Nkhani

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Kukula kwa mafupa kumawonekera kwambiri paunyamata.Kafukufukuyu anali ndi cholinga chofuna kufotokozera momwe thupi lachinyamata limakhudzira thupi komanso mphamvu pamafupa a mineral density marker ndi kagayidwe ka mafupa kuti athandizire kukula kwa mafupa paunyamata komanso kupewa kufowoka kwamtsogolo.Kuchokera mu 2009 mpaka 2015, achinyamata 277 (anyamata 125 ndi atsikana 152) a zaka 10/11 ndi 14/15 adatenga nawo mbali pa kafukufukuyu.Miyezo imaphatikizapo kulimbitsa thupi / kulemera kwa thupi (mwachitsanzo, chiŵerengero cha minofu, ndi zina zotero), mphamvu yogwira, kachulukidwe ka mafupa a mafupa (osteosonometry index, OSI), ndi zizindikiro za mafupa a metabolism (mtundu wa alkaline phosphatase ndi mtundu wa I collagen cross-linked N) .- peptide yomaliza).Kugwirizana kwabwino pakati pa kukula kwa thupi / mphamvu yogwira ndi OSI kunapezeka mwa atsikana azaka za 10/11.Kwa anyamata azaka za 14/15, kukula konse kwa thupi / mphamvu zogwira kumalumikizidwa bwino ndi OSI.Kusintha kwa kuchuluka kwa minofu ya thupi kunali kogwirizana bwino ndi kusintha kwa OSI mwa amuna ndi akazi.Kutalika, chiŵerengero cha minofu ya thupi ndi mphamvu zogwira pa zaka za 10/11 mwa amuna ndi akazi zimagwirizanitsidwa kwambiri ndi OSI (zabwino) ndi zizindikiro za mafupa a metabolism (zoipa) pa 14 / 15 zaka.Thupi lokwanira pakatha zaka 10-11 mwa anyamata mpaka zaka 10-11 mwa atsikana zitha kukhala zogwira mtima pakukulitsa mafupa apamwamba kwambiri.
Mchaka cha 2001, bungwe la World Health Organization (WHO) linati anthu azikhala ndi moyo wathanzi kuti akhale ndi moyo wathanzi pa moyo wake watsiku ndi tsiku.Ku Japan, kusiyana pakati pa zaka zoyembekezeka za moyo wathanzi ndi avareji ya moyo ukuyembekezeka kupitilira zaka 102.Choncho, "National Movement for Health Promotion in the 21st Century (Healthy Japan 21)" inalengedwa kuti ikhale ndi moyo wathanzi3,4.Kuti izi zitheke, ndikofunikira kuchedwetsa nthawi ya anthu yosamalira.Movement syndrome, kufooka ndi kufooka kwa mafupa5 ndiye zifukwa zazikulu zopezera chithandizo chamankhwala ku Japan.Kuphatikiza apo, kuwongolera kagayidwe kachakudya, kunenepa kwambiri kwaubwana, kufooka ndi motor syndrome ndi njira yopewera kufunikira kwa chisamaliro6.
Monga tonse tikudziwira, kuchita masewera olimbitsa thupi nthawi zonse ndikofunika kuti tikhale ndi thanzi labwino.Kusewera masewera, makina oyendetsa magalimoto, omwe amakhala ndi mafupa, mafupa ndi minofu, ayenera kukhala athanzi.Chotsatira chake, bungwe la Japan Orthopedic Association linatanthauzira "Motion Syndrome" mu 2007 monga "kusayenda chifukwa cha matenda a musculoskeletal ndi [momwe] pali chiopsezo chachikulu chofuna chisamaliro cha nthawi yaitali m'tsogolomu"7, ndipo njira zodzitetezera zaphunziridwa. kuyambira pamenepo.ndiye.Komabe, malinga ndi 2021 White Paper, ukalamba, fractures, ndi matenda a musculoskeletal8 amakhalabe omwe amayambitsa zosowa za chisamaliro ku Japan, zomwe zimawerengera gawo limodzi mwa magawo anayi a zosowa zonse za chisamaliro.
