Smith Emily M, Drager Kelly, Groves Erik M, Gabel Leigh, Boyd Steven K, Burt Lauren A
Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada.
Canadian Sport Institute Alberta, Calgary, Alberta, Canada.
BMJ Open Sport Exerc Med. 2025 Jan 30;11(1):e002320. doi: 10.1136/bmjsem-2024-002320. eCollection 2025.
Relative energy deficiency in sport (REDs) is a syndrome resulting from problematic low energy availability (LEA). Low areal bone mineral density (aBMD) is a primary indicator of LEA, measured by dual X-ray absorptiometry (DXA). High-resolution peripheral quantitative CT (HR-pQCT) is an advanced imaging device that provides measures of volumetric BMD (vBMD), bone microarchitecture, geometry and strength. This study aimed to assess the prevalence of REDs in elite winter sport athletes and to observe the associations in bone parameters using HR-pQCT in athletes identified as at-risk or not at-risk of REDs.
Participants included 101 elite athletes (24.1±4.4 SD years; 52% female). The REDs Clinical Assessment Tool (CAT2) was used to determine REDs risk. HR-pQCT scans of the non-dominant radius and left tibia were analysed on REDs risk grouping.
17 athletes (17%; 71% female) were at-risk based on the REDs CAT2. After covarying for lean mass, OR suggested a higher likelihood of REDs risk classification for athletes with low cortical thickness, cortical area, total vBMD and bone strength.
Impaired total vBMD, bone strength and cortical bone parameters were approximately twice as likely (OR: 1.9-3.0) in athletes at-risk of REDs. Results agree with the consensus statement that HR-pQCT may identify impaired bone health in athletes at-risk of REDs. Future directions should use HR-pQCT to explore REDs risk longitudinally, using bone change over time, as this may provide greater insight. Using advanced imaging to explore REDs risk in a population of winter high-performance athletes is novel.
运动相关能量缺乏症（REDs）是一种由低能量可利用性（LEA）问题导致的综合征。低面积骨密度（aBMD）是LEA的主要指标，通过双能X线吸收法（DXA）测量。高分辨率外周定量CT（HR-pQCT）是一种先进的成像设备，可提供体积骨密度（vBMD）、骨微结构、几何形状和强度的测量值。本研究旨在评估优秀冬季项目运动员中REDs的患病率，并观察使用HR-pQCT在被确定为有或无REDs风险的运动员中骨参数的相关性。
参与者包括101名优秀运动员（年龄24.1±4.4岁标准差；52%为女性）。使用REDs临床评估工具（CAT2）来确定REDs风险。根据REDs风险分组对非优势桡骨和左胫骨进行HR-pQCT扫描分析。
根据REDs CAT2，17名运动员（17%；71%为女性）有风险。在对瘦体重进行协变量调整后，OR表明皮质厚度、皮质面积、总vBMD和骨强度低的运动员REDs风险分类的可能性更高。
REDs风险运动员的总vBMD、骨强度和皮质骨参数受损的可能性大约是其两倍（OR：1.9 - 3.0）。结果与共识声明一致，即HR-pQCT可能识别出有REDs风险的运动员的骨健康受损情况。未来的研究方向应使用HR-pQCT纵向探索REDs风险，利用随时间的骨变化，因为这可能提供更多见解。使用先进成像技术在冬季高水平运动员群体中探索REDs风险是新颖的。
