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Kukura kwebhonzo kunonyanya kutaurwa panguva yekuyaruka.Ichi chidzidzo chine chinangwa chekujekesa maitiro ekuvaka muviri wevachiri kuyaruka uye kusimba pamapfupa emineral density markers uye bone metabolism kubatsira kuvandudza kukura kwebhonzo panguva yekuyaruka uye kudzivirira ramangwana osteoporosis.Kubva muna 2009 kusvika 2015, vechidiki 277 (vakomana 125 nevasikana 152) vane makore 10/11 ne14/15 vakapinda muongororo iyi.Zviyero zvinosanganisira fitness/body mass index (semuenzaniso, tsandanyama ratio, nezvimwewo), simba rekubata, bone mineral density (osteosonometry index, OSI), uye mamakisi emapfupa metabolism (bone-type alkaline phosphatase uye mhando I collagen cross-linked N) .-terminal peptide).Kuwirirana kwakanaka pakati pehukuru hwemuviri / simba rekubata uye OSI yakawanikwa muvasikana vane makore 10/11.Muvakomana vane makore 14/15 makore, saizi yese yemuviri / simba rekubata zvinhu zvaive zvakabatana neOSI.Shanduko muzvikamu zvetsandanyama dzemuviri dzakabatana zvakanaka neshanduko muOSI muvanhurume vese.Kureba, kusimba kwemuviri wemuviri uye simba rekubata pamakore e10 / 11 muhutano hwepabonde hwakanyanya kubatanidzwa neOSI (positive) uye bone metabolism markers (negative) pa 14 / 15 yemakore.Kuva nemuviri wakakwana mushure memakore gumi-11 ezera muvakomana uye kusvika kumakore gumi-11 ezera muvasikana zvingava zvinobudirira mukuwedzera peak bone mass.
Hupenyu hunotarisirwa kuraramwa hwakakurudzirwa nesangano reWorld Health Organisation (WHO) mugore ra2001 sekuti hurefu hwenguva iyo munhu anogona kurarama hupenyu hwakanaka ari ega muhupenyu hwake hwemazuva ese.MuJapan, mukaha uripo pakati pekutarisirwa kwehupenyu hune hutano uye avhareji yehupenyu hunotarisirwa kudarika makore gumi2.Nokudaro, "National Movement for Health Promotion mu21st Century (Healthy Japan 21)" yakasikwa kuti iwedzere hutano hunotarisirwa hupenyu3,4.Kuti uite izvi, zvakakosha kunonoka nguva yevanhu yekutarisira.Movement syndrome, kushaya simba uye osteoporosis5 ndizvo zvikonzero zvikuru zvekutsvaga kurapwa muJapan.Pamusoro pezvo, kutonga kwe metabolic syndrome, kufutisa kwevacheche, frailty uye mota syndrome chiyero chekudzivirira kudiwa kwekutarisirwa6.
Sezvatinoziva tose, kurovedza muviri zvine mwero nguva dzose kunokosha kuti uve noutano hwakanaka.Kutamba mitambo, iyo mota system, iyo ine mapfupa, majoini uye tsandanyama, inofanirwa kuve ine hutano.Somugumisiro, iyo Japan Orthopedic Association yakatsanangura "Motion Syndrome" mu2007 se "kusagadzikana nekuda kwehutano hwemusculoskeletal uye [umo] kune ngozi yakawanda inoda kutarisirwa kwenguva refu mune ramangwana" 7, uye matanho ekudzivirira akadzidzwa. kubva ipapo.zvino.Nekudaro, zvinoenderana neiyo 2021 White Pepa, kuchembera, kuputsika, uye musculoskeletal kusagadzikana8 zvinoramba zviri izvo zvinonyanya zvikonzero zvekutarisira zvinodiwa muJapan, zvichiverengera chikamu chechina chezvose zvinodiwa zvekuchengeta.