Makamaka, fracture-osteoporosis imanenedwa kuti imakhudza 7.9% ya amuna ndi 22.9% ya amayi oposa 40 ku Japan9,10.Kuzindikira msanga ndi chithandizo kukuwoneka kuti ndiyo njira yofunika kwambiri yopewera matenda a osteoporosis.Kuunika kwa kuchuluka kwa mafupa am'mafupa (BMD) ndikofunikira kuti muzindikire msanga ndi kulandira chithandizo.Mayamwidwe amphamvu a X-ray (DXA) akhala akugwiritsidwa ntchito ngati chizindikiritso chowunika mafupa m'njira zosiyanasiyana.Komabe, fractures zanenedwa kuti zimachitika ngakhale ndi BMD yapamwamba, ndipo mu 2000 msonkhano wa National Institutes of Health (NIH) 11 wogwirizana unalimbikitsa kuwonjezeka kwa fupa ngati muyeso wa fupa.Komabe, kuyeza mtundu wa mafupa kumakhalabe kovuta.
Njira imodzi yowunika BMD ndi ultrasound (quantitative ultrasound, QUS)12,13,14,15.Kafukufuku wasonyezanso kuti zotsatira za QUS ndi DXA zimagwirizana16,17,18,19,20,21,22,23,24,25,26,27.Komabe, QUS siyosokoneza, siwotulutsa ma radiation, ndipo itha kugwiritsidwa ntchito kuyesa amayi apakati ndi ana.Kuphatikiza apo, ili ndi mwayi wowonekera kuposa DXA, kutanthauza kuti imachotsedwa.
Mafupa amatengedwa ndi osteoclasts ndipo amapangidwa ndi osteoblasts.Kuchulukana kwa mafupa kumasungidwa ngati kagayidwe ka mafupa ndi abwinobwino ndipo pali mgwirizano pakati pa kukhazikika kwa mafupa ndi kupanga mafupa.
Mosiyana ndi zimenezi, kagayidwe ka mafupa kamene kamayambitsa kuchepa kwa BMD.Choncho, kuti azindikire msanga matenda a osteoporosis, zizindikiro za fupa la fupa, zomwe ndi zizindikiro zodziimira zomwe zimagwirizanitsidwa ndi BMD, kuphatikizapo zizindikiro za mapangidwe a fupa ndi kuphulika kwa fupa, zimagwiritsidwa ntchito poyesa fupa la mafupa ku Japan.The Fracture Intervention Trial (FIT) yokhala ndi mapeto oletsa kuphulika inasonyeza kuti BMD ndi chizindikiro cha mapangidwe a fupa m'malo mwa fupa resorption16,28.Mu phunziro ili, zizindikiro za kagayidwe ka fupa zinayesedwanso kuti ziphunzire mozama za kayendedwe ka mafupa.Izi zikuphatikizapo zolembera za mapangidwe a mafupa (fupa-mtundu wa alkaline phosphatase, BAP) ndi zolembera za fupa la resorption (mtundu wolumikizana ndi N-terminal I collagen peptide, NTX).
Unyamata ndi msinkhu wa kukula kwapamwamba (PHVA), pamene kukula kwa fupa kumakhala mofulumira komanso nsonga za mafupa (peak bone mass, PBM) pafupifupi zaka 20 zapitazo.
Njira imodzi yopewera matenda osteoporosis ndikuwonjezera PBM.Komabe, popeza tsatanetsatane wa kagayidwe ka mafupa mwa achinyamata sizikudziwika, palibe njira zinazake zomwe anganene kuti awonjezere BMD.
