Disordered Eating, Development of Menstrual Irregularity, and Reduced Bone Mass Change After a 3-Year Follow-Up In Female Adolescent Endurance Runners

2021 ◽  
pp. 1-8
Author(s):  
Michelle T. Barrack ◽  
Marta D. Van Loan ◽  
Mitchell Rauh ◽  
Jeanne F. Nichols
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Disordered Eating ◽  
Bone Mineral ◽  
Female Adolescent ◽  
Mineral Density ◽  
Menstrual Cycles ◽  
Endurance Runners

This prospective study evaluated the 3-year change in menstrual function and bone mass among 40 female adolescent endurance runners (age 15.9 ± 1.0 years) according to baseline disordered eating status. Three years after initial data collection, runners underwent follow-up measures including the Eating Disorder Examination Questionnaire and a survey evaluating menstrual function, running training, injury history, and prior sports participation. Dual-energy X-ray absorptiometry was used to measure bone mineral density and body composition. Runners with a weight concern, shape concern, or global score ≥4.0 or reporting >1 pathologic behavior in the past 28 days were classified with disordered eating. Compared with runners with normal Eating Disorder Examination Questionnaire scores at baseline, runners with disordered eating at baseline reported fewer menstrual cycles/year (6.4 ± 4.5 vs. 10.5 ± 2.8, p = .005), more years of amenorrhea (1.6 ± 1.4 vs. 0.3 ± 0.5, p = .03), and a higher proportion of menstrual irregularity (75.0% vs. 31.3%, p = .02) and failed to increase lumbar spine or total hip bone mineral density at the 3-year follow-up. In a multivariate model including body mass index and menstrual cycles in the past year at baseline, baseline shape concern score (B = −0.57, p value = .001) was inversely related to the annual number of menstrual cycles between assessments. Weight concern score (B = −0.40, p value = .005) was inversely associated with lumbar spine bone mineral density Z-score change between assessments according to a multivariate model adjusting for age and body mass index. These finding support associations between disordered eating at baseline and future menstrual irregularities or reduced accrual of lumbar spine bone mass in female adolescent endurance runners.

scholarly journals Influence of different playing surfaces on bone mass accretion in male adolescent football players: A one-season study

2019 ◽  
Vol 233 (4) ◽  
pp. 536-547
Author(s):  
Gabriel Lozano-Berges ◽  
Ángel Matute-Llorente ◽  
Alejandro Gómez-Bruton ◽  
Alex González-Agüero ◽  
Germán Vicente-Rodríguez ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Bone Mineral ◽  
Elastic Layer ◽  
Areal Bone Mineral Density ◽  
Football Players ◽  
Third Generation ◽  
Artificial Turf ◽  
Mineral Density

There are different surfaces on which football is played, but their influence on bone mass accretion still remains unknown. The aims of this study were to compare bone mass accretion between football players and controls, and evaluate the influence of two different playing surfaces on bone accretion. A total of 27 male football players (13.2 ± 0.5 years) and 15 controls (12.6 ± 1.1 years) participated in this study. Football players were classified into two groups according to the surface they trained on: 14 on third-generation artificial turf with elastic layer and 13 on third-generation artificial turf without elastic layer. Bone mineral content and areal bone mineral density were measured using dual-energy X-ray absorptiometry. Bone mineral apparent density variables were calculated. Bone geometry and strength of the non-dominant tibia were assessed with peripheral quantitative computed tomography. For both football players and controls, bone variables measured at subtotal body, lumbar spine, legs and tibia ( p < 0.05) significantly increased. Based on the time spent practicing football, the increase in areal bone mineral density for the legs ( p < 0.05) was higher in football players than controls. Moreover, lumbar spine bone mineral apparent density increased more in third-generation artificial turf without elastic layer players in comparison with third-generation artificial turf with elastic layer players ( p < 0.05). Playing football on third-generation artificial turf with elastic layer and third-generation artificial turf without elastic layer seems to positively affect bone mass during growth. After playing for one season on these playing surfaces, football practice on third-generation artificial turf without elastic layer with the lower shock absorption seems to have produced the highest increment in areal bone mineral density at lumbar spine. Thus, football practice on surfaces with lower shock absorption could provide an extra benefit on bone health.