Kunyanya, kuputsika-kunokonzera osteoporosis inonzi inokanganisa 7.9% yevarume uye 22.9% yevakadzi vanopfuura 40 muJapan9,10.Kukurumidza kuonekwa uye kurapwa kunoratidzika seyo nzira inonyanya kukosha yekudzivirira osteoporosis.Kuongororwa kwefupa remamineral density (BMD) kwakakosha pakuonekwa nekukurumidza uye kurapwa.Dual simba X-ray absorption (DXA) yagara ichishandiswa sechiratidzo chekuongorora mapfupa mune dzakasiyana siyana radiological modalities.Zvisinei, kuputsika kwakataurwa kuti kunoitika kunyange neBMD yakakwirira, uye muna 2000 musangano weNational Institutes of Health (NIH) 11 wekubvumirana wakakurudzira kuwedzera kwepfupa sechiyero chekuongorora mapfupa.Zvisinei, kuongorora kunaka kwemapfupa kunoramba kwakaoma.
Imwe nzira yekuongorora BMD ndeye ultrasound (quantitative ultrasound, QUS)12,13,14,15.Zvidzidzo zvakaratidzawo kuti mhedzisiro yeQUS neDXA yakabatana16,17,18,19,20,21,22,23,24,25,26,27.Nekudaro, QUS haipindike, isiri-radioactive, uye inogona kushandiswa kuongorora vakadzi vane pamuviri nevana.Mukuwedzera, ine mukana wakajeka pamusoro peDXA, kureva kuti inobviswa.
Bone inotorwa neosteoclasts uye inoumbwa neosteoblasts.Bone density inochengetedzwa kana bhonzo metabolism yakajairika uye pane kuenzana pakati pekudzosa kwebhonzo nekuumbwa kwemapfupa.
Sezvineiwo, abnormal bone metabolism inokonzeresa kuderera kweBMD.Nokudaro, nokuda kwekuonekwa kwekutanga kweosteoporosis, zviratidzo zvemasabolism emapfupa, ayo ari zviratidzo zvakasununguka zvakabatana neBMD, kusanganisira zviratidzo zvekugadzirwa kwemapfupa uye kuputika kwepfupa, zvinoshandiswa kuongorora bone metabolism muJapan.The Fracture Intervention Trial (FIT) ine kuguma kwekudzivirira kuputsika kwakaratidza kuti BMD chiratidzo chekugadzirwa kwepfupa pane bone resorption16,28.Muchidzidzo ichi, zvicherechedzo zvemasabolism emapfupa zvakayerwawo kuti vadzidze zvine hungwaru kusimba kwebhonzo metabolism.Izvi zvinosanganisira zviratidzo zvekuumbwa kwemapfupa (bone-type alkaline phosphatase, BAP) uye zviratidzo zvebhonzo resorption (cross-linked N-terminal type I collagen peptide, NTX).
Kuyaruka izera repeak growth rate (PHVA), apo kukura kwebhonzo kunokurumidza uye kusimba kwemapfupa (peak bone mass, PBM) makore makumi maviri apfuura.
Imwe nzira yekudzivirira osteoporosis ndeyekuwedzera PBM.Nekudaro, sezvo iwo mametabolism emapfupa muvachiri kuyaruka asingazivikanwe, hapana kupindira chaiko kunogona kukurudzirwa kuwedzera BMD.
Naizvozvo, chidzidzo ichi chine chinangwa chekujekesa mhedzisiro yekuumbwa kwemuviri uye kusimba kwemuviri pane bhonzo mineral density uye skeletal markers panguva yekuyaruka, apo kukura kwemapfupa kunonyanya kushanda.
Ichi chidzidzo chemakore mana kubva pagiredhi rechishanu rechikoro chepuraimari kusvika kugiredhi rechitatu rejunior high school.
Vatori vechikamu vaisanganisira vakomana nevasikana vachiri kuyaruka vakapinda muIwaki Health Promotion Project Primary neSecondary Health Survey mugiredhi rechishanu repuraimari negiredhi rechitatu rejunior high school.
Zvikoro zvina zvepuraimari nejuniya zvakasarudzwa, zviri munharaunda yeIwaki yeHirosaki City kuchamhembe kweJapan.Ongororo yakaitwa mumatsutso.
Kubva 2009 kusvika 2011, vanobvuma giredhi 5 vadzidzi (makore 10/11) uye vabereki vavo vakabvunzurudzwa uye kuyerwa.Pazvidzidzo mazana matatu nemakumi mapfumbamwe nemashanu, vanhu mazana matatu nemakumi matanhatu nemumwe vakapinda muongororo iyi, inova chikamu che91.4%.