Choncho, kafukufukuyu ankafuna kufotokozera momwe thupi limapangidwira komanso mphamvu za thupi pa kachulukidwe ka mafupa a mafupa ndi zizindikiro za chigoba paunyamata, pamene kukula kwa mafupa kumakhala kogwira ntchito kwambiri.
Awa ndi maphunziro a zaka zinayi kuyambira giredi 5 kusukulu ya pulayimale mpaka giredi lachitatu la sekondale yocheperako.
Ophunzirawo anali anyamata ndi atsikana omwe adachita nawo kafukufuku wa Iwaki Health Promotion Project Primary ndi Secondary Health Survey m'giredi lachisanu kusukulu ya pulayimale ndi giredi lachitatu la junior sekondale.
Masukulu anayi a pulayimale ndi a sekondale anasankhidwa, omwe ali m’chigawo cha Iwaki mumzinda wa Hirosaki kumpoto kwa Japan.Kafukufukuyu adachitika m'dzinja.
Kuchokera mu 2009 mpaka 2011, ophunzira ovomerezeka a giredi 5 (wazaka 10/11) ndi makolo awo adafunsidwa ndikuyesedwa.Mwa maphunziro 395, anthu 361 adachita nawo kafukufukuyu, omwe ndi 91.4%.
Kuchokera mu 2013 mpaka 2015, ophunzira a sekondale ovomerezeka a chaka chachitatu (azaka 14/15) ndi makolo awo adafunsidwa ndikuyesedwa.Mwa maphunziro 415, anthu 380 adachita nawo kafukufukuyu, omwe ndi 84.3%.
Omwe adatenga nawo gawo 323 adaphatikizanso anthu omwe adadwala matenda amtima, matenda a shuga, dyslipidemia, kapena matenda oopsa, omwe amamwa mankhwala, omwe adasweka, anthu omwe adavulala kwambiri, komanso omwe adasowa posanthula zinthu.Osaphatikizidwa.Achinyamata okwana 277 (anyamata 125 ndi atsikana 152) adaphatikizidwa pakuwunikaku.
Zigawo za kafukufukuyu zinaphatikizapo mafunso, kuyeza kachulukidwe ka mafupa, kuyezetsa magazi (zizindikiro za kagayidwe ka mafupa), ndi kuyeza kwa thupi.Kafukufukuyu adachitika tsiku limodzi la sukulu ya pulayimale ndi masiku 1-2 a kusekondale.Kufufuzako kunatenga masiku asanu.
Mafunso anaperekedwa pasadakhale kuti amalizitse okha.Ophunzira adafunsidwa kuti amalize mafunso ndi makolo awo kapena owasamalira, ndipo mafunsowo adasonkhanitsidwa pa tsiku la kuyeza.Akatswiri anayi a zaumoyo anaunikanso mayankhowo ndi kufunsa anawo kapena makolo awo ngati anali ndi mafunso.Zofunsazo zinali ndi zaka, jenda, mbiri yachipatala, mbiri yakale yachipatala, ndi momwe mankhwala alili.
Monga gawo la kuunika kwa thupi pa tsiku la phunzirolo, miyeso ya kutalika ndi maonekedwe a thupi anatengedwa.
Kuyeza kwa thupi kumaphatikizapo kulemera kwa thupi, kuchuluka kwa mafuta a thupi (% mafuta), ndi kuchuluka kwa thupi (% minofu).Miyezo idatengedwa pogwiritsa ntchito makina owerengera thupi potengera njira ya bioimpedance (TBF-110; Tanita Corporation, Tokyo).Chipangizochi chimagwiritsa ntchito ma frequency angapo 5 kHz, 50 kHz, 250 kHz ndi 500 kHz ndipo chakhala chikugwiritsidwa ntchito m'maphunziro akulu akulu29,30,31.Chipangizochi chapangidwa kuti chiziyeza anthu omwe ali ndi msinkhu wa 110 cm ndi zaka 6 kapena kuposerapo.
