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Int J Sports Med 2024; 45(01): 55-62
DOI: 10.1055/a-2161-5668
Orthopedics & Biomechanics

Differences of Bone Mineral Density by Characteristics of Sports in Amenorrheic Athletes

Sayaka Nose-Ogura
1   Department of Sports Medicine and Research, JAPAN High Performance Sport Center, Japan Institute of Sports Sciences, Kita-ku, Japan
2   Department of Obstetrics and Gynecology, The University of Tokyo, Bunkyo-ku, Japan
,
Osamu Yoshino
3   Department of Obstetrics and Gynecology, The University of Yamanashi, Yamanashi, Japan
,
Sakiko Kinoshita
2   Department of Obstetrics and Gynecology, The University of Tokyo, Bunkyo-ku, Japan
,
Hiroe Nakamura
2   Department of Obstetrics and Gynecology, The University of Tokyo, Bunkyo-ku, Japan
,
Miyuki Harada
2   Department of Obstetrics and Gynecology, The University of Tokyo, Bunkyo-ku, Japan
,
Osamu Hiraike
2   Department of Obstetrics and Gynecology, The University of Tokyo, Bunkyo-ku, Japan
,
Yutaka Osuga
2   Department of Obstetrics and Gynecology, The University of Tokyo, Bunkyo-ku, Japan
,
Michiko Dohi
1   Department of Sports Medicine and Research, JAPAN High Performance Sport Center, Japan Institute of Sports Sciences, Kita-ku, Japan
,
Kohei Nakajima
1   Department of Sports Medicine and Research, JAPAN High Performance Sport Center, Japan Institute of Sports Sciences, Kita-ku, Japan
,
Takashi Kawahara
1   Department of Sports Medicine and Research, JAPAN High Performance Sport Center, Japan Institute of Sports Sciences, Kita-ku, Japan
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Abstract

Hypothalamic amenorrhea leads to a hypoestrogenic state, causing decreased bone mineral density (BMD), while strong impact loading on bone has been shown to increase BMD. The purpose of this study is to compare BMD in female athletes based on menstrual status and their sports/events by impact loading characteristics. BMD at the lumbar spine was measured by dual-energy X-ray absorptiometry and hormone level. The subjects were classified into four groups and BMD and hormone levels were compared among the four groups, which were divided into amenorrheic athletes (AAs) and eumenorrheic athletes (EAs). This study recruited 410 female athletes (164 in the AAs and 246 in the EAs), 55 athletes in non-impact sports, 123 in low-impact sports, 141 in multidirectional sports, and 91 in high-impact sports. In the AAs group, BMD Z-score was lowest in low-impact sports (Z-score: –1.53 [–1.76, –1.30]), and was highest in high-impact sports (Z-score: 0.02 [–0.34, 0.38]). In multidirectional and high-impact sports, BMD Z-score in the AAs group did not show results lower than the average for non-athletes. When screening female athletes for low BMD, it is important to evaluate the risk of low BMD based on the impact loading characteristics of their sports/events, in addition to the menstrual state.

Key words

bone mineral density - amenorrheic female athletes - impact loading characteristics


Publication History

Received: 25 May 2023

Accepted: 22 August 2023

Article published online:
09 October 2023

© 2023. Thieme. All rights reserved.

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