Feyz Medical Sciences Journal
مجله علوم پزشکی فيض
Feyz Med Sci J
Medical Sciences
http://feyz.kaums.ac.ir
29
journal29
3060-5806
3060-5814
fa
jalali
1405
4
1
gregorian
2026
7
1
30
online
1
fulltext
fa
تاثیر انواع تمرینات ورزشی بر سطوح استئوکلسین و استئوپونتین در بزرگسالان با و بدون بیماری: یک مطالعه مرور نظام مند و فراتحلیل
Effects of Different Types of Exercise Training on Osteocalcin and Osteopontin Levels in Adults With and Without Disease: A Systematic Review and Meta-Analysis
medicine, paraclinic
medicine, paraclinic
مروري
Review
<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">سابقه و هدف:</span></span></span></span></b><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> استئوکلسین (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OCN</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">) و استئوپونتین (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OPN</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">)</span></span></span></span> <span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">بیومارکرهای مهم استخوان هستند و اثر ورزش بر آنها در مطالعات مختلف نتایج متفاوتی داشته است. بنابراین، این مطالعه با هدف بررسی تأثیر انواع تمرینات ورزشی بر سطوح </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OCN</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> و </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OPN</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> در بزرگسالان با و بدون بیماری، به روش مرور نظاممند و فراتحلیل انجام شد.</span></span></span></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">مواد و روش­ها: </span></span></span></span></b><a name="_Hlk149244532"><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">این مطالعه</span></span></span></span></a><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> براساس دستورالعمل کوکران<sup> </sup>و پریزما</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"></span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> طراحی شد</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> و یک جستجوی نظاممند از ابتدا تا </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">22 آذر ۱۴۰۴ (13 دسامبر ۲۰۲۵) </span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">در پایگاههای </span></span></span></span><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">(</span></span></span></strong><strong><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow">PubMed</span></span></strong><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">، </span></span></span></strong><strong><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow">Scopus</span></span></strong><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">، </span></span></span></strong><strong><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow">Web of Science</span></span></strong><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">، </span></span></span></strong><strong><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow">Google Scholar</span></span></strong><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">، </span></span></span></strong><strong><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow">Magiran</span></span></strong><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">، </span></span></span></strong><strong><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow">Noormags</span></span></strong><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"></span></span></span></strong><strong><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">،</span></span></span></strong><strong> </strong><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow">Irandoc</span></span><strong> </strong><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">و </span></span></span></strong><strong><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow">SID</span></span></strong><strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">) </span></span></span></strong><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">انجام گرفت.</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> معیارهای ورود</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">تمامی کارآزماییهای بالینی کنترل شده تصادفی و غیرتصادفی که انواع </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">تمرینات ورزشی بر سطوح </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OCN</span></span></span><span style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> و </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OPN</span></span></span><span style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> در بزرگسالان</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">(18 سال به بالا) از هر دو جنس با و بدون بیماری<span style="color:black">، </span>دارای حداقل هر دوگروه مداخله تمرینی و شاهد بوده </span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">و دادههای کافی برای محاسبه اندازه اثر بودند، وارد مطالعه شدند.</span></span></span> <span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">معیارهای خروج مطالعات غیر اصیل، حیوانی، فاقد گروه شاهد، دارای مداخلات ترکیبی غیرقابل تفکیک، فاقد دادههای آماری کافی یا فاقد گزارش </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OCN</span></span></span><span style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> یا </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OPN</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> از مطالعه حذف شدند.</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">برای محاسبه اندازه اثر از تفاوت میانگین استانداردشده (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">SMD</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">)</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">با فاصله اطمینان </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">۹۵</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">٪</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> استفاده شد. ناهمگونی مطالعات با شاخص </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">I²</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> و سوگیری انتشار با نمودار فانل پلات و آزمون ایگر بررسی شد. تحلیل دادهها نیز با نرمافزار </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">CMA2</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> انجام گرفت.</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="background:yellow"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">یافته­ها:</span></span></span></span></b><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> در مجموع 23 مطالعه (28 مداخله تمرین ورزشی) با 740 شرکتکننده بزرگسال با و بدون بیماری وارد فراتحلیل شدند. نتایج نشان داد که انواع تمرینات ورزشی موجب افزایش معنادار سطح </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OCN</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> (448/87</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">I²=</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">، 001/0</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span calibri="" style="font-family:"><span style="color:black">></span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">P</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">، 310/0 الی 274/1</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">CI: </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> %95، 792/0</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">SMD=</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">) </span></span></span></span><strong><span lang="AR-SA" style="font-size:11.