scholarly journals Alcohol consumption and bone mineral density in elderly women

2012 ◽  
Vol 16 (4) ◽  
pp. 704-712 ◽  
Author(s):  
Isolde Sommer ◽  
Arja T Erkkilä ◽  
Ritva Järvinen ◽  
Jaakko Mursu ◽  
Joonas Sirola ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Alcohol Consumption ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Alcohol Intake ◽  
Elderly Women ◽  
Mineral Density ◽  
Lifestyle Questionnaire

AbstractObjectiveFindings regarding alcohol consumption and bone mineral density (BMD) in elderly women have been inconsistent. The objective of the present study was to explore the association of alcohol intake with BMD in elderly women.DesignThis cohort study included women from the population-based Kuopio Osteoporosis Risk Factor and Prevention – Fracture Prevention Study (OSTPRE-FPS). Alcohol intake and potential confounders were assessed at baseline and after 3 years of follow-up using a lifestyle questionnaire. In addition, an FFQ was distributed in the third year to measure dietary intake, including alcohol. Women underwent BMD measurements at the femoral neck and lumbar spine at baseline and after 3 years of follow-up.SettingKuopio Province, Finland.SubjectsThree hundred elderly women (mean age 67·8 years) who provided both BMD measurements and FFQ data.ResultsAlcohol consumption estimated from the FFQ and lifestyle questionnaire was significantly associated with BMD at both measurement sites after adjustment for potential confounders, including lifestyle and dietary factors (P < 0·05). Using the FFQ, women drinking >3 alcoholic drinks/week had significantly higher BMD than abstainers, 12·0 % at the femoral neck and 9·2 % at the lumbar spine. Results based on the lifestyle questionnaire showed higher BMD values for all alcohol-consuming women at the femoral neck and for women drinking 1–3 alcoholic beverages/week at the lumbar spine, compared with non-users.ConclusionsThe results from OSTPRE-FPS suggest that low to moderate alcohol intake may exert protective effects on bone health in elderly women.

scholarly journals Low Bone Mass and Osteoporosis in Hispanic Acute Lymphoblastic Leukemia Survivors. Is It a Real Problem ?

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 5015-5015
Author(s):  
Alfonso Orozco ◽  
Juan Rangel-Patiño ◽  
Mayra Valdez-Carrizales ◽  
Roberta Demichelis
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Acute Lymphoblastic Leukemia ◽  
Bone Mass ◽  
Bone Mineral ◽  
Research Funding ◽  
Lymphoblastic Leukemia ◽  
Mineral Density ◽  
High Prevalence

