Response of bone mineral density, inflammatory cytokines, and biochemical bone markers to a 32-week combined loading exercise programme in older men and women

Arch Gerontol Geriatr. 2013 Sep-Oct;57(2):226-33. doi: 10.1016/j.archger.2013.03.014. Epub 2013 Apr 23.


This study examines the effects of 32 weeks of exercise training on balance, lower-extremity muscle strength, bone mineral density (BMD) and serum levels of bone metabolism and inflammatory markers in older adults. Forty-seven healthy older adults (women=24, men=23; mean age 68.2 years) participated in a exercise intervention (60min/session) that included resistance exercise training (2 days/week) at 75-80% of maximum plus a multicomponent weight-bearing impact exercise training (1 day/week). Outcome measures included lumbar spine and proximal femoral BMD, dynamic balance, muscle strength, serum levels of bone metabolism markers [osteocalcin (OC), C-terminal telopeptide of Type I collagen (CTX), osteoprotegerin (OPG) and receptor activator of nuclear factor kappa B ligand (RANKL)] and serum levels of inflammatory markers [high sensitive (hs)-C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ]. Potential confounding variables included body composition, dietary intake (using 4-day diet records), and accelerometer-based physical activity. After 32 weeks, both men and women increased dynamic balance (6.4%), muscle strength (11.0%) and trochanter (0.7%), intertrochanter (0.7%), total hip (0.6%), and lumbar spine BMD (1.7%), while OC, CTX, OPG and RANKL levels remained unchanged. In addition, hs-CRP and IFN-γ levels were decreased, while TNF-α levels were unchanged, and a decrease in IL-6 levels was only observed in men. These findings suggest that our combined impact protocol reduces inflammation and increases BMD, balance, and lower-extremity muscle strength, despite having little effect on bone metabolism markers. This reinforces the role of exercise to counteract the age-related inflammation, and the muscle strength, balance and BMD reduction.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Bone Density / physiology*
  • Bone and Bones / physiology
  • C-Reactive Protein / analysis
  • Collagen Type I / blood
  • Cytokines / blood*
  • Cytokines / physiology
  • Exercise / physiology*
  • Female
  • Humans
  • Interferon-gamma / blood
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Muscle Strength / physiology
  • Osteocalcin / blood
  • Osteoprotegerin / blood
  • Peptides / blood
  • Postural Balance / physiology
  • RANK Ligand / blood
  • Tumor Necrosis Factor-alpha / blood


  • Biomarkers
  • Collagen Type I
  • Cytokines
  • Interleukin-6
  • Osteoprotegerin
  • Peptides
  • RANK Ligand
  • Tumor Necrosis Factor-alpha
  • collagen type I trimeric cross-linked peptide
  • Osteocalcin
  • Interferon-gamma
  • C-Reactive Protein