Kubva 2013 kusvika 2015, vadzidzi vechikoro chesekondari vanobvumirana (14/15 makore ekuberekwa) nevabereki vavo vakabvunzurudzwa uye kuyerwa.Pazvidzidzo mazana mana negumi neshanu, vanhu mazana matatu nemakumi masere vakapinda muongororo iyi, chinova chikamu che84.3%.
Vatori vechikamu 323 vaisanganisira vanhu vane nhoroondo yechirwere chemoyo, chirwere cheshuga, dyslipidemia, kana hypertension, vanhu vanonwa mishonga, vanhu vane nhoroondo yekutyoka, vanhu vane nhoroondo yekutyoka kwecalcaneus, uye vanhu vasina kukosha mukuongorora zvinhu.Kunze.Huwandu hwevachiri kuyaruka mazana maviri nemakumi manomwe nevanomwe (125 vakomana nevasikana zana nemakumi mashanu nevaviri) vakaverengerwa muongororo iyi.
Zvikamu zvekuongorora zvaisanganisira mibvunzo yemibvunzo, kuyerwa kwehutano hwemapfupa, kuongororwa kweropa (zviratidzo zvemapfupa emasabolism), uye zviyero zvehutano.Ongororo iyi yakaitwa mukati mezuva 1 rechikoro chepuraimari uye 1-2 mazuva echikoro chesekondari.Kuferefeta kwakatora mazuva mashanu.
Gwaro remibvunzo rakapiwa pachine nguva kuti rizadziswe.Vatori vechikamu vakakumbirwa kuti vapedze mibvunzo nevabereki vavo kana vachengeti, uye mibvunzo yakaunganidzwa pazuva rekuyerwa.Nyanzvi ina dzehutano hweveruzhinji dzakaongorora mhinduro dzacho uye dzakabvunza vana kana vabereki vavo kana vaine mibvunzo.Mibvunzo yemubvunzo yaisanganisira makore, murume kana mukadzi, nhoroondo yekurapa, nhoroondo yekurapa yazvino, uye mamiriro ekurapa.
Sechikamu chekuongorora kwepanyama pazuva rekudzidza, zviyero zvehurefu uye kuumbwa kwemuviri zvakatorwa.
Zviyero zvekuumbwa kwemuviri zvaisanganisira uremu hwemuviri, muzana yemafuta emuviri (% mafuta), uye muzana yehuremu hwemuviri (% tsandanyama).Zviyero zvakatorwa pachishandiswa body composition analyzer zvichibva pane bioimpedance method (TBF-110; Tanita Corporation, Tokyo).Chishandiso chinoshandisa ma frequency akawanda 5 kHz, 50 kHz, 250 kHz uye 500 kHz uye chakashandiswa muzvidzidzo zvakawanda zvevakuru29,30,31.Chishandiso ichi chakagadzirirwa kuyera vatori vechikamu vangangoita 110 cm kureba uye 6 makore ezera kana kupfuura.
BMD ndicho chikamu chikuru chekusimba kwemapfupa.BMD ongororo yakaitwa neECUS ichishandisa bone ultrasound mudziyo (AOS-100NW; Aloka Co., Ltd., Tokyo, Japan).Nzvimbo yekuyera yaive calcaneus, iyo yakaongororwa uchishandisa Osteo Sono-Assessment Index (OSI).Mudziyo uyu unoyera kumhanya kwezwi (SOS) uye transmission index (TI), izvo zvinobva zvashandiswa kuverenga OSI.SOS inoshandiswa kuyera calcification uye bone mineral density34,35 uye TI inoshandiswa kuyera kuderedzwa kwebroadband ultrasound, index of bone quality assessment12,15.OSI inoverengerwa uchishandisa inotevera fomula:
Saka kuratidza maitiro eSOS neTI.Naizvozvo, OSI inoonekwa seimwe yezvakakosha zvechiratidzo chepasi rose mukuongororwa kweacoustic bone.
Kuti tiongorore simba remhasuru, takashandisa simba rekubata, iyo inofungidzirwa kuratidza simba remuviri wose37,38.Isu tinotevedzera nzira ye "New Physical Fitness Test" yeSports Bureau yeBazi reDzidzo, Tsika, Mitambo, Sainzi neTekinoroji.