BMD ndiye chigawo chachikulu cha mphamvu ya mafupa.Kuwunika kwa BMD kunachitidwa ndi ECUS pogwiritsa ntchito chipangizo cha ultrasound cha mafupa (AOS-100NW; Aloka Co., Ltd., Tokyo, Japan).Malo oyezera anali calcaneus, omwe adayesedwa pogwiritsa ntchito Osteo Sono-Assessment Index (OSI).Chipangizochi chimayesa liwiro la mawu (SOS) ndi index transmission index (TI), zomwe zimagwiritsidwa ntchito powerengera OSI.SOS imagwiritsidwa ntchito poyesa calcification ndi fupa la mineral density34,35 ndipo TI imagwiritsidwa ntchito poyesa kuchepa kwa broadband ultrasound, index of bone quality assessment12,15.OSI imawerengedwa pogwiritsa ntchito njira iyi:
Chifukwa chake kuwonetsa mawonekedwe a SOS ndi TI.Chifukwa chake, OSI imawonedwa ngati imodzi mwazofunikira za chizindikiro chapadziko lonse lapansi pakuwunika kwa fupa lamayimbidwe.
Kuti tiwone mphamvu ya minofu, tinkagwiritsa ntchito mphamvu zogwira, zomwe zimaganiziridwa kuti zimasonyeza mphamvu ya thupi lonse37,38.Timatsatira njira ya "New Physical Fitness Test"39 ya Sports Bureau ya Unduna wa Maphunziro, Chikhalidwe, Masewera, Sayansi ndi Ukadaulo.
Smedley gripping dynamometer (TKK 5401; Takei Scientific Instruments Co., Ltd., Niigata, Japan).Amagwiritsidwa ntchito kuyeza mphamvu yogwira ndikusintha m'lifupi mwake kuti cholumikizira cha interphalangeal chala cha mphete chisunthike 90 °.Poyezera, malo a chiwalocho atayima ndi miyendo yotambasula, muvi wa gauge wamanja umasungidwa kuyang'ana kunja, mapewa amasunthira pang'ono kumbali, osakhudza thupi.Ophunzirawo adafunsidwa kuti agwire dynamometer ndi mphamvu zonse pamene akutulutsa mpweya.Pakuyezera, otenga nawo mbali adafunsidwa kuti asunge chogwirizira cha dynamometer pomwe akukhalabe ndi kaimidwe koyambira.Dzanja lililonse limayesedwa kawiri, ndipo lamanzere ndi lamanja limayesedwa mosinthana kuti lipeze mtengo wabwino kwambiri.
M'mawa kwambiri m'mimba yopanda kanthu, magazi anasonkhanitsidwa kuchokera kwa ana a sukulu ya sekondale yachitatu, ndipo kuyesa magazi kunaperekedwa kwa LSI Medience Co., Ltd. Kampaniyo inayesanso mapangidwe a mafupa (BAP) ndi fupa la mafupa pogwiritsa ntchito CLEIA ( njira ya enzymatic immunochemiluminescent assay).kwa resorption marker (NTX).
Miyezo yopezeka m’giredi lachisanu kusukulu ya pulayimale ndi giredi lachitatu la sukulu ya sekondale yocheperako inafanizidwa pogwiritsa ntchito mayeso a t-awiri awiri.
Kuti mufufuze zinthu zomwe zingasokoneze, mgwirizano pakati pa OSI pa kalasi iliyonse ndi kutalika, kuchuluka kwa mafuta a thupi, kuchuluka kwa minofu, ndi mphamvu zogwirira zinatsimikiziridwa pogwiritsa ntchito ma coefficients ogwirizana.Kwa ophunzira asukulu yasekondale ya giredi lachitatu, kulumikizana pakati pa OSI, BAP, ndi NTX kudatsimikiziridwa pogwiritsa ntchito ma coefficients olumikizana pang'ono.
