Ward KA, Roberts SA, Adams JE, Mughal MZ. Bone geometry and density in the skeleton of pre-pubertal gymnasts and school children. Bone 36, 1012-1018

The University of Manchester, Manchester, England, United Kingdom
Bone (Impact Factor: 3.97). 07/2005; 36(6):1012-8. DOI: 10.1016/j.bone.2005.03.001
Source: PubMed


We have studied the differences between the peripheral and axial skeleton of pre-pubertal gymnasts and controls. We hypothesised that compared to controls, gymnasts would have larger and stronger radius and tibia diaphyses with greater bone mineral content and larger cross-sectional muscle area. At the distal metaphyseal sites of the radius and tibia, gymnasts would have greater bone cross-sectional area and total and trabecular volumetric bone mineral density (vBMD). Differences between the lumbar spine, total body and body composition in gymnasts versus controls were also studied. Peripheral quantitative computed tomography (pQCT) was used to measure bone geometry, density and muscle of the peripheral skeleton; dual energy X-ray absorptiometry (DXA) for total body and axial measurements. Eighty-six pre-pubertal children, 44 gymnasts (mean age 9.0 years, range 5.4-11.9 years) and 42 controls (mean age 8.8 years, range 5.6-11.9 years) were studied. Eighty-four children were Caucasian, one child was mixed race, one Chinese. Data were adjusted for age, sex and height. Differences in the effect size between sexes were also tested. At the 50% radius diaphysis gymnasts had larger bones (9.2%, p = 0.0054) with greater cortical area (8.2%, p = 0.022) and stress strain index (surrogate measure of bone strength) than controls (13.6%, p = 0.015). The effect size was different between males and females for cortical thickness (p = 0.03). At the 65% tibia diaphysis, gymnasts had greater cortical area (5.3%, p = 0.057) and thickness (6.2%, p = 0.068) than controls; consequently, bone strength was 5.4% higher (p = 0.14). There were no significant differences in cortical volumetric bone mineral density (vBMD) at the radius or tibia diaphysis between the groups. There was a difference in effect size for tibia muscle cross-sectional area between the sexes (p = 0.035). At the distal radius and tibia total and trabecular vBMD was greater (Total: radius 17%, p < 0.0001, tibia: 5.7%, p = 0.0053; trabecular: radius 21%, p < 0.0001, tibia 4.5%, p = 0.11). Bone size was not different in gymnasts compared to controls Lumbar spine BMC (12.3%, p = 0.0007), areal bone mineral density (aBMD) (9.1%, p = 0.0006) and bone mineral apparent density (BMAD) (7.6%, p = 0.0047) were greater in gymnasts but vertebral size was not significantly different. Likewise, total body BMD (3.5%, p = 0.0057) and BMC (4.78%, p = 0.085) were greater in gymnasts but there were no differences in skeletal size. These data suggest site-specific differences in how the pre-pubertal skeleton develops in response to the repetitive loading it experiences when participating in regular gymnastics. At diaphyseal sites these differences are predominantly in the bone and muscle geometry and not density. Conversely, at trabecular sites, the differences are increased density rather than geometry. In conclusion, the present study has demonstrated skeletal differences between gymnasts and controls. These differences appear to be site and sex specific.

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Available from: Kate A Ward, Feb 22, 2015
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    • "Muscle mass provides an excellent index of the mechanical stimulation to bone and is highly correlated to bone mass, density, and architecture (Wetzsteon et al. 2011). Multiple studies in healthy children have shown an association between physical activity and aBMD,[414253–55] and athletes, such as gymnasts[56] and tennis players,[57] have increased bone density, dimensions, and strength during growth. Moreover, modest increases in weight-bearing physical activity can result in significant improvements in bone density and strength in growing children and adolescents.[58] "
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    ABSTRACT: During normal childhood and adolescence, the skeleton undergoes tremendous change. Utilizing the processes of modeling and remodeling, the skeleton acquires its adult configuration and ultimately achieves peak bone mass. Optimization of peak bone mass requires the proper interaction of environmental, dietary, hormonal, and genetic influences. A variety of acute and chronic conditions, as well as genetic polymorphisms, are associated with reduced bone density, which can lead to an increased risk of fracture both in childhood and later during adulthood. Bone densitometry has an established role in the evaluation of adults with bone disorders, and the development of suitable reference ranges for children now permits the application of this technology to younger individuals. We present a brief overview of the factors that determine bone density and the emerging role of bone densitometry in the assessment of bone mass in growing children and adolescents.
    12/2012; 16(Suppl 2):S205-12. DOI:10.4103/2230-8210.104040
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    • "Alternatively, bone mineral may be deposited on the endosteal surface, producing a thicker cortical shell without a wider bone. (Duncan et al., 2002, Greene et al., 2005, Ward et al., 2005). "
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    • "Besides BMD measurement, we have conducted strength–strain indices with respect to Y axis (SSIy) to assess the difference in mechanical property of OVX + IBAN + PTH group which showed the similar BMD values to the OVX + IBAN group [37]. The SSI is related to both geometrical properties and cortical density [38] [39]. "
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