Abstract
Hypotheses:Values of serum markers related to bone quality are abnormal in young female ballet dancers. Methods: In 13 elite Japanese female ballet dancers (average age, 22 years), markers related to bone quality were investigated. These included: serum homocystein (HC), a marker of increased oxidative stress; pentosidine (Pent), a marker of glycation- or oxidation-induced non-enzymatic cross-links; markers of bone metabolism (bone alkaline phosphatase, BAP; tartrate-resistant acid phosphatase 5b, TRAP5b) and bone mineral density (BMD). It was determined whether there is a relationship between bone quality markers’ levels are related to amenorrhea and/or fatigue fractures. Results: Two dancers had fatigue fractures and 3 had a history of secondary amenorrhea. The average BMD was 1.305 ± 0.12 (g/cm2), in all these cases the Z-score was higher than -1.0. Although the serum levels of BAP, TRAP5b, and HC were normal in all examined dancers, in 2 out of 3 dancers with a history of secondary amenorrhea, pentosidine serum levels were increased. No relationship between bone quality markers’ levels and fatigue fractures was found. Conclusion: Latent deterioration of bone quality may occur in female athletes with secondary amenorrhea and otherwise normal BMD and calcium metabolism markers.
Highlights
Introductionfemale athlete triad (FAT) can be clinically manifested by stress fractures
Serum levels of homocystein (HC), a marker of increased oxidative stress, and Pent have been widely used as determinants of bone quality [6] [7] [10]-[15]; no studies have been performed on status of bone quality in young female athletes
Two ballet dancers had a history of fatigue fracture: one developed bilateral pars-interarticularis fracture of the 4th lumbar spine and the other suffered from a tibial fracture
Summary
FAT can be clinically manifested by stress fractures. It has been recently addressed by the International Olympic Committee (IOC), and focus was mainly on relative energy deficiency in FAT [3] [4]. In regard to bone health, the position stands have related only to bone mineral density (BMD), but BMD is only one of bone strength indicators: even amongst patients with the same BMD values, fractures develop only in few. Serum levels of homocystein (HC), a marker of increased oxidative stress, and Pent have been widely used as determinants of bone quality [6] [7] [10]-[15]; no studies have been performed on status of bone quality in young female athletes
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