Mechanical loading during growth is associated with plane-specific differences in vertebral geometry: A cross-sectional analysis comparing artistic gymnasts vs. non-gymnasts.
Mechanical loading during growth is associated with plane-specific differences in vertebral geometry: A cross-sectional analysis comparing artistic gymnasts vs. non-gymnasts.
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DOI：
10.1016/j.bone.2011.07.033
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发表时间：
2011-11
期刊：
影响因子：
4.1
通讯作者：
Scerpella, Tamara A.
中科院分区：
文献类型：
--
作者：
Dowthwaite, Jodi N.;Rosenbaum, Paula F.;Scerpella, Tamara A.
腰椎的几何形状，密度和骨强度指数进行了评估相对于月经初潮状态，使用艺术体操暴露在生长过程中作为一个模型的机械负荷。对114名女性（60名前体操运动员和54名非体操运动员）进行L3的配对后前位（PA）和仰卧位外侧（LAT）DXA扫描，获得配对（PALAT）与标准PA和LAT结局比较的输出。评估了BMC、面积BMD、椎体尺寸、骨矿物质表观密度（BMAD）、轴向抗压强度（IBS）和骨折风险指数，将椎体几何形状建模为椭圆柱体。双因素ANCOVA检验了体操暴露、月经初潮状态及其相互作用的统计学效应，并适当调整了年龄和身高。与非体操运动员相比，体操运动员表现出更大的PABMD，PABMC，PAWIDTH，PA横截面面积（CSA），PAVOLUME，LATBMD，LATBMAD，PALATCSA和PALATIBS（p<0.05）。非体操运动员表现出更大的LATDEPTH/PAWIDTH，LATBMC/PABMC，LATVHEIGHT，LATAREA和骨折风险指数。使用椭圆体椎体几何模型，未检测到PA或PALAT BMAD的显著差异。相比之下，长方体模型结果（Carter 1992）表明了错误的前/体操运动员PABMAD优势，这是由于线性骨骼尺寸比例变化的无效假设造成的。体操暴露与较短，较宽的椎体，产生更大的轴向压缩强度和较低的骨折风险，尽管没有BMAD的优势。我们的研究结果表明，平面特定的脊椎几何适应的重要性，在增长过程中的机械负荷。与单独的PA或LAT平面扫描相比，配对扫描输出可以更准确地评估这种适应性。
Lumbar spine geometry, density and indices of bone strength were assessed relative to menarche status, using artistic gymnastics exposure during growth as a model of mechanical loading. Paired posteroanterior (PA) and supine lateral (LAT) DXA scans of L3 for 114 females (60 ex/gymnasts and 54 non-gymnasts) yielded output for comparison of paired (PALAT) versus standard PA and LAT outcomes. BMC, areal BMD, vertebral body dimensions, bone mineral apparent density (BMAD), axial compressive strength (IBS) and a fracture risk index were evaluated, modeling vertebral body geometry as an ellipsoid cylinder. Two-factor ANCOVA tested statistical effects of gymnastic exposure, menarche status and their interaction, adjusting for age and height as appropriate. Compared to non-gymnasts, ex/gymnasts exhibited greater PABMD, PABMC, PAWIDTH, PA CROSS-SECTIONAL AREA (CSA), PAVOLUME, LATBMD, LATBMAD, PALATCSA and PALATIBS (p<0.05). Non-gymnasts exhibited greater LATDEPTH/PAWIDTH, LATBMC/PABMC, LATVHEIGHT, LATAREA and Fracture Risk Index. Using ellipsoid vertebral geometric models, no significant differences were detected for PA or PALAT BMAD. In contrast, cuboid model results (Carter 1992) suggested erroneous ex/gymnast PABMAD advantages, resulting from invalid assumptions of proportional variation in linear skeletal dimensions. Gymnastic exposure was associated with shorter, wider vertebral bodies, yielding greater axial compressive strength and lower fracture risk, despite no BMAD advantage. Our results suggest the importance of plane-specific vertebral geometric adaptation to mechanical loading during growth. Paired scan output provides a more accurate assessment of this adaptation than PA or LAT plane scans alone.
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