背景：中壯年男性長跑者是近年來馬拉松等長跑運動的代表族群，以往在長跑與骨質健康方面的研究存在分歧，這些研究結果是否能夠真實反映長跑運動對中壯年男性骨密度的影響有待進一步釐清。目的：透過一年的長期追蹤研究，探討中壯年男性長跑者骨密度和骨代謝狀態的變化。方法：本研究招募20名40~60歲中壯年男性長跑者，以及20名同年齡層不運動對照組，進行一年期的追蹤研究，以比賽期、季外訓練期、季前訓練期和第二年的比賽期4個時期的中段為收集數據時間點，數據指標目包含基本量測 (包含身高、體重、身體質量指數 (Body Mass Index，BMI)、三分鐘登階心肺功能測試)、血液指標分析 (包含骨特異性鹼性磷酸酶 (Bone-specific alkaline phosphatase ，BAP)、I型膠原羧基末端肽 (C-terminal telpeptides of type-I collagen，CTX-1 )以及骨密度掃描，包含各部位之面積骨密度 (areal bone mineral density，aBMD )與骨礦質量 (bone mineral content，BMC)。統計方法將以混合設計二因數變異數分析進行組間差異性考量，進而評估中壯年長跑者的骨質健康狀況。結果：長跑組有較低的體脂率 (p＜0.001)及較高的心肺適能指數，體重標準化前全身以及各肢段aBMD、BMC長跑組沒有差異，體重標準化後長跑組肋骨、腿部以及全身aBMD、BMC顯著高於對照組 (p＜0.05)，同時長跑組也展示出更高的骨代謝率及相對健康的能量代謝結果。結論：經過一年之長期追蹤研究，我們發現中壯年男性長跑者相較於同齡健康男性而言，骨密度較高、骨代謝狀態較活躍。

Purpose: To find out the variations of bone mineral density and bone metabolic status in middle-aged male long-distance runners through a one-year long-term follow-up study.
Method: In this study, we recruited 20 middle-aged (aged 40 to 60) male long-distance runners, and 20 non-exercise healthy males of the same age as a control group, to conduct a one-year follow-up study. The data were collected in the middle of four periods as follows: competition period, off-season training period, pre-season training period and competition period of the second year. The following data indicators are selected: basic measurement including height, weight, body mass index(BMI),cardiopulmonary function test for three-minute stair climbing; blood index analysis including bone-specific alkaline phosphatase (BAP),C-terminal telpeptides of type-I collagen(CTX-1);bone density scanning including areal bone mineral density (aBMD) and bone mineral content(BMC) in the different part of the body. We used the mixed design two-factor variance statistical method to investigate the difference between the groups, and further evaluated the bone health status of middle-age male long-distance runners.
Result: The distance runner group shows lower blood fat rate (p＜0.001), and higher cardiopulmonary fitness indexes. There is no difference between distance runner group and control group in aBMD and BMC of total body and each limbs before weight standardization, but long-distance running group shows higher aBMD and BMC in ribs, legs and total body compared with control group after weight standardization (p＜0.05). At the same time, long-distance running group shows higher bone metabolic rate and relatively healthier energy metabolism results.
Conclusion：Compared with healthy males of the same age, middle-aged male long-distance runners show higher BMD and more active bone metabolic state.

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