Smedley inobata dynamometer (TKK 5401; Takei Scientific Instruments Co., Ltd., Niigata, Japan).Inoshandiswa kuyera simba rekubata uye kugadzirisa hupamhi hwekubata kuitira kuti proximal interphalangeal joint yemhete yemunwe inoshanduka 90 °.Pakuyera, nzvimbo yegumbo yakamira nemakumbo akatambanudzwa, museve wegeji yemaoko unochengetwa wakatarisa kunze, mapendekete anotamirwa zvishoma kumativi, kwete kubata muviri.Vatori vechikamu vakakumbirwa kuti vabate dynamometer nechisimba chakazara sezvavaiburitsa.Munguva yekuyera, vatori vechikamu vakakumbirwa kuti vachengetedze mubato we dynamometer vachiri kuchengetedza chimiro chekutanga.Ruoko rumwe norumwe runopimwa kaviri, uye ruboshwe nerworudyi runoyerwa zvakachinjana kuti ruwane ukoshi hwakanakisisa.
Mangwanani-ngwanani padumbu risina chinhu, ropa rakatorwa kubva kuvana vechikoro chesekondari chechitatu, uye kuongororwa kweropa kwakaendeswa kuLSI Medience Co., Ltd. enzymatic immunochemiluminescent assay) nzira.ye resorption marker (NTX).
Matanho akawanikwa mugiredhi rechishanu rechikoro chepuraimari uye giredhi rechitatu rejunior high school akafananidzwa pachishandiswa t-bvunzo dzakapetwa.
Kuti uongorore zvinogona kuvhiringidza zvinhu, kuwirirana pakati peOSI yekirasi yega yega uye urefu, chikamu chemafuta emuviri, chikamu chemhasuru, uye simba rekubata zvakasimbiswa uchishandisa chikamu chekubatanidza coefficients.Kune vadzidzi vegiredhi rechitatu vechikoro chesekondari, kuwirirana pakati peOSI, BAP, neNTX kwakasimbiswa pachishandiswa chidimbu chekoresheni coefficients.
Kuongorora mhedzisiro yekuchinja kwemuviri uye simba kubva mugiredhi rechishanu rechikoro chepuraimari kusvika kugiredhi rechitatu rejunior high school paOSI, shanduko muhuwandu hwemafuta emuviri, huremu hwemhasuru, uye kusimba kwekubata kwakabatana nekuchinja kweOSI kwakaongororwa.Shandisa multiple regression analysis.Muchidzidzo ichi, shanduko yeOSI yakashandiswa sechinangwa chekuchinja uye shanduko yechinhu chimwe nechimwe yakashandiswa sechinhu chinotsanangura.
Logistic regression analysis yakashandiswa kuverenga odds ratios ne 95% nguva dzekusavimbika kufungidzira hukama pakati pemafitness parameters mugiredhi rechishanu rechikoro chepuraimari nebhonzo metabolism (OSI, BAP neNTX) mugiredhi rechitatu rechikoro chesekondari.
Hurefu, chikamu chemafuta emuviri, chikamu chetsandanyama, uye simba rekubata zvakashandiswa sezviratidzo zvekusimba/kusimba kuvadzidzi vegiredhi rekutanga, imwe neimwe yaishandiswa kuisa vadzidzi mumapoka akaderera, ari pakati, uye akakwirira.
SPSS 16.0J software (SPSS Inc., Chicago, IL, USA) yakashandiswa kuongorora nhamba uye p kukosha <0.05 yaionekwa seyakakosha.
Chinangwa chechidzidzo, kodzero yekubuda muchidzidzo chero nguva, uye maitiro ekutonga data (kusanganisira kuvanzika kwedata uye kusazivikanwa kwedata) zvakatsanangurwa zvakadzama kune vese vatori vechikamu, uye mvumo yakanyorwa yakawanikwa kubva kune vatori vechikamu ivo pachavo kana kubva kuvabereki vavo. ./ vachengeti.
Iwaki Health Promotion Project Primary uye Secondary School Health Study yakagamuchirwa neHirosaki University Graduate School of Medicine Institutional Review Board (nhamba yemvumo 2009-048, 2010-084, 2011-111, 2013-339, 2014-060 uye 2015).-075).
Chidzidzo ichi chakanyoreswa neUniversity Hospitals Medical Information Network (UMIN-CTR, https://www.umin.ac.jp; zita rebvunzo: Iwaki Health Promotion Project bvunzo yekurapa; uye UMIN bvunzo ID: UMIN000040459).