Kuti mufufuze zotsatira za kusintha kwa thupi ndi mphamvu kuchokera ku giredi 5 ya pulayimale kupita ku giredi lachitatu la sukulu ya sekondale ya OSI, kusintha kwa kuchuluka kwa mafuta a thupi, minofu, ndi mphamvu zogwira zomwe zimagwirizanitsidwa ndi kusintha kwa OSI zinayesedwa.Gwiritsani ntchito kusanthula kambiri.Pakuwunikaku, kusintha kwa OSI kunagwiritsidwa ntchito ngati chandamale chandamale ndipo kusintha kwa chinthu chilichonse kumagwiritsidwa ntchito ngati kusinthika kofotokozera.
Kusanthula kachitidwe ka zinthu kunagwiritsidwa ntchito kuwerengera kuchuluka kwa mikangano ndi 95% nthawi yodalirika kuti athe kuyerekezera ubale womwe ulipo pakati pa magawo olimba m'giredi lachisanu kusukulu ya pulayimale ndi metabolism ya mafupa (OSI, BAP ndi NTX) m'giredi lachitatu la kusekondale.
Kutalika, kuchuluka kwa mafuta a thupi, kuchuluka kwa minofu, ndi mphamvu zogwira zidagwiritsidwa ntchito ngati zizindikiro za kulimba / kulimbitsa thupi kwa ophunzira a pulayimale a pulayimale yachisanu, iliyonse yomwe imagwiritsidwa ntchito kugawa ophunzira m'magulu otsika, apakati, ndi apamwamba.
Pulogalamu ya SPSS 16.0J (SPSS Inc., Chicago, IL, USA) idagwiritsidwa ntchito posanthula ziwerengero ndipo ma p <0.05 adawonedwa ngati ofunika kwambiri.
Cholinga cha kafukufukuyu, ufulu wotuluka mu kafukufukuyu nthawi ina iliyonse, komanso kasamalidwe ka data (kuphatikiza chinsinsi cha data ndi kusadziwikiratu kwa data) zidafotokozedwa mwatsatanetsatane kwa onse omwe adatenga nawo gawo, ndipo chilolezo cholembedwa chinapezedwa kuchokera kwa omwe adatenga nawo gawo kapena kwa makolo awo. ./ othandizira.
Iwaki Health Promotion Project Primary and Secondary School Health Study inavomerezedwa ndi Hirosaki University Graduate School of Medicine Institutional Review Board (nambala yovomerezeka 2009-048, 2010-084, 2011-111, 2013-339, 2014-060 ndi 2015).-075).
Kafukufukuyu adalembetsedwa ndi University Hospitals Medical Information Network (UMIN-CTR, https://www.umin.ac.jp; dzina la mayeso: Iwaki Health Promotion Project mayeso achipatala; ndi ID ya mayeso a UMIN: UMIN000040459).
Kwa anyamata, zizindikiro zonse zimakula kwambiri, kupatulapo % mafuta, ndipo mwa atsikana, zizindikiro zonse zimakula kwambiri.M'chaka chachitatu cha sukulu ya sekondale, mfundo za fupa la metabolism mwa anyamata zinali zapamwamba kwambiri kuposa atsikana, zomwe zimasonyeza kuti fupa la metabolism mwa anyamata panthawiyi linali lotanganidwa kwambiri kuposa atsikana.
Kwa atsikana a giredi lachisanu, kulumikizana kwabwino kunapezeka pakati pa kukula kwa thupi / mphamvu yogwira ndi OSI.Komabe, zimenezi sizinaonekere mwa anyamata.
M'gulu la anyamata a giredi lachitatu, kukula konse kwa thupi / mphamvu zogwira zidalumikizidwa bwino ndi OSI komanso kulumikizidwa moyipa ndi NTX ndi / BAP.Mosiyana ndi zimenezi, mchitidwe umenewu sunatchulidwe kwambiri mwa atsikana.
