Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Spaulding National Running Center, Harvard Medical School, Cambridge, MA.
Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford, CA.
Med Sci Sports Exerc. 2018 Dec;50(12):2536-2543. doi: 10.1249/MSS.0000000000001711.
Athletes in weight-bearing sports may benefit from higher bone mineral density (BMD). However, some athletes are at risk for impaired BMD with female athlete triad (Triad). The purpose of this study is to understand the influence of sports participation and Triad on BMD. We hypothesize that athletes in high-impact and multidirectional loading sports will have highest BMD, whereas nonimpact and low-impact sports will have lowest BMD. Triad risk factors are expected to reduce BMD values independent of sports participation.
Two hundred thirty-nine female athletes participating in 16 collegiate sports completed dual-energy x-ray absorptiometry (DXA) scans to measure BMD z-scores of the lumbar spine (LS) and total body (TB). Height and weight were measured to calculate body mass index (BMI). Triad risk assessment variables were obtained from preparticipation examination. Mean BMD z-scores were compared between sports and by sport category (high-impact, multidirectional, low-impact, and nonimpact). Multivariable regression analyses were performed to identify differences of BMD z-scores accounting for Triad and body size/composition.
Athlete populations with lowest average BMD z-scores included synchronized swimming (LS, -0.34; TB, 0.21) swimming/diving (LS, 0.34; TB, -0.06), crew/rowing (LS, 0.27; TB, 0.62), and cross-country (LS, 0.29; TB, 0.91). Highest values were in gymnastics (LS, 1.96; TB, 1.37), volleyball (LS, 1.90; TB, 1.74), basketball (LS, 1.73; TB, 1.99), and softball (LS, 1.68; TB, 1.78). All Triad risk factors were associated with lower BMD z-scores in univariable analyses; only low BMI and oligomenorrhea/amenorrhea were associated in multivariable analyses (all P < 0.05). Accounting for Triad risk factors and body size/composition, high-impact sports were associated with higher LS and TB BMD z-scores and nonimpact sports with lower LS and TB BMD z-scores compared to low-impact sport (all P < 0.05).
Both sport type and Triad risk factors influence BMD. Athletes in low-impact and nonimpact sports and athletes with low BMI and oligomenorrhea/amenorrhea are at highest risk for reduced BMD.
承重运动的运动员可能受益于更高的骨密度（BMD）。然而，一些运动员由于女性运动员三联征（三联征）而存在 BMD 受损的风险。本研究的目的是了解运动参与和三联征对 BMD 的影响。我们假设高冲击和多方向加载的运动的运动员将具有最高的 BMD，而无冲击和低冲击的运动将具有最低的 BMD。预计三联征风险因素会降低 BMD 值，而与运动参与无关。
239 名参加 16 项大学运动的女性运动员完成了双能 X 射线吸收法（DXA）扫描，以测量腰椎（LS）和全身（TB）的 BMD z 分数。测量身高和体重以计算体重指数（BMI）。从参与前检查中获得三联征风险评估变量。比较了运动之间和运动类别的平均 BMD z 分数（高冲击、多方向、低冲击和非冲击）。进行多变量回归分析以确定考虑三联征和身体大小/组成的 BMD z 分数差异。
平均 BMD z 分数最低的运动员群体包括花样游泳（LS，-0.34；TB，0.21）游泳/跳水（LS，0.34；TB，-0.06）、赛艇/划船（LS，0.27；TB，0.62）和越野（LS，0.29；TB，0.91）。最高值见于体操（LS，1.96；TB，1.37）、排球（LS，1.90；TB，1.74）、篮球（LS，1.73；TB，1.99）和垒球（LS，1.68；TB，1.78）。所有三联征风险因素在单变量分析中均与较低的 BMD z 分数相关；仅低 BMI 和稀发排卵/闭经在多变量分析中相关（均 P < 0.05）。考虑到三联征风险因素和身体大小/组成，与低冲击运动相比，高冲击运动与 LS 和 TB BMD z 分数较高相关，而非冲击运动与 LS 和 TB BMD z 分数较低相关（均 P < 0.05）。
运动类型和三联征风险因素都影响 BMD。低冲击和非冲击运动的运动员以及 BMI 低和稀发排卵/闭经的运动员的 BMD 降低风险最高。
