Osteoporosis International

, Volume 24, Issue 9, pp 2433–2440 | Cite as

Sclerostin and Pref-1 have differential effects on bone mineral density and strength parameters in adolescent athletes compared with non-athletes

  • P. K. Fazeli
  • K. E. Ackerman
  • L. Pierce
  • G. Guereca
  • M. Bouxsein
  • M. Misra
Original Article
First Online:
Received:
Accepted:

Abstract

Summary

Excessive exercise can have detrimental effects on bone; however, the mechanisms leading to bone loss are not well understood. Sclerostin and preadipocyte factor (Pref)-1 are two hormones which inhibit bone formation. The present study demonstrates that these hormones may have differential effects in athletes as compared to non-athletes.

Introduction

Exercise activity is common in female adolescents, however, excessive exercise can have detrimental effects on bone mineral density (BMD). Mechanisms underlying this decrease in bone mass are not well understood. We investigated the effects of sclerostin, a potent inhibitor of bone formation via WNT signaling inhibition, and Pref-1, a suppressor of osteoblast differentiation, on BMD, bone turnover markers and bone strength in adolescent athletes.

Methods

We studied 50 adolescents between 15–21 years of age: 17 amenorrheic athletes (AA), 17 eumenorrheic athletes (EA), and 16 nonathletic controls (NA). We measured spine and hip BMD by dual energy x-ray absorptiometry and estimated failure load and stiffness at the distal radius and tibia using micro-finite element analysis. We also measured fasting sclerostin, Pref-1, N-terminal propeptide of type 1 procollagen, and C-terminal collagen cross-links levels.

Results

Sclerostin levels were higher in AA and EA compared with NA (AA: 0.42 ± 0.15 ng/mL, EA: 0.44 ± 0.09 ng/mL, NA: 0.33 ± 0.14 ng/mL; p = 0.047). In EA, sclerostin was positively associated with lumbar spine (LS) BMD and its Z-score (R = 0.52, p = 0.03 and R = 0.55, p = 0.02, respectively) whereas in NA, sclerostin was inversely associated with LS BMD (R = −0.61, p = 0.01). Pref-1 levels were similar in all three groups and there were significant inverse associations between Pref-1, BMD, and estimated bone strength in NA.

Conclusions

Sclerostin and Pref-1 may have differential effects on bone in adolescent athletes compared to non-athletes.

Keywords

Adolescent athletes Bone strength Pref-1 Sclerostin 

Abbreviations

AA

Amenorrheic athletes

EA

Eumenorrheic athletes

NA

Non-athletes

LS

Lumbar spine

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Notes

Acknowledgments

We thank the research nurses and bionutritionists at the Clinical Research Center of Massachusetts General Hospital and our subjects, without whom this study would not have been possible. The project described was supported by NIH Grant nos 1 R01 HD060827-01A1 (Misra), K23 DK094820-01 (Fazeli), and UL1 RR025758-03, Harvard Clinical and Translational Science Center, from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.

Conflicts of interest

None

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  • P. K. Fazeli
    • 1
  • K. E. Ackerman
    • 1
  • L. Pierce
    • 1
  • G. Guereca
    • 1
  • M. Bouxsein
    • 2
  • M. Misra
    • 1
  1. 1.Neuroendocrine UnitMassachusetts General HospitalBostonUSA
  2. 2.Center for Advanced Orthopaedic StudiesBeth Israel Deaconess Medical CenterBostonUSA

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