Panali zochitika zazikulu pazovuta za OSI yapamwamba mwa ophunzira a giredi lachitatu ndi lachisanu pamtunda wapamwamba, kuchuluka kwamafuta, kuchuluka kwa minofu, ndi magulu amphamvu zogwira.
Kuphatikiza apo, kutalika kwakukulu, kuchuluka kwamafuta amthupi, kuchuluka kwa minofu, ndi mphamvu zogwira m'giredi lachisanu amuna ndi akazi amakonda kutsitsa kwambiri chiŵerengero cha zovuta za BAP ndi NTX m'kalasi lachisanu ndi chinayi.
Kukonzanso ndi kubwezeretsanso fupa kumachitika moyo wonse.Ntchito za kagayidwe ka mafupa izi zimayendetsedwa ndi mahomoni osiyanasiyana40,41,42,43,44,45,46 ndi ma cytokines.Pali nsonga ziwiri za kukula kwa mafupa: kukula koyambirira asanakwanitse zaka 5 ndi kukula kwachiwiri paunyamata.Mu gawo lachiwiri la kukula, kukula kwa fupa lalitali la fupa kumatsirizidwa, mzere wa epiphyseal umatseka, fupa la trabecular limakhala wandiweyani, ndipo BMD imayenda bwino.Ophunzira mu phunziroli anali mu nthawi ya chitukuko cha makhalidwe achiwiri ogonana, pamene kutulutsidwa kwa mahomoni ogonana kunali kogwira ntchito ndipo zinthu zomwe zimakhudza kagayidwe ka mafupa zinali zogwirizana.Rauchenzauner et al.[47] inanena kuti kagayidwe ka mafupa paunyamata ndi wosiyana kwambiri ndi zaka ndi jenda, komanso kuti BAP ndi tartrate-resistant phosphatase, chizindikiro cha resorption mafupa, amachepetsa pambuyo pa zaka 15 zakubadwa.Komabe, palibe kafukufuku yemwe wachitika kuti afufuze izi mwa achinyamata aku Japan.Palinso malipoti ochepa okhudza zomwe zikuchitika mu zolembera zokhudzana ndi DXA komanso zomwe zimayambitsa kagayidwe ka mafupa mwa achinyamata aku Japan.Chifukwa chimodzi cha zimenezi ndicho kusafuna kwa makolo ndi osamalira kulola kuti ana awo apimidwe mwachisawawa, monga ngati kutenga magazi ndi kutulutsa ma radiation, popanda matenda kapena chithandizo.
Kwa atsikana a giredi lachisanu, kulumikizana kwabwino kunapezeka pakati pa kukula kwa thupi / mphamvu yogwira ndi OSI.Komabe, zimenezi sizinaonekere mwa anyamata.Izi zikusonyeza kuti kukula kwa thupi pa nthawi ya kutha msinkhu kumakhudza OSI mwa atsikana.
Mawonekedwe onse a thupi / mphamvu zogwira adalumikizidwa bwino ndi OSI m'gulu lachitatu la anyamata.Mosiyana ndi zimenezi, izi sizinatchulidwe kwambiri mwa atsikana, kumene kusintha kokha kwa minofu ndi mphamvu zogwira ntchito zinali zogwirizana ndi OSI.Kusintha kwa kuchuluka kwa minofu ya thupi kunali kogwirizana bwino ndi kusintha kwa OSI pakati pa amuna ndi akazi.Zotsatirazi zikusonyeza kuti mwa anyamata, kuwonjezeka kwa kukula kwa thupi / mphamvu ya minofu kuchokera ku sukulu 5 mpaka 3 kumakhudza OSI.
Kutalika, chiŵerengero cha minofu ya thupi, ndi mphamvu zogwira m'kalasi lachisanu la sukulu ya pulayimale zinali zogwirizana kwambiri ndi ndondomeko ya OSI ndipo zinali zogwirizana kwambiri ndi miyeso ya kagayidwe ka mafupa m'kalasi lachitatu la sekondale.Deta iyi imasonyeza kuti kukula kwa kukula kwa thupi (kutalika kwa msinkhu ndi thupi ndi thupi) ndi mphamvu zogwira kumayambiriro kwa unyamata zimakhudza OSI ndi kagayidwe ka mafupa.