Muvakomana, zviratidzo zvose zvakawedzera zvakanyanya, kunze kwe% mafuta, uye muvasikana, zviratidzo zvose zvakawedzera zvakanyanya.Mugore rechitatu rejunior chikoro chesekondari, kukosha kweiyo bone metabolism index muvakomana zvakare kwakakwira zvakanyanya kupfuura kuvasikana, izvo zvakaratidza kuti bhonzo metabolism muvakomana panguva iyi yainyanya kushanda kupfuura muvasikana.
Kune vasikana vegiredhi rechishanu, kuwirirana kwakanaka kwakawanikwa pakati pehukuru hwemuviri / simba rekubata uye OSI.Zvisinei, tsika iyi haina kuonekwa muvakomana.
Mugiredhi rechitatu vakomana, saizi yese yemuviri / simba rekubata zvinhu zvaive zvakabatana neOSI uye zvisina hukama neNTX uye / BAP.Kusiyana neizvi, maitiro aya akanga asinganyanyi kutaurwa muvasikana.
Paive nemaitiro akakosha mukusawirirana kweOSI yepamusoro mugiredhi rechitatu nerechishanu pakukwirira kwepamusoro, chikamu chemafuta, chikamu chetsandanyama, uye mapoka esimba rekubata.
Pamusoro pezvo, kureba kwepamusoro, huwandu hwemafuta emuviri, huwandu hwemhasuru, uye kusimba kwekubata mugiredhi rechishanu varume nevakadzi vaiwanzodzikisira huwandu hwemaodds eBAP neNTX zvibodzwa mugiredhi repfumbamwe.
Kugadziriswa zvakare uye resorption yemapfupa kunoitika muhupenyu hwese.Aya mabasa emapfupa emagetsi anotungamirirwa nehomoni dzakasiyana-siyana40,41,42,43,44,45,46 uye cytokines.Kune nhongonya mbiri mukukura kwemapfupa: kukura kwekutanga kusati kwasvika makore mashanu uye kwechipiri kukura panguva yekuyaruka.Muchikamu chechipiri chekukura, kukura kweakisi yakareba yepfupa kunopedzwa, mutsara wepiphyseal unovhara, trabecular bone inova dense, uye BMD inovandudza.Vatori vechikamu muchidzidzo ichi vaive munguva yekuvandudzwa kwehunhu hwechipiri hwepabonde, apo kuburitswa kwemahomoni ebonde kwaishanda uye zvinhu zvaikanganisa mapfupa emasabolism zvakapindirana.Rauchenzauner et al.[47] yakashuma kuti pfupa remasabolism mukuyaruka rinonyanya kushanduka nezera uye zvepabonde, uye kuti zvose BAP uye tartrate-resistant phosphatase, chiratidzo chepfupa resorption, inoderera mushure memakore gumi nemashanu.Nekudaro, hapana ongororo yakaitwa kuti iongorore izvi zvinhu muvachiri kuyaruka vechiJapan.Kune zvakare mishumo yakanyanya kushomeka pane mafambiro muDXA-ane hukama mamaki uye zvinhu zvebhonzo metabolism muJapan pwere.Chimwe chikonzero cheizvi kusada kwevabereki nevatarisiri kubvumira nzvero dzisiri dzenguva dzose pavana vavo, zvakadai sokuunganidzwa kweropa nemwaranzi, pasina kuongororwa kana kurapwa.
Kune vasikana vegiredhi rechishanu, kuwirirana kwakanaka kwakawanikwa pakati pehukuru hwemuviri / simba rekubata uye OSI.Zvisinei, tsika iyi haina kuonekwa muvakomana.Izvi zvinoratidza kuti kukura kwekukura kwemuviri panguva yekuyaruka kunokanganisa OSI muvasikana.
Zvese chimiro chemuviri / kubata simba zvinhu zvaive zvakabatana neOSI mugiredhi rechitatu vakomana.Kusiyana neizvi, maitiro aya aive asinganyanyi kutaurwa muvasikana, uko chete shanduko muchikamu chetsandanyama uye simba rekubata zvakabatanidzwa neOSI.Shanduko muzvikamu zvetsandanyama dzemuviri dzaive dzakabatana nekuchinja kweOSI pakati pebonde.Izvi zvinoratidza kuti muvakomana, kuwedzera kwekukura kwemuviri / simba retsandanyama kubva kumagiredhi 5 kusvika ku3 kunokanganisa OSI.
