osteoporosis, ana amfani da alamomi na metabolism na kashi, waɗanda ke da alamun masu zaman kansu da ke hade da BMD, ciki har da alamomi na samuwar kashi da haɓakar kashi, don tantance ƙwayar kasusuwa a Japan.Gwajin shiga tsakani (FIT) tare da ƙarshen rigakafin karaya ya nuna cewa BMD alama ce ta samuwar kashi maimakon resorption na kashi16,28.A cikin wannan binciken, an kuma auna alamomin metabolism na kashi don yin nazari da gaske game da kuzarin metabolism na kashi.Waɗannan sun haɗa da alamomin samuwar kashi (nau'in kashi alkaline phosphatase, BAP) da alamomi na resorption na kashi (nau'in N-terminal mai haɗin giciye I collagen peptide, NTX).
Balaga ita ce shekarun girma na kololuwa (PHVA), lokacin da girmar ƙashi ke da sauri kuma girman ƙasusuwan ƙashi (kololuwar ƙashi, PBM) kimanin shekaru 20 da suka wuce.
Hanya ɗaya don hana osteoporosis shine ƙara PBM.Duk da haka, tun da ba a san cikakkun bayanai game da ƙwayar kasusuwa a cikin samari ba, ba za a iya ba da shawara na musamman don ƙara BMD ba.
Sabili da haka, wannan binciken ya yi niyya don bayyana tasirin tsarin jiki da ƙarfin jiki akan ƙananan ma'adinai na kasusuwa da alamomin skeletal a lokacin samartaka, lokacin da girman kashi ya fi aiki.
Wannan karatu ne na tsawon shekaru hudu daga aji na biyar na makarantar firamare zuwa aji uku na karamar sakandare.
Mahalarta taron sun hada da yara maza da mata matasa wadanda suka halarci aikin inganta kiwon lafiya na matakin farko da na sakandare a Iwaki a aji na biyar na makarantar firamare da aji uku na karamar sakandare.
An zaɓi makarantun firamare huɗu da ƙananan sakandare, waɗanda ke gundumar Iwaki na birnin Hirosaki a arewacin Japan.An gudanar da binciken ne a cikin kaka.
Daga 2009 zuwa 2011, an yi hira da iyayensu tare da aunawa daliban aji 5 (shekaru 10/11).Daga cikin batutuwa 395, mutane 361 ne suka shiga binciken, wanda kashi 91.4 ne.
Daga 2013 zuwa 2015, an yi hira da iyayensu da kuma aunawa daliban sakandare na shekaru uku (14/15).Daga cikin batutuwa 415, mutane 380 ne suka shiga binciken, wanda kashi 84.3 ne.
Mahalarta 323 sun haɗa da mutanen da ke da tarihin cututtukan cututtukan zuciya, ciwon sukari, dyslipidemia, ko hauhawar jini, mutanen da ke shan magunguna, mutanen da ke da tarihin karyewa, mutanen da ke da tarihin faɗuwar calcaneus, da mutanen da ba su da ƙima a cikin abubuwan bincike.Banda.Kimanin matasa 277 (maza 125 da 'yan mata 152) an haɗa su a cikin binciken.
Abubuwan binciken sun haɗa da tambayoyin tambayoyi, ma'auni mai yawa na kashi, gwajin jini (alamomi na metabolism na kashi), da ma'aunin dacewa.An gudanar da binciken ne a lokacin makarantar firamare na kwana 1 da kwana 1-2 na makarantar sakandare.Binciken ya dauki kwanaki 5.
An ba da takardar tambaya a gaba don kammalawa.An tambayi mahalarta don kammala tambayoyin tare da iyayensu ko masu kula da su, kuma an tattara tambayoyin a ranar da aka auna.Masana kiwon lafiyar jama'a hudu sun yi bitar martanin kuma sun tuntubi yaran ko iyayensu idan suna da wata tambaya.Abubuwan tambayoyin sun haɗa da shekaru, jinsi, tarihin likita, tarihin likita na yanzu, da matsayin magani.
A matsayin wani ɓangare na kima na jiki a ranar binciken, an ɗauki ma'auni na tsayi da kuma tsarin jiki.
Ma'aunin tsarin jiki ya haɗa da nauyin jiki, yawan kitsen jiki (% mai), da kuma yawan adadin jiki (% tsoka).An ɗauki ma'auni ta amfani da na'urar tantance abubuwan da ke cikin jiki bisa tsarin bioimpedance (TBF-110; Tanita Corporation, Tokyo).Na'urar tana amfani da mitoci da yawa 5 kHz, 50 kHz, 250 kHz da 500 kHz kuma an yi amfani da ita a yawancin karatun manya29,30,31.An ƙera na'urar don auna mahalarta waɗanda tsayin su aƙalla cm 110 da shekaru 6 ko fiye.
