Osteoporosis International

, Volume 22, Issue 12, pp 3055–3066 | Cite as

In peripubertal girls, artistic gymnastics improves areal bone mineral density and femoral bone geometry without affecting serum OPG/RANKL levels

  • L. Maïmoun
  • O. Coste
  • D. Mariano-Goulart
  • F. Galtier
  • T. Mura
  • P. Philibert
  • K. Briot
  • F. Paris
  • C. Sultan
Original Article



Peripubertal artistic gymnasts display elevated areal bone mineral density at various bone sites, despite delayed menarche and a high frequency of menstrual disorders, factors that may compromise bone health. The concomitant improvement in femoral bone geometry and strength suggested that this type of physical activity might have favourable clinical impact.


The purpose of this study is to evaluate the effect of artistic gymnastics (GYM) on areal bone mineral density (aBMD), femoral bone geometry and bone markers and its relationship with the osteoprotegerin (OPG)/rank-ligand (RANKL) system in peripubertal girls.


Forty-six girls (age 10–17.2 years) were recruited for this study: 23 elite athletes in the GYM group (training 12–30 h/week, age at start of training 5.3 years) and 23 age-matched (±6 months; leisure physical activity ≤ 3 h/week) controls (CON). The aBMD at whole body, total proximal femur, lumbar spine, mid-radius and skull was determined using dual-X-ray absorptiometry. Hip structural analysis (HSA software) was applied at the femur to evaluate cross-sectional area (CSA, cm2), cross-sectional moment of inertia (CSMI, cm4), and the section modulus (Z, cm3) and buckling ratio at neck, intertrochanteric region and shaft. Markers of bone turnover and OPG/RANKL levels were also analysed.


GYM had higher (5.5–16.4%) non-adjusted aBMD and adjusted aBMD for age, fat-free soft tissue and fat mass at all bone sites, skull excepted and the difference increased with age. In the three femoral regions adjusted for body weight and height, CSA (12.5–18%), CSMI (14–18%), Z (15.5–18.6%) and mean cortical thickness (13.6–21%) were higher in GYM than CON, while the buckling ratio (21–27.1%) was lower. Bone markers decreased with age in both groups and GYM presented higher values than CON only in the postmenarchal period. A similar increase in RANKL with age without OPG variation was observed for both groups.


GYM is associated not only with an increase in aBMD but also an improvement in bone geometry associated with an increase in bone remodelling. These adaptations seem to be independent of the OPG/RANKL system.


Areal bone mineral density Bone geometry Bone mass acquisition Bone strength Intensive training Markers of bone turnover OPG/RANKL system Peripuberty 


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • L. Maïmoun
    • 1
  • O. Coste
    • 1
    • 2
  • D. Mariano-Goulart
    • 3
  • F. Galtier
    • 4
    • 5
  • T. Mura
    • 5
    • 6
  • P. Philibert
    • 1
  • K. Briot
    • 7
  • F. Paris
    • 1
    • 8
  • C. Sultan
    • 1
    • 8
    • 9
  1. 1.Service d’Hormonologie, Hôpital LapeyronieCHU Montpellier et UMIMontpellierFrance
  2. 2.Direction Régionale de la Jeunesse, des Sports et Cohésion SocialeMontpellierFrance
  3. 3.Service de Médecine Nucléaire, Hôpital LapeyronieCHU MontpellierMontpellierFrance
  4. 4.Centre d’Investigation Clinique et Département des Maladies EndocriniennesCHRU MontpellierMontpellierFrance
  5. 5.CIC 1001, INSERMMontpellierFrance
  6. 6.Centre d’Investigation Clinique et Département d’information MédicaleCHRU MontpellierMontpellierFrance
  7. 7.Service de Rhumatologie, Hôpital CochinAPHP ParisParisFrance
  8. 8.Unité d’Endocrinologie Pédiatrique, Hôpital Arnaud de VilleneuveCHU Montpellier et UMIMontpellierFrance
  9. 9.Unité d’Endocrinologie PédiatriqueHôpital Arnaud de VilleneuveMontpellierFrance

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