Male Runners With Lower Energy Availability Have Impaired Skeletal Integrity Compared to Nonathletes
Authors' conclusion
Despite weight-bearing activity, skeletal integrity is impaired in male runners with lower caloric intake relative to exercise energy expenditure, which may increase bone stress injury risk. Lower estradiol and lean mass are associated with lower tibial strength in runners.
Study context
- Population
- Men aged 16–30 years; clinical research center
- Participants
- 39 men
- Exposure
- Male runners vs nonathlete controls
- Runnersn = 20
- Controlsn = 19reference
- Outcome
- aBMD (DXA); tibia and radius volumetric bone mineral density (BMD) and microarchitecture (HR-pQCT); failure load; serum testosterone, estradiol, leptin; energy availability
Methodological detailssingle-centre clinical research center
- Single-centre clinical research center
Main finding
As reported in the abstract
Lumbar spine BMD Z-score
Runners
−1.4
± 0.8
Controls
−0.8
0.8
P < 0.05
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Lumbar spine BMD Z-score, runners with EA <median vs controlsLower with EA <median (−1.5 ± 0.7) | P = 0.028 |
| Hip BMD Z-score, runners with EA ≥median vs controlsHigher with EA ≥median (0.3 ± 0.7 vs −0.4 ± 0.5) | P = 0.002 |
Tibial vBMD and microarchitecture, runners with energy availability (EA) <median vs controls
- Lower tibial total and trabecular vBMD, trabecular bone volume fraction, cortical porosity and apparent modulus vs controls (P < .05)
- Adjusted for calcium intake and running mileage
Associations with tibial failure load among runners
- Appendicular lean mass and serum estradiol positively associated (R ≥ 0.45, P ≤ .046); testosterone not
Original publication
Male Runners With Lower Energy Availability Have Impaired Skeletal Integrity Compared to Nonathletes. J Clin Endocrinol Metab. Published 20 April 2023. doi:10.
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