BMD shine babban bangaren ƙarfin kashi.ECUS ta yi kima BMD ta amfani da na'urar duban dan tayi na kashi (AOS-100NW; Aloka Co., Ltd., Tokyo, Japan).Wurin aunawa shine calcaneus, wanda aka kimanta ta amfani da Osteo Sono-Assessment Index (OSI).Wannan na'ura tana auna saurin sauti (SOS) da kuma isar da saƙo (TI), waɗanda ake amfani da su don ƙididdige OSI.Ana amfani da SOS don auna ƙididdiga da ƙarancin ma'adinai na kashi34,35 kuma ana amfani da TI don auna raguwar duban dan tayi, ma'auni na ƙimar ingancin kashi12,15.Ana ƙididdige OSI ta amfani da dabara mai zuwa:
Don haka yana nuna halayen SOS da TI.Saboda haka, OSI ana daukarsa a matsayin daya daga cikin dabi'u na duniya mai nuna alama a cikin kima na acoustic kashi.
Don tantance ƙarfin tsoka, mun yi amfani da ƙarfin riko, wanda aka yi la'akari da ƙarfin tsokar jiki duka37,38.Muna bin tsarin "Sabuwar Gwajin Jiki"39 na Ofishin Wasanni na Ma'aikatar Ilimi, Al'adu, Wasanni, Kimiyya da Fasaha.
Smedley gripping dynamometer (TKK 5401; Takei Scientific Instruments Co., Ltd., Niigata, Japan).Ana amfani da shi don auna ƙarfin riko da daidaita faɗin riko ta yadda mahaɗin interphalangeal na kusa na yatsan zobe ya juye 90°.Lokacin aunawa, matsayi na ƙafar ƙafa yana tsaye tare da ƙafar ƙafafu, kibiya na ma'auni na hannun yana ci gaba da fuskantar waje, kafadu suna dan matsawa zuwa gefe, ba taba jiki ba.Daga nan an nemi mahalarta su kama dynamometer da cikakken ƙarfi yayin da suke fitar da numfashi.A yayin aunawa, an nemi mahalarta su ci gaba da rike madannin dynamometer yayin da suke rike ainihin matsayi.Ana auna kowane hannu sau biyu, kuma hannun hagu da dama ana auna su a madadinsu don samun mafi kyawun ƙima.
Da sanyin safiya ba tare da komai ba, an tara jini daga yara kanana masu aji uku, kuma an gabatar da gwajin jinin ga LSI Medience Co., Ltd. Kamfanin ya kuma auna samuwar kashi (BAP) da yawan kashi ta hanyar amfani da CLEIA ( Enzymatic immunochemiluminescent assay) Hanyar.don alamar resorption (NTX).
Matakan da aka samu a aji biyar na makarantar firamare da aji uku na karamar sakandare an kwatanta su ta hanyar amfani da t-tests.
Don bincika yuwuwar dalilai masu ruɗani, alaƙa tsakanin OSI na kowane aji da tsayi, adadin kitsen jiki, yawan tsoka, da ƙarfin riko an inganta su ta amfani da ƙididdiga masu alaƙa.Ga ɗaliban makarantar sakandare na aji uku, an tabbatar da alaƙa tsakanin OSI, BAP, da NTX ta amfani da juzu'i na daidaitawa.
Don bincika tasirin canje-canje a cikin jiki da ƙarfi daga aji biyar na makarantar firamare zuwa aji uku na ƙaramar makarantar sakandare akan OSI, an bincika canje-canje a cikin yawan kitsen jiki, ƙwayar tsoka, da ƙarfin kamawa da ke da alaƙa da canje-canje a OSI.Yi amfani da nazarin koma baya da yawa.A cikin wannan bincike, an yi amfani da canji a cikin OSI a matsayin maƙasudin manufa kuma an yi amfani da canji a kowane kashi a matsayin ma'anar bayani.
An yi amfani da bincike na koma-baya don ƙididdige ƙididdige ƙididdiga tare da 95% tazarar amincewa don ƙididdige alaƙa tsakanin sigogin dacewa a aji na biyar na makarantar firamare da ƙasusuwan kashi (OSI, BAP da NTX) a cikin aji na uku na makarantar sakandare.
An yi amfani da tsayi, kaso mai kitse, yawan tsoka, da ƙarfin riko a matsayin alamomin dacewa/jin daɗi ga ɗaliban firamare na biyar, kowanne daga cikinsu an yi amfani da su don rarraba ɗalibai zuwa ƙananan ƙananan, matsakaita, da kuma ƙungiyoyi masu girma.