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:">در مقایسه با گروه شاهد شدند، </span></span></span></strong><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">با این حال، تغییرات </span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">سطح </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">OPN</span></span></span> <span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">(905/38</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">I²=</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">، 629/0</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">P=</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">، 816/0- الی 493/0</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">CI: </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> %95، 161/0-</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:yellow"><span style="color:black">SMD=</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">)</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">از لحاظ آماری معنادار نبود.</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:yellow"><span style="font-family:"B Lotus""></span></span></span></span></span></span></span><br>
<b><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">نتیجه گیری:</span></span></span></span></b><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> انواع تمرینات ورزشی باعث افزایش </span></span></span></span><span style="font-size:10.0pt"><span style="background:yellow"><span new="" roman="" style="font-family:" times=""><span style="color:black">OCN</span></span></span></span><span dir="RTL" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> در بزرگسالان با و بدون بیماری میشود، اما تأثیر معنادار بر</span></span></span></span><span style="font-size:10.0pt"><span style="background:yellow"><span new="" roman="" style="font-family:" times=""><span style="color:black">OPN</span></span></span></span><span dir="RTL" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black"> ندارد. با این حال، با توجه به ناهمگنی بالای مطالعات و احتمال سوگیری انتشار </span></span></span></span><span style="font-size:10.0pt"><span style="background:yellow"><span new="" roman="" style="font-family:" times=""><span style="color:black">OCN </span></span></span></span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="background:yellow"><span b="" lotus="" style="font-family:"><span style="color:black">، این یافتهها باید با احتیاط تفسیر شوند و برای تأیید آنها انجام کارآزماییهای بالینی با کیفیت بالا و روششناسی استاندارد ضروری است.</span></span></span></span>
<span style="font-size:9pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%"><span style="color:black">Background and aim: </span></span></span></span></b><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%"><span style="color:black">Osteocalcin (OCN) and osteopontin (OPN) are important bone biomarkers, and the effects of exercise on these markers have shown inconsistent results across various studies. Therefore, this study aimed to investigate the effects of different types of exercise interventions on OCN and OPN levels in adults with and without diseases through a systematic review and meta-analysis.</span></span></span></span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:black"></span></span></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%"><span style="color:black">Materials and Methods: </span></span></span></span></b><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%">This study was designed based on the Cochrane and PRISMA guidelines. A systematic search was conducted from inception to December 13, 2025, in the databases PubMed, Scopus, Web of Science, Google Scholar, Magiran, Noormags, Irandoc, and SID.The inclusion criteria comprised all randomized and non-randomized controlled clinical trials that investigated the effects of various exercise interventions on OCN and OPN levels in adults(≥18 years) of both sexes, with and without diseases, included at least an exercise intervention group and a control group, and provided sufficient data for effect size calculation.The exclusion criteria included non-original studies, animal studies, studies without a control group, studies with inseparable combined interventions, studies lacking sufficient statistical data, or studies that did not report OCN or OPN outcomes.</span></span></span> <span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%">The standardized mean difference(SMD) with a 95% confidence interval was used to calculate the effect size. Study heterogeneity was assessed using the I² statistic, and publication bias was evaluated through funnel plots and Egger’s test. Data analysis was performed using CMA2 software.</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"B Mitra""></span></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%"><span style="color:black">Results: </span></span></span></span></b><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%">A total of 23 studies (28 exercise interventions), including 740 adult participants with and without diseases, were included in the meta-analysis. The results showed that various types of exercise significantly increased OCN levels</span></span></span><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%"><span style="color:black"> (SMD=0.792, 95% CI: 0.310 to 1.274, P<0.001, I²=87.448%)</span></span></span></span><span style="background:yellow"> ompared with the control group; however, changes in OPN levels</span><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%"><span style="color:black"> (SMD=−0.161, 95% CI: −0.816 to 0.493, P=0.629, I²=38.905%) </span></span></span></span><span style="background:yellow">were not statistically significant.</span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span style="color:black"></span></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="background:yellow"><span style="line-height:115%"><span style="color:black">Conclusion: </span></span></span></span></b><span style="background:yellow">Different types of exercise increase OCN levels in adults with and without diseases; however, they do not have a significant effect on OPN levels. Nevertheless, due to the high heterogeneity among studies and the potential risk of publication bias regarding OCN, these findings should be interpreted with caution. Further high-quality clinical trials with standardized methodologies are required to confirm these results.</span><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:black"></span></span></span></span></span></span><br>
تمرینات ورزشی, استئوکلسین, استئوپونتین, بزرگسال, بیماری.
Exercise Training, Osteocalcin, Osteopontin, Adults, Chronic Diseases.
0
0
http://feyz.kaums.ac.ir/browse.php?a_code=A-10-4541-1&slc_lang=fa&sid=1
Fatemeh
Kazeminasab
فاطمه
کاظمی نسب
fkazeminasab@kashanu.ac.ir
2900319475328460053418
2900319475328460053418
No
Omid
Zafarmand
امید
ظفرمند
omidzafarmand2202@gmil.com
2900319475328460053419
2900319475328460053419
Yes
Sahar
Parseh
سحر
پارسه
Saharnazparse@gmail.com
2900319475328460053420
2900319475328460053420
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