Elevated Creatine Kinase and Lactic Acid Dehydrogenase and Decreased Osteocalcin and Uncarboxylated Osteocalcin are Associated with Bone Stress Injuries in Young Female Athletes
Elevated Creatine Kinase and Lactic Acid Dehydrogenase and Decreased Osteocalcin and Uncarboxylated Osteocalcin are Associated with Bone Stress Injuries in Young Female Athletes
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DOI：
10.1038/s41598-018-36982-0
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发表时间：
2018-12-21
影响因子：
4.6
通讯作者：
Nakamura, Masaya
中科院分区：
文献类型：
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作者：
Miyamoto, Takeshi;Oguma, Yuko;Nakamura, Masaya
应力性骨折不仅限制了运动员的运动成绩，而且限制了他们的日常生活活动。因此，预防它们至关重要。对于女运动员来说，包括能量可用性低、功能性下丘脑性闭经和骨质疏松症在内的三重症状被认为是应激损伤的危险因素，但目前还没有预测这些结果的生物标志物。在这里，我们评估了56名女大学运动员，发现其中13人有应力性骨损伤史。Logistic回归分析表明，痛经包括闭经，但不减少食物摄入量或体重减轻，与应激损伤显着相关。当我们将受试者分为应力性骨折组和非骨折组时，我们发现骨折组的血清肌酸激酶（CK）和乳酸脱氢酶（LDH）水平显着较高，而骨形成参数骨钙素和未羧基化骨钙素（ucOC）显着降低。低维生素D水平与应力性骨折有关，但骨折患者的血清维生素D水平高于非骨折患者。我们对32名受试者进行了为期一年的随访，在此期间有三名受试者出现了新的压力性损伤。应力性断裂历史的历史与经历新的应力性断裂显著相关。我们还发现，新骨折的受试者进行了显着更大的运动活动比非骨折的受试者。总之，我们的数据表明，血清CK和LDH升高，血清骨钙素和ucOC降低是应力性损伤的生物标志物，评价这些标志物沿着痛经，应力性骨折史或高运动活动可以预测女性运动员未来的应力性骨折。
Stress fractures are a limitation for athletes not only in sports performance but in activities of daily living. Thus, preventing them is crucial. In female athletes, a triad of symptoms including low energy availability, functional hypothalamic amenorrhea and osteoporosis are considered risk factors for stress injuries, but biomarkers predictive of these outcomes are not available. Here, we evaluated 56 female university athletes and found that 13 had a history of stress bone injuries. Logistic regression analysis demonstrated that dysmenorrhea including amenorrhea, but not reduced food intake or body weight loss, was significantly associated with stress injuries. When we subdivided subjects into stress fracture and non-fracture groups, we found that serum levels of creatine kinase (CK) and lactic acid dehydrogenase (LDH) were significantly higher in the fracture group, while osteocalcin and uncarboxylated osteocalcin (ucOC), which are bone forming parameters, significantly decreased. Low vitamin D levels are associated with stress fractures, but serum vitamin D levels were higher in fracture compared to non-fracture subjects. We followed up 32 subjects for one year, and three exhibited new stress injuries during that period. A history of stress fracture history is significantly associated with experiencing a new stress fracture. We also found that subjects with new fracture performed significantly greater exercise activity than did non-fracture subjects. Taken together, our data indicate that increased serum CK and LDH and decreased serum osteocalcin and ucOC are biomarkers of stress injuries, and evaluating these markers along with dysmenorrhea, stress fracture history or high sports activity could predict future stress fractures in female athletes.