An yi amfani da software na SPSS 16.0J (SPSS Inc., Chicago, IL, Amurka) don nazarin ƙididdiga kuma an yi la'akari da ƙimar p <0.05 a cikin ƙididdiga.
Makasudin binciken, hakkin janyewa daga binciken a kowane lokaci, da kuma ayyukan sarrafa bayanai (ciki har da sirrin bayanan sirri da ɓoye bayanan) an bayyana su dalla-dalla ga duk mahalarta, kuma an sami izini a rubuce daga mahalarta kansu ko kuma daga iyayensu. ./ masu gadi.
Cibiyar Nazarin Kiwon Lafiya ta Makarantar Firamare da Sakandare ta Cibiyar Nazarin Lafiya ta Iwaki ta amince da Cibiyar Nazarin Cibiyar Nazarin Magunguna ta Jami'ar Hirosaki (lambar amincewa 2009-048, 2010-084, 2011-111, 2013-339, 2014-060 da 2015).-075).
An yi rajistar wannan binciken tare da Cibiyar Bayar da Bayanan Kiwon Lafiya ta Jami'ar (UMIN-CTR, https://www.umin.ac.jp; jarrabawar sunan: Iwaki Health Promotion Project exam; da ID na jarrabawar UMIN: UMIN000040459).
A cikin yara maza, duk alamun sun karu sosai, ban da % mai, kuma a cikin 'yan mata, duk alamun sun karu sosai.A cikin shekara ta uku na karamar makarantar sakandare, da darajar da kashi metabolism index a cikin yara maza ma sun kasance da muhimmanci fiye da a cikin 'yan mata, wanda ya nuna cewa kashi metabolism a cikin maza a wannan lokacin ya fi aiki fiye da 'yan mata.
Ga 'yan mata masu aji biyar, an sami kyakkyawar alaƙa tsakanin girman jiki/ƙarfin riko da OSI.Duk da haka, ba a lura da wannan yanayin a cikin yara maza ba.
A cikin yara maza na uku, duk girman girman jiki/ƙarfin ƙarfin riko an danganta su da OSI kuma suna da alaƙa da NTX da /BAP.Sabanin haka, wannan yanayin ba a bayyana shi ba a cikin 'yan mata.
An sami sauye-sauye masu mahimmanci a cikin ƙima don mafi girma OSI a cikin ɗalibai na uku da na biyar a tsayin tsayi, kashi mai mai, yawan tsoka, da ƙungiyoyi masu ƙarfi.
Bugu da ƙari, tsayi mafi girma, yawan kitsen jiki, yawan tsoka, da ƙarfin riko a aji biyar maza da mata sun yi ƙoƙarin rage ƙimar rashin daidaituwa ga maki BAP da NTX a aji na tara.
Sake kafawa da resorption na kashi yana faruwa a duk tsawon rayuwa.Wadannan ayyuka na rayuwa na kasusuwa ana tsara su ta hanyar hormones daban-daban40,41,42,43,44,45,46 da cytokines.Akwai kololuwa guda biyu a cikin haɓakar ƙashi: girma na farko kafin shekaru 5 da haɓaka na biyu yayin samartaka.A cikin kashi na biyu na girma, ci gaban tsayin tsayin kashi ya ƙare, layin epiphyseal ya rufe, kashin trabecular ya zama mai yawa, kuma BMD ya inganta.Mahalarta a cikin wannan binciken sun kasance a cikin lokacin haɓaka halayen halayen jima'i na biyu, lokacin da ɓoyewar jima'i na jima'i yana aiki kuma abubuwan da suka shafi ƙwayar kasusuwa suna haɗuwa.Rauchenzauner et al.[47] ya ruwaito cewa ƙasusuwan kasusuwa a cikin samartaka yana da matukar canzawa tare da shekaru da jinsi, da kuma cewa duka BAP da tartrate-resistant phosphatase, alamar haɓakar kashi, raguwa bayan shekaru 15.Koyaya, ba a gudanar da bincike don bincika waɗannan abubuwan a cikin samari na Japan ba.Hakanan akwai taƙaitaccen rahotanni game da abubuwan da ke faruwa a cikin alamomi masu alaƙa da DXA da kuma abubuwan da ke haifar da haɓakar ƙashi a cikin samari na Japan.Ɗayan dalili na wannan shi ne rashin son iyaye da masu kula da su don ba da izinin gwaje-gwaje masu banƙyama a kan 'ya'yansu, kamar tarin jini da radiation, ba tare da ganewar asali ko magani ba.
Ga 'yan mata masu aji biyar, an sami kyakkyawar alaƙa tsakanin girman jiki/ƙarfin riko da OSI.Duk da haka, ba a lura da wannan yanayin a cikin yara maza ba.Wannan yana nuna cewa haɓakar girman jiki a lokacin farkon balaga yana rinjayar OSI a cikin 'yan mata.