Zaka zachiwiri za kukula kwapamwamba (PHVA) m'Chijapani zinkawoneka zaka 13 kwa anyamata ndi zaka 11 kwa atsikana, ndi kukula mofulumira kwa anyamata49.Ali ndi zaka 17 mwa anyamata ndi zaka 15 mwa atsikana, mzere wa epiphyseal umayamba kutseka, ndipo BMD imawonjezeka ku BMD.Chifukwa cha mbiriyi ndi zotsatira za phunziroli, timalingalira kuti kuwonjezeka kwa msinkhu, minofu, ndi mphamvu za minofu mwa atsikana mpaka giredi 5 ndizofunikira pakukula kwa BMD.
Kafukufuku wam'mbuyomu wa ana omwe akukula ndi achinyamata awonetsa kuti zolembera za mafupa a resorption ndi mapangidwe a mafupa pamapeto pake zimawonjezeka50.Izi zitha kuwonetsa kagayidwe kachakudya m'mafupa.
Ubale pakati pa mafupa a metabolism ndi BMD wakhala mutu wa maphunziro ambiri akuluakulu51,52.Ngakhale malipoti ena53, 54, 55, 56 amasonyeza zosiyana pang'ono za amuna, kubwereza zomwe zapezeka kale zikhoza kufotokozedwa mwachidule motere: "Zizindikiro za kagayidwe ka fupa zimawonjezeka panthawi ya kukula, kenako zimachepa ndikukhala zosasinthika mpaka zaka za 40, ukalamba. ”.
Ku Japan, mayendedwe a BAP ndi 3.7–20.9 µg/L kwa amuna athanzi ndi 2.9–14.5 µg/L kwa amayi athanzi omwe ali ndisanathe kusamba.Makhalidwe a NTX ndi 9.5-17.7 nmol BCE/L kwa amuna athanzi ndi 7.5-16.5 nmol BCE/L kwa amayi athanzi omwe ali ndi premenopausal.Poyerekeza ndi izi muphunziro lathu, zisonyezo zonsezi zidayenda bwino m'makalasi achitatu a sekondale yocheperako, yomwe imadziwika kwambiri mwa anyamata.Izi zikusonyeza ntchito ya mafupa kagayidwe mu lachitatu giredi, makamaka anyamata.Chifukwa cha kusiyana pakati pa amuna ndi akazi kungakhale kuti anyamata a kalasi ya 3 adakali mu gawo la kukula ndipo mzere wa epiphyseal sunatseke, pamene atsikana mu nthawi ino mzere wa epiphyseal uli pafupi kutseka.Ndiko kuti, anyamata a m'kalasi lachitatu adakali ndi kukula kwa chigoba, pamene atsikana ali kumapeto kwa nthawi ya kukula kwa chigoba ndikufika pa msinkhu wa kukula kwa chigoba.Zomwe zimachitika pamafupa a metabolism omwe adapezedwa mu kafukufukuyu amafanana ndi zaka zomwe zikukula kwambiri mwa anthu aku Japan.
Kuonjezera apo, zotsatira za phunziroli zinasonyeza kuti ophunzira a sukulu ya pulayimale yachisanu ndi asanu omwe ali ndi thupi lolimba komanso mphamvu zakuthupi anali ndi zaka zazing'ono pachimake cha mafupa a metabolism.
Komabe, malire a kafukufukuyu ndikuti zotsatira za kusamba sizinaganizidwe.Chifukwa kagayidwe ka mafupa amakhudzidwa ndi mahomoni ogonana, maphunziro amtsogolo ayenera kufufuza zotsatira za kusamba.