Abstract Introduction: The survival rates in children and adolescent or young adults with acute lymphoblastic leukemia (ALL) have improved in the last decades. Cancer survivors can have reduced bone mineral density (BMD) related both to the underlying disease and the treatment. This can persist for up to 20 years, increasing the risk of osteopenia / osteoporosis and the development of fractures that can generate disability and loss of function. The risk factors for the development of disorders of BMD in the adult ALL survivors has been little studied and there are no formal guideline recommendations on the long-term follow-up and treatment of these patients. We evaluated ALL-survivor patients in Mexico; both ALL and osteoporosis are more prevalent in Hispanic patients, therefore we implemented conducting a dual-energy x-ray absorptiometry (DXA) during follow-up. Primary objective: Our main objective was to know the prevalence of alterations in bone mineral density (BMD) in a cohort of Hispanic ALL-survivors. Secondary objectives: To identify risk factors and the incidence of complications associated with BMD alterations. Methods: An observational, case-control study in a cohort of adult ALL survivors with follow-up at a referral center´s acute leukemia clinic in Mexico City. We include patients with more than one year of elective cessation of treatment in whom a DXA was performed as the routine follow-up for survivors. We compared the characteristics of the cases (patients with alterations in BMD) with the controls (patients without alterations in BMD). We define alterations in BMD by the WHO and the International Society of clinical DXA: the term of low BMD was used for younger patients and osteoporosis/osteopenia for older. Results: 61 ALL survivors were identified, 86.9% had B-Cell ALL and 13.1% T-Cell ALL. The median age at diagnosis was 12 years (1-55 years) and at the time of the study, 27 years (20-69 years). The majority (78.8%) had less than 18 years-old at diagnosis. The median follow-up from treatment cessation to densitometry was 142 months (10-499 months). An alteration in BMD was found in 63.9% of the patients: 84.6% were classified as low BMD for age and 15.4% as osteopenia/osteoporosis. The most frequently affected site was the spine (40%) followed by the hip and spine (32.5%) and the hip (10%). The median T-score and Z-score by area are shown in Table 1. Table 2 shows the characteristics of ALL-survivors with or without alterations in BMD. The median follow-up time was not different between the 2 groups. Gender, age at diagnosis, the use of induction dexamethasone and other chemotherapeutic agents, vitamin D deficiency, and hypogonadism were not associated with an increased risk of alterations in BMD. Receiving induction chemotherapy between 8 and 18 years of age (age where the highest bone mass is acquired) does not affect in the BMD at follow-up. During follow-up, three patients developed fractures: one pathological and 2 associated with trauma. The patient with a pathological fracture is a man with ALL diagnosed at 8 years of age and had an ankle fracture at 12 years associated with osteoporosis. Discussion and Conclusions: Alterations in BMD are very frequent in our cohort of ALL-survivors despite being a very young population (90% are under 50 years of age). We could not replicate the classically associated risk factors for altered BDM. We only found a non-significant trend for hematopoietic-stem cell transplantation (HSCT) and radiotherapy. This was previously been associated with alterations in different hormonal axes. Despite the high-prevalence of alterations in BMD, the incidence of fractures is very low. This may be related to the fact that it is unknown how to interpret DXA in a group of patients who received chemotherapy/radiotherapy in growth stages. Despite the limitations (small number of patients, the time between treatment and densitometry is heterogeneous and hormonal axes are not measured in all patients), given the high prevalence of BMA alterations, a better understanding of DXA findings in this group of patients is needed. Figure 1 Figure 1. Disclosures Rangel-Patiño: Bristol: Consultancy; Abbvie: Speakers Bureau. Demichelis: AMGEN: Consultancy, Speakers Bureau; Novartis: Consultancy, Research Funding, Speakers Bureau; Astellas: Consultancy; Bristol/Celgene: Consultancy, Speakers Bureau; Jazz: Consultancy; ASH: Research Funding; Gilead: Consultancy; Abbvie: Consultancy, Speakers Bureau.

Effect of Zoledronic Acid on Bone Mineral Density in Thalassemia-Induced Osteoporosis: Results of a Phase II Clinical Trial.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3826-3826
Author(s):  
Ali Taher ◽  
Sami Azar ◽  
Wael Shamseddeen ◽  
Dany Habr ◽  
Adlette Inati ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Zoledronic Acid ◽  
Femoral Neck ◽  
Adverse Events ◽  
Bone Mineral ◽  
Beta Thalassemia ◽  
Mineral Density ◽  
Significant Change