Duk abubuwan da ke da alaƙa da sifar jiki/ƙarfin riko suna da alaƙa da OSI a cikin yara maza na uku.Sabanin haka, wannan yanayin ba shi da ma'ana a cikin 'yan mata, inda kawai canje-canje a cikin adadin tsoka da ƙarfin kamawa suna da alaƙa da OSI.Canje-canje a cikin ma'auni na tsoka na jiki an haɗa su da kyau tare da canje-canje a cikin OSI tsakanin jima'i.Wadannan sakamakon sun nuna cewa a cikin yara maza, karuwa a girman jiki / ƙarfin tsoka daga maki 5 zuwa 3 yana rinjayar OSI.
Tsawon tsayi, rabon tsoka da tsoka a aji na biyar na makarantar firamare sun kasance da alaƙa da alaƙa da ma'aunin OSI kuma suna da alaƙa da ma'auni na ƙasusuwan ƙashi a aji na uku na makarantar sakandare.Wadannan bayanan sun nuna cewa ci gaban girman jiki (tsawo da jiki-da-jiki rabo) da kuma rikitar da ƙarfi a farkon samartaka yana rinjayar OSI da ƙasusuwan kashi.
Shekaru na biyu na kololuwar girma (PHVA) a cikin Jafananci an lura da shekaru 13 ga maza da shekaru 11 ga mata, tare da haɓaka cikin sauri a cikin maza49.A cikin shekaru 17 a cikin yara maza da shekaru 15 a cikin 'yan mata, layin epiphyseal ya fara rufewa, kuma BMD yana ƙaruwa zuwa BMD.Idan aka yi la’akari da wannan baya da sakamakon wannan binciken, muna tsammanin cewa haɓaka tsayi, yawan tsoka, da ƙarfin tsoka a cikin ‘yan mata har zuwa aji biyar yana da mahimmanci don haɓaka BMD.
Binciken da aka yi a baya na yara da matasa masu tasowa sun nuna cewa alamun sakewar kashi da samuwar kashi a ƙarshe ya karu50.Wannan na iya yin nuni da metabolism na kashi mai aiki.
Dangantakar da ke tsakanin metabolism na kashi da BMD ya kasance batun binciken da yawa a cikin manya51,52.Ko da yake wasu rahotanni53, 54, 55, 56 sun nuna ɗan bambanci a cikin maza, nazarin binciken da aka yi a baya za a iya taƙaita shi kamar haka: "Alamomin ƙashi na karuwa a lokacin girma, sa'an nan kuma suna raguwa kuma ba su canzawa har zuwa shekaru 40, tsufa. ”.
A Japan, ƙimar ma'anar BAP shine 3.7-20.9 µg/L ga maza masu lafiya da 2.9-14.5 µg/L ga mata masu haihuwa masu lafiya.Mahimman ƙididdiga na NTX sune 9.5-17.7 nmol BCE/L ga maza masu lafiya da 7.5-16.5 nmol BCE/L don lafiyayyen matan premenopausal.Idan aka kwatanta da waɗannan ƙididdiga a cikin bincikenmu, duka alamomin sun inganta a cikin aji uku na ƙananan sakandare, wanda ya fi bayyana a cikin yara maza.Wannan yana nuna ayyukan haɓakar ƙashi a cikin ƴan aji uku, musamman maza.Dalilin bambancin jinsi na iya zama cewa yara maza na 3rd har yanzu suna cikin lokacin girma kuma layin epiphyseal bai riga ya rufe ba, yayin da a cikin 'yan mata a wannan lokacin layin epiphyseal yana kusa da rufewa.Wato, yara maza a cikin aji na uku har yanzu suna tasowa kuma suna da haɓakar kwarangwal mai aiki, yayin da 'yan mata ke ƙarshen lokacin girma na kwarangwal kuma suna kaiwa matakin girma na kwarangwal.Abubuwan da ke faruwa a cikin alamomin haɓakar ƙashi da aka samu a cikin wannan binciken ya dace da shekarun matsakaicin girma a cikin yawan jama'ar Japan.
Bugu da kari, sakamakon wannan binciken ya nuna cewa daliban makarantar firamare na aji biyar masu karfin jiki da karfin jiki suna da karancin shekaru a kololuwar metabolism na kashi.
Duk da haka, iyakancewar wannan binciken shine cewa ba a la'akari da tasirin jinin haila ba.Saboda ƙwayar kasusuwa yana tasiri ta hanyar jima'i na jima'i, nazarin gaba yana buƙatar bincika sakamakon haila.