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Bone micro-architecture of elite alpine skiers is not reflected by bone mineral density

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Abstract

Summary

Bone quality is affected by muscle forces and external forces. We investigated how micro-architecture is influenced in elite alpine skiers who have received high loading levels throughout their adolescent bone development. Bone strength was higher in skiers, likely due to external forces, but muscle forces may also be a significant contributor.

Introduction

Impact loading and muscle forces affect bone quality, but little is known about how they influence 3 dimensional aspects of bone structure. This study investigated bone quality in female and male elite alpine skiers using high-resolution peripheral quantitative computed tomography (HR-pQCT).

Methods

HR-pQCT at the distal radius and tibia, whole-body lean mass, and muscle strength were assessed in 10 female (22.7 ± 3.9 years) and 12 male (25.5 ± 3.3 years) Canadian national alpine team athletes and compared to recreationally active female (N = 10, 23.8 ± 3.2 years) and male (N = 12; 23.7 ± 3.6 years) control subjects. HR-pQCT standard parameters and customized cortical and finite element (FE) analyses were performed and analyzed using one-way ANOVA and Pearson’s correlation.

Results

Male and female skiers had stronger bones than controls at radius (38–49 %, p < 0.001) and tibia (24–28 %, p < 0.001). This result was not consistently reflected by total bone mineral density (BMD) because higher trabecular BMD occurred in parallel with lower cortical BMD, which was due to a redistribution of mineral leading to a shift of the endocortical margin toward a thicker cortex. The endocortical regional adaptation was likely responsible for the greater strength of the athletes’ bones. Lean mass and muscle strength was 29 to 90 % greater (p < 0.001) in athletes compared to controls. Good associations between muscle strength and FE-estimated bone strength were found (r = 0.63 to 0.80; p < 0.001), although micro-architecture was more strongly associated with muscle outcomes in females than males.

Conclusions

Higher bone strength in elite alpine skiers is achieved through micro-architectural adaptation that is not apparent by BMD measurements alone. The improved micro-architecture at radius and tibia suggests that muscle forces may play an important role in bone adaptation.

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Acknowledgments

This work was supported by grants from German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) and the Canadian Institutes of Health Research (CIHR). We are thankful for all participating athletes from Alpine Canada as well as the support from their coaches and the Exercise Physiology group at the Roger Jackson Center for Health and Wellness Research, University of Calgary. Thank you to our control subjects for participating in the study.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Schulich School of Engineering, University of Calgary, Calgary, Canada

    A.-M. Liphardt, J. D. Schipilow & S. K. Boyd

  2. Department of Radiology, University of Calgary, Calgary, Canada

    S. K. Boyd

  3. Roger Jackson Centre for Health and Wellness Research, University of Calgary, Calgary, Canada

    A.-M. Liphardt, J. D. Schipilow, H. M. Macdonald, M. Kan, A. Zieger & S. K. Boyd

  4. Institute of Biomechanics and Orthopedics, German Sport University Cologne (DSHS Köln), Köln, Germany

    A.-M. Liphardt

  5. Department of Orthopaedics, University of British Columbia, Vancouver, Canada

    H. M. Macdonald

  6. Child & Family Research Institute, Vancouver, Canada

    H. M. Macdonald

  7. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada

    H. M. Macdonald

  8. Department of Sport Science, University of Konstanz, Constance, Germany

    A. Zieger

  9. McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Room HRIC 3AC64, Calgary, Alberta, T2N 4Z6, Canada

    M. Kan & S. K. Boyd

  10. Institute of Training Science and Sport Informatics, German Sport University Cologne (DSHS Köln), Köln, Germany

    A.-M. Liphardt

Authors
  1. A.-M. Liphardt
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  2. J. D. Schipilow
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  3. H. M. Macdonald
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  4. M. Kan
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  5. A. Zieger
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  6. S. K. Boyd
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Corresponding author

Correspondence to S. K. Boyd.

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Liphardt, AM., Schipilow, J.D., Macdonald, H.M. et al. Bone micro-architecture of elite alpine skiers is not reflected by bone mineral density. Osteoporos Int 26, 2309–2317 (2015). https://doi.org/10.1007/s00198-015-3133-y

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  • DOI: https://doi.org/10.1007/s00198-015-3133-y

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