Abstract Background: Osteoporosis is an important cause of morbidity in beta-thalassemia patients. Bisphosphonates are potent inhibitors of osteoclast activity and have been recently used for the treatment of osteoporosis in beta-thalassemia. The aim of this study is to assess the efficacy and safety of zoledronic acid in Lebanese thalassemics with osteoporosis. Methods: Eighteen thalassemic patients (13 thalassemia major and 5 intermedia) with osteoporosis defined as Z-score &lt;−2.5 were given zoledronic acid 4 mg i.v. every 3 months over a period of 12 months (Total of 4 doses administered). The efficacy of treatment was assessed by measuring Bone Mineral Density (BMD) at the lumbar spine, femoral neck and hip at baseline, 6 and 12 months. Other efficacy measurements included markers of bone formation and resorption (bone alkaline phosphatase (BAP), osteocalcin (OC), and urinary deoxypyridinoline (Dpd)), assessment of pain score, analgesic score, and performance score measured at baseline and at 3-month intervals. Safety assessment included regular physical exams, standard hematology and clinical chemistry tests, and adverse events recording. All patients were on Ca/Vitamin D supplementation prior to and during the study. Ten thalassemic osteoporotic patients were followed up only with serial BMDs as controls. Results: The characteristics of all patients are shown in Table 1. Both groups had no significant difference with respect to age, gender and baseline BMD. Patients taking zoledronic acid had a significant increase in their spine, femoral neck, trochanter and total hip BMD measurements over the 12-month period (all p-values&lt;0.05). Patients in the control group, on the other hand, did not have any significant change except in the spine BMD. The BMD values are presented in Table 2. There was a significant change in the levels of the OC and BAP over the 12-month follow-up in the treatment group (p=0.00 for both). Dpd levels did not significantly change overall (p=0.06) although they decreased throughout the study. Reported adverse events included joint pain in 9 patients (50%) after the 1st dose and in 2 (11.1%) after the 2nd dose and responding very well to oral analgesics. Two patients (11.1%) had perioral numbness and 3 (16.7%) had low grade fever after the 1st dose. No treatment-related adverse events were reported after the 3rd and 4th doses. No patients withdrew from the study. Conclusions: Treatment of Lebanese thalassemic osteoporotic patients with zoledronic acid 4 mg every 3 months is effective in increasing BMD at the lumbar spine and hip and is well-tolerated. Well-controlled studies with longer follow-up are needed to determine the fracture-reduction benefits and the most optimal zoledronic acid treatment dose and frequency in this patient population. Table 1: Main characteristics of the studied groups Table 2: BMD values of the treatment and control groups

scholarly journals Individualized treatment with denosumab in children with osteogenesis imperfecta – follow up of a trial cohort

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Heike Hoyer-Kuhn ◽  
Mirko Rehberg ◽  
Christian Netzer ◽  
Eckhard Schoenau ◽  
Oliver Semler
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Side Effects ◽  
Osteogenesis Imperfecta ◽  
Bone Mineral ◽  
Bone Pain ◽  
Mineral Density ◽  
Osteoclastic Activity ◽  
Activity Marker

