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The Influence of Intensive Physical Exercise on Bone Acquisition in Adolescent Elite Female and Male Artistic Gymnasts

Division of Endocrinology (K.B.M., P.M., A.T., A.K., A.G.V.), Department of Internal Medicine, and Department of Obstetrics and Gynecology (N.A.G.), Division of Reproductive Endocrinology, University of Patras Medical School, Patras 265 00, Greece; International Gymnastic Federation (K.B.M., M.L.), CH 2740 Moutier 1, Switzerland; and International Olympic Committee (M.L.), Lausane, Switzerland

Address all correspondence and requests for reprints to: Apostolos G. Vagenakis, Division of Endocrinology, Department of Internal Medicine, University of Patras Medical School, Patras 265 00, Greece. E-mail: vag.inmd{at}med.upatras.gr.

Physical exercise enhances bone acquisition during adolescence. The aim of the study was to evaluate the influence of intensive physical exercise on bone acquisition in adolescent elite artistic gymnasts. The study included 262 athletes (93 males and 169 females, aged 13–23 yr) participating in the 24th European Championship held in Greece. Bone age compared with chronological age was delayed by 2 yr for females (n = 120) and 1 yr for males (n = 68). For both sexes, the growth chart of bone mineral density (BMD) followed a normal pattern when estimated according to bone age rather than chronological age. For females, BMD was positively correlated with bone age, chronological age, height, body weight, body mass index, body fat, lean body mass, and with age of onset of training, and negatively with duration of exercise and intensity of training (P values range from <0.05 to <0.0001). Multiple regression analysis revealed that age of onset of training was the major parameter attenuating the effect of exercise on BMD (P < 0.001). The latter was related to the stage of puberty (P < 0.05). For males, BMD was correlated positively with bone age, height, body weight, and lean body mass (P values range from <0.01 to 0.0001). Multiple regression analysis revealed that the more powerful factor influencing BMD was weight (P < 0.01). In conclusion, bone acquisition in adolescents under intensive physical training follows the normal pattern only when estimated according to bone age. The age of onset, the duration, and the intensity of exercise attenuate the bone acquisition, at least in female artistic gymnasts.

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