This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stacey, E. Articles by Rutherford, O. M. Search for Related Content PubMed PubMed Citation Articles by Stacey, E. Articles by Rutherford, O. M.

Decreased Nitric Oxide Levels and Bone Turnover in Amenorrheic Athletes with Spinal Osteopenia¹

Department of Physiology (E.S., P.K., O.M.R.), Imperial College School of Medicine, St. Mary’s Campus, London W2 1PG, United Kingdom; and Department of Histochemistry (M.V.J.H., J.M.P.), Imperial College School of Medicine, Hammersmith Campus, London W12 0NN, United Kingdom

Address all correspondence and requests for reprints to: Dr. Olga M. Rutherford, Department of Physiology, Imperial College School of Medicine, Norfolk Place, London W2 1PG, United Kingdom.

Amenorrheic athletes have been likened to postmenopausal women, with low estrogen levels and osteopenia. It has been suggested that estrogen exerts its antiresorptive actions on bone via a nitric oxide (NO)-dependent mechanism. This study investigated whether the mechanism of bone loss in amenorrheic athletes is similar to that of postmenopausal women with reduced NO levels and high bone turnover.

Eleven amenorrheic athletes, 15 eumenorrheic athletes, and 10 sedentary controls were studied. Spine and hip bone mineral density was measured using dual-energy x-ray absorptiometry. Bone turnover was assessed by biochemical markers of formation (osteocalcin and bone-specific alkaline phosphatase) and resorption (deoxypyridinoline). NO metabolites were measured from 24-h urine samples using a chemiluminescence assay.

Spine, but not hip, bone mineral density was reduced in the amenorrheic group, compared with the eumenorrheic (P = 0.0001) and control (P = 0.04) groups. Osteocalcin, bone-specific alkaline phosphatase, and deoxypyridinoline were similar in all groups. NO metabolites were lower in the amenorrheic group, compared with controls (P = 0.035), despite a higher dietary intake of nitrates.

Unlike postmenopausal women, amenorrheic athletes do not have raised bone turnover but do have reduced NO metabolites and spinal osteopenia. The results show, however, that reduced NO production is a common denominator in both conditions and further support the importance of NO in estrogen-mediated protection of skeletal mass and strength.

This article has been cited by other articles:

				S. J. WIMALAWANSA Rationale for Using Nitric Oxide Donor Therapy for Prevention of Bone Loss and Treatment of Osteoporosis in Humans Ann. N.Y. Acad. Sci., November 1, 2007; 1117(1): 283 - 297. [Abstract] [Full Text] [PDF]

				M. J. De Souza and N. I. Williams Physiological aspects and clinical sequelae of energy deficiency and hypoestrogenism in exercising women Hum. Reprod. Update, September 1, 2004; 10(5): 433 - 448. [Abstract] [Full Text] [PDF]

				F.-S. Wang, C.-J. Wang, Y.-J. Chen, Y.-T. Huang, H.-C. Huang, P.-R. Chang, Y.-C. Sun, and K. D. Yang Nitric Oxide Donor Increases Osteoprotegerin Production and Osteoclastogenesis Inhibitory Activity in Bone Marrow Stromal Cells from Ovariectomized Rats Endocrinology, May 1, 2004; 145(5): 2148 - 2156. [Abstract] [Full Text] [PDF]

				J. Pfeilschifter, R. Koditz, M. Pfohl, and H. Schatz Changes in Proinflammatory Cytokine Activity after Menopause Endocr. Rev., February 1, 2002; 23(1): 90 - 119. [Abstract] [Full Text] [PDF]

				H. W. Vesper, L. M. Demers, R. Eastell, P. Garnero, M. Kleerekoper, S. P. Robins, A. K. Srivastava, G. R. Warnick, N. B. Watts, and G. L. Myers Assessment and Recommendations on Factors Contributing to Preanalytical Variability of Urinary Pyridinoline and Deoxypyridinoline Clin. Chem., February 1, 2002; 48(2): 220 - 235. [Abstract] [Full Text] [PDF]

				M. Lehtonen-Veromaa, T. Möttönen, K. Irjala, I. Nuotio, A. Leino, and J. Viikari A 1-Year Prospective Study on the Relationship between Physical Activity, Markers of Bone Metabolism, and Bone Acquisition in Peripubertal Girls J. Clin. Endocrinol. Metab., October 1, 2000; 85(10): 3726 - 3732. [Abstract] [Full Text]