Abstract Background Osteogenesis imperfecta (OI) is a rare disease leading to hereditary bone fragility. Nearly 90% of cases are caused by mutations in the collagen genes COL1A1/A2 (classical OI) leading to multiple fractures, scoliosis, short stature and nonskeletal findings as blue sclera, hypermobility of joints, bone pain and delayed motor function development. Bisphosphonates are used in most moderate and severely affected patients assuming that an increase of bone mineral density might reduce fractures and bone pain in patients with OI. Denosumab as a RANK ligand antibody inhibiting osteoclast maturation has been approved for osteoporosis treatment in adults. First data from small clinical trials promised a high efficacy of Denosumab in children with OI. Aim of this analysis was a retrospective evaluation of an individualized biomarker-associated treatment regime with Denosumab in 10 children with classical OI which were followed for 1 year after their participation in a pilot trial with Denosumab. Therefore urinary deoxypyridinoline levels were evaluated frequently as an osteoclastic activity marker and depending on that levels Denosumab injections were scheduled individually. Methods Ten patients (age range: 6.16–12.13 years; all participated in the former OI-AK phase 2 trial (NCT01799798)) were included in the follow-up period. Denosumab was administered subcutaneously depending on the individual urinary excretion course of deoxypyridinoline (DPD/Crea) as osteoclastic activity marker with 1 mg/kg body weight. DPD/Crea levels were evaluated before denosumab administration and afterwards. If patients present after an initial decrease after injection with a re-increase up to the DPD/crea level before Denosumab injection next dosage was planned. Changes of areal bone mineral density (aBMD) using dual energy x-ray absorptiometry of the lumbar spine after 12 month was evaluated. Safety was assessed by bone metabolism markers and side effect reporting. Results During follow-up mean relative change of lumbar aBMD was − 6.4%. Lumbar spine aBMD z-Scores decreased from − 1.01 ± 2.61 (mean ± SD) to − 1.91 ± 2.12 (p = 0.015). Mobility changed not significantly (GMFM-88 -6.49 ± 8.85% (p = 0.08). No severe side effects occurred. Dose intervals could be extended in the mean from 12 weeks previously to 20.3 weeks. Conclusions On average, it was possible to prolong the intervals between drug administrations and to reduce the total dose about by 25% without a decrease of mobility or change of vertebral shape despite a reduction of lumbar aBMD during 1 year of biomarker-directed Denosumab treatment. Further trials are necessary to balance side effects and highest efficacy in children.

HRT preserves increases in bone mineral density and reductions in body fat after a supervised exercise program

1998 ◽  
Vol 84 (5) ◽  
pp. 1506-1512 ◽  
Author(s):  
Wendy M. Kohrt ◽  
Ali A. Ehsani ◽  
Stanley J. Birge
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Exercise Program ◽  
Treatment Phase ◽  
Mineral Density ◽  
Supervised Exercise ◽  
Total Body ◽  
Exercise Induced

The aims of this study were to confirm our previous finding that hormone-replacement therapy (HRT) augments exercise-induced increases in bone mineral density (BMD) in older women and to determine whether HRT preserves the adaptations when exercise is reduced or discontinued. The study included an 11-mo treatment phase and a 6-mo follow-up phase. Participants, aged 66 ± 3 yr, were assigned to control (Con; n = 10), exercise (Ex; n = 18), HRT ( n = 10), and Ex+HRT ( n = 16) groups. HRT was continued during the follow-up. After the treatment phase, changes in total body BMD were −0.5 ± 1.7, 1.5 ± 1.4, 1.2 ± 0.8, and 2.7 ± 1.2% in Con, Ex, HRT, and Ex+HRT, respectively. Ex+HRT was more effective than HRT in increasing BMD of the total body and tended ( P = 0.08) to be more effective at the lumbar spine. Ex+HRT was more effective than Ex in increasing BMD of the total body, lumbar spine, and trochanter. Exercise-induced gains in BMD were preserved during the follow-up only in those individuals on HRT. HRT also attenuated fat accumulation, particularly in the abdominal region, after the exercise program. These findings suggest that HRT is an important adjunct to exercise for the prevention not only of osteoporosis but also of diseases related to abdominal obesity.

scholarly journals Impact of Futsal and Swimming Participation on Bone Health in Young Athletes

2017 ◽  
Vol 60 (1) ◽  
pp. 85-91
Author(s):  
André Seabra ◽  
Ricardo J. Fernandes ◽  
Elisa Marques ◽  
Miguel Moura ◽  
Esther Ubago-Guisado ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Bone Mineral ◽  
Lower Limbs ◽  
Childhood And Adolescence ◽  
Mineral Density ◽  
Control Subjects ◽  
Impact Sport ◽  
The Impact

