Abstract
Background: The relationship between bone metabolism-related gene polymorphisms and low bone mineral density (BMD) risk factors in female athletes is unclear. This study aimed at investigating whether the sensitivity of low BMD risk factors to BMD depends on estrogen receptor α (ERα) gene polymorphisms in Japanese female athletes.Materials and Methods: This study included 280 collegiate female athletes from 12 competitive sports (age, 19.2 ± 1.3 years). Data on sports participation, age at menarche, menstrual cycles, prior stress fractures, and prior eating disorders were obtained through a questionnaire-type survey. Sports types were classified into endurance, esthetic, aquatic, ball, and high load in consideration of exercise load characteristics. ERα gene PvuII (rs2234693) and XbaI (rs9340799) polymorphisms were analyzed by TaqMan® assay. The total body BMD was measured by dual-energy X-ray absorptiometry.Results: On multiple regression analysis, sports types, body mass index (BMI), menarche, and XbaI polymorphism remained robust independent predictors of BMD. However, prior stress fractures and menstrual cycles were excluded. In athletes carrying the XX+Xx genotype of XbaI polymorphism, sports types and BMI were associated with BMD. However, in athletes carrying the xx genotype of XbaI polymorphism, sports types, BMI, and menarche were associated with BMD. These results indicated that athletes carrying the xx genotype with delayed menarche had low BMD.Conclusions: In collegiate female athletes, participation in endurance, esthetic, and aquatic sports types and a low BMI are associated with low BMD. In addition, delayed menarche may negatively affect BMD in athletes carrying the xx type of ERα gene XbaI polymorphism.
Highlights
Low-energy availability, amenorrhea, and osteoporosis have been defined as the female athlete triad.[1]
In collegiate female athletes, participation in endurance, esthetic, and aquatic sports types and a low body mass index (BMI) are associated with low bone mineral density (BMD)
In this study, we investigated the effect of low BMD risk factors and estrogen receptor a (ERa) gene polymorphisms on BMD and whether the sensitivity of low BMD risk factors to BMD depends on ERa gene polymorphisms in collegiate female athletes
Summary
Low-energy availability, amenorrhea, and osteoporosis have been defined as the female athlete triad (the triad).[1]. Previous studies have reported that low BMD risk factors include low body mass index (BMI),[2,3,4,5] delayed menarche,[2,3,4,5] menstrual abnormalities such as oligomenorrhea or amenorrhea,[2,3,4,5,6] prior eating disorders,[2,3,4] prior stress fractures,[2,3,4,5] as well as participation in long-distance, aquatic, and esthetic types of sports.[4,7,8] a cumulative number of low BMD risk factors was associated with an increased risk of low BMD.[9] low BMD risk factors in female athletes are being identified. Delayed menarche may negatively affect BMD in athletes carrying the xx type of ERa gene XbaI polymorphism
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