Sexual dimorphism of femoral neck cross-sectional bone geometry in athletes and non-athletes: a hip structural analysis study

Abstract

The characterisation of bone geometry in male and female athletes may increase our understanding of how physical loading may enhance bone strength in both sexes. This study investigated sexual dimorphism in hip geometry of athletes and age- and sex-matched non-athletes. Dual energy X-ray absorptiometry of the left proximal femur was performed in 62 male (n = 31; 30.2 ± 4.6 years) and female (n = 31; 27.9 ± 5.2 years) competitive endurance runners, and 36 male (n = 18; 28.7 ± 5.8 years) and female (n = 18; 29.1 ± 5.3 years) non-athletes. The hip structural analysis programme determined areal bone mineral density (aBMD), bone area (BA), hip axis length, cross-sectional area (CSA), and cross-sectional moment of inertia (CSMI) of the femoral neck. Strength indices were derived from the femoral strength index (FSI) (Yoshikawa et al., J Bone Miner Res 9:1053-1064, 1994). Despite similar size-adjusted aBMD, sexual dimorphism was apparent for BA, CSA and CSMI, with superior values in men compared to women (P < 0.01). FSI was greater in male and female athletes than non-athletes (P < 0.01). From all groups, results in male athletes inferred greatest resistance to axial (CSA) and bending loads (FSI). Estimates of bone strength (FSI) were greater in female athletes than male and female non-athletes, supporting the osteogenic value of regular loading of the hip.

Hip Structural Analysis in Adolescent and Young Adult Oligoamenorrheic and Eumenorrheic Athletes and Nonathletes

“…One study reported greater bone strength estimates using HSA in 18-to 35-year-old athletes versus nonathletes but did not compare amenorrheic with eumenorrheic athletes (4). There are also limited data in adolescence and young adulthood, a time critical for bone accrual toward attainment of peak bone mass.…”

“…Hip structural analysis (HSA) is a technique that uses the properties of dual energy x-ray absorptiometry (DXA) images to derive geometric parameters for the hip that are associated with bone strength (4). This is a validated technique to assess hip bone geometry, which avoids the significant radiation associated with QCT at this site.…”

Insights Into Relationships Between Body Mass, Composition and Bone: Findings in Elite Rugby Players

“…Research elsewhere however, suggests that HSA is superior in both young adult women and men athletes, with women athletes demonstrating greater strength indices than non-athletic men (23). HSA was utilised to derive values of bone geometry.…”

Hip Structural Analysis in Adolescent Boys With Anorexia Nervosa and Controls

“…HSA derives strength parameters for the hip using properties of DXA images (11). This validated technique allows assessment of hip bone geometry while avoiding radiation associated with QCT at this site.…”