Abstract Physical activity plays a crucial role in bone mass acquisition during childhood and adolescence, with weightbearing and high-impact sport activities being more beneficial. This study sought to evaluate the impact of different sports activities on bone mineral density and content in male Portuguese athletes. Seventy adolescent boys (aged 12-15 years) including 28 futsal players (FG), 20 swimmers (SG) and 22 non-athletic adolescents used as control subjects (CG), participated in the current study. Areal bone mineral density (aBMD) and areal bone mineral content (aBMC) were measured by dual energy x-ray absorptiometry (DEXA). Futsal players had significantly higher aBMD (lumbar spine - FG: 0.95 ± 0.18, SG: 0.80 ± 0.13, CG: 0.79 ± 0.13 g/cm2, p = 0.001; pelvis - FG: 1.17 ± 0.21, SG: 0.91 ± 0.12, CG: 0.98 ± 0.10 g/cm2, p < 0.001; lower limbs - FG: 1.21 ± 0.19, SG: 0.97 ± 0.10, CG: 0.99 ± 0.09 g/cm2, p < 0.001) and aBMC (lumbar spine - FG: 51.07 ± 16.53, SG: 40.19 ± 12.47, CG: 40.50 ± 10.53 g, p = 0.013; pelvis - FG: 299.5 ± 110.61, SG: 170.02 ± 55.82, CG: 183.11 ± 46.78 g, p < 0.001; lower limbs - FG: 427.21 ± 117.11, SG: 300.13 ± 76.42, CG: 312.26 ± 61.86 g/cm2, p < 0.001) than swimmers and control subjects. Data suggest that futsal, as a weightbearing and high or odd-impact sport, may improve bone mass during childhood and adolescence.

scholarly journals Restoration of the coupling process and normalization of bone mass following successful treatment of endogenous Cushing’s syndrome: A prospective, long-term study

2006 ◽  
Vol 154 (1) ◽  
pp. 109-118 ◽  
Author(s):  
Cybèle Kristo ◽  
Rune Jemtland ◽  
Thor Ueland ◽  
Kristin Godang ◽  
Jens Bollerslev
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Cushing’S Syndrome ◽  
Biochemical Markers ◽  
Cushing's Syndrome ◽  
Mineral Density ◽  
Long Term Outcome

Objective: Endogenous Cushing’s syndrome (CS) is associated with bone loss and an increased risk of fractures. However, the long-term outcome of treatment on bone health has not been adequately clarified. Design: We followed 33 patients with active CS prospectively before and twice after treatment (mean follow-up 33 (n = 25) and 71 months (n = 18), respectively). The patients were compared to age-, sex- and body mass index (BMI)-matched controls, also followed longitudinally. Methods: Bone mineral indices (bone mineral density (BMD), bone mineral content (BMC) and bone area) were evaluated in the lumbar spine (LS), femoral neck (FN), and total body (TB) by dual-energy X-ray absorptiometry (DXA). Biochemical markers of bone turnover were assessed by serum levels of osteocalcin and C-terminal telopeptides of Type-1 collagen (CTX-1). Results: Mann–Whitney rank sum tests showed that BMD of the LS, FN and TB was reduced by 14.8% (P < 0.001), 15.7% (P < 0.001), and 9.2% (P < 0.001) in CS vs. controls at baseline, with markedly reduced serum osteocalcin (P = 0.014) and increased CTX-1 (P = 0.012) levels, but no correlation between markers. At first follow-up, BMD was increased in LS (7.9%, P < 0.001) and FN (3.5%, P = 0.003) compared to baseline. The time-dependent rise in BMD (LS (r = 0.59; P = 0.002) and FN (r = 0.52; P = 0.007); Spearman’s rank correlation), in CS was paralleled by increased osteocalcin (275%, P < 0.001) and correlation between biochemical markers (r = 0.92, P < 0.001; Pearson’s correlation). TB BMD did not increase significantly before the second follow-up, when BMD Z-scores were normalized in all three compartments. Conclusion: Our observations demonstrate restoration of coupled bone remodeling and normalization of bone mineral density in all measured skeletal compartments of treated CS patients after prolonged recovery, first significant in predominantly trabecular bone (i.e. lumbar spine).

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