Kureba, chiyero chemuviri-musuru, uye simba rekubata mugiredhi rechishanu rechikoro chepuraimari zvakanyatsobatanidzwa neOSI index uye zvakanyanya kushamwaridzana nezviyero zvemasabolism emapfupa mugiredhi rechitatu rechikoro chesekondari.Aya data anoratidza kuti kukura kwekukura kwemuviri (kureba uye muviri-kune-muviri ratio) uye simba rekubata mukutanga kuyaruka kunokanganisa OSI uye bone metabolism.
Zera rechipiri repeak growth rate (PHVA) muchiJapan rakaonekwa pamakore gumi nematatu kuvakomana uye 11 makore kuvasikana, nekukura nekukurumidza muvakomana49.Pazera remakore gumi nemanomwe muvakomana uye makore gumi nemashanu muvasikana, mutsara wepiphyseal unotanga kuvhara, uye BMD inowedzera kune BMD.Tichifunga nezvenyaya iyi uye nemhedzisiro yechidzidzo ichi, tinofungidzira kuti kuwedzera urefu, huremu hwemhasuru, uye kusimba kwemhasuru muvasikana kusvika giredhi rechishanu zvakakosha pakuwedzera BMD.
Zvidzidzo zvakapfuura zvevana vari kukura nevechiri kuyaruka zvakaratidza kuti mamaki ekudzoreredza mapfupa uye kuumbwa kwemapfupa anozopedzisira awedzera50.Izvi zvinogona kuratidza kushanda kwebhonzo metabolism.
Ukama huri pakati pefupa metabolism neBMD yave iri nyaya yezvidzidzo zvakawanda muvakuru51,52.Kunyange zvazvo mimwe mishumo53, 54, 55, 56 ichiratidza maitiro akasiyana-siyana muvarume, kuongororwa kwezvakawanikwa kare kunogona kupfupikiswa sezvinotevera: "Zviratidzo zvemasabolism emapfupa anowedzera panguva yekukura, zvino anoderera uye anoramba asingashanduki kusvika pazera re40, kukwegura. ”.
MuJapan, BAP mareferensi maitiro ndeye 3.7-20.9 µg/L yevarume vane hutano uye 2.9-14.5 µg/L yevakadzi vane hutano hwepamberi pemenopausal.Reference values ​​​​yeNTX ndeye 9.5-17.7 nmol BCE/L yevarume vane hutano uye 7.5-16.5 nmol BCE/L yevakadzi vane hutano premenopausal.Zvichienzaniswa neaya mareferenzi maitiro mukudzidza kwedu, zvese zviratidzo zvakavandudzwa mugiredhi rechitatu repazasi sekondari chikoro, icho chainyanya kutaurwa muvakomana.Izvi zvinoratidza basa remasabolism emapfupa muvatatu-graders, kunyanya vakomana.Chikonzero chekusiyana kwevakadzi kunogona kuva kuti vakomana vekirasi ye3 vachiri muchikamu chekukura uye mutsara wepiphyseal hausati wavhara, asi muvasikana munguva ino mutsara wepiphyseal uri pedyo nekuvhara.Ndiko kuti, vakomana vari mugiredhi rechitatu vachiri kukura uye vane kushingaira skeletal kukura, asi vasikana vari pakupera skeletal kukura nguva uye kusvika padanho kukura skeletal.Mafambiro mumapfupa emasabolism mamaki akawanikwa muchidzidzo ichi anoenderana nezera rekukura kwekukura muhuwandu hweJapan.
Mukuwedzera, migumisiro yechidzidzo ichi yakaratidza kuti vadzidzi vegiredhi yechishanu vechikoro chepuraimari vane muviri wakasimba uye simba remuviri vaiva nezera duku pakukwirira kwefupa remetabolism.
Zvisinei, muganhu wechidzidzo ichi ndechokuti mhedzisiro yekuenda kumwedzi haina kuverengerwa.Nekuti bhonzo metabolism inopesvedzerwa nehomoni dzepabonde, zvidzidzo zvenguva yemberi zvinoda kuongorora mhedzisiro yekuenda kumwedzi.