Sains Malaysiana 47(1)(2018): 123–129

http://dx.doi.org/10.17576/jsm-2018-4701-15

Bone Mineral Density and Associated Risk Factors among Female Athletes: A Cross-Sectional Study

(Ketumpatan Mineral Tulang dan Faktor Risiko yang berkaitan dalam kalangan Atlet Wanita: Suatu Kajian Rentas

NUR SYAMSINA AHMAD^1*, MOHAMAD SHARIFF A. HAMID², JADEERA PHAIK GEOK CHEONG¹ & SAREENA HANIM HAMZAH¹

¹Sports Centre, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

²Sports Medicine Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

Received: 16 March 2017/Accepted: 25 May 2017

ABSTRACT

Menstrual irregularity and disordered eating were previously identified as risk factors for low bone mineral density (BMD) in female athletes. Therefore, an investigation for more potential factors that could be associated with low BMD among Malaysian female athletes is required. The aim of this study was to assess the association of BMD with energy availability, body weight, body fat, estrogen level and bone loading status in female athletes and to what extent those factors predict BMD. Energy intake and expenditure, body weight, Bone Physical Activity Questionnaire (BPAQ) score and estrogen level were determined from 85 female athletes aged 18-30 years in this cross-sectional study. Bone mineral density was measured by using an ultrasound bone densitometry device at the calcaneus bone. The female athletes' body weight and fat percentage were 56±9 kg and 27±6%, respectively and they were all eumenorrheic. Fifty three percent of them had low BMD (z- score < 0). Their mean energy intake (1291±33 kcal/day) was lower than energy expenditure (1807±34 kcal/day) which resulted in a low energy availability (29±1 kcal/day/kg FFM). BMD was positively associated with BPAQ score (r=0.4, p=0.000) and body weight (r=0.3, p=0.005) but negatively associated with energy expenditure (r=-0.4, p=0.000). There was no association of BMD with energy intake, energy availability, body fat percentage and estrogen level. In conclusion, BMD was associated with energy expenditure, body weight and BPAQ score among female athletes. Regression analysis showed that energy expenditure and BPAQ score were the main factors to predict BMD.

Keywords: Energy intake; exercise; hormone; nutrient; physical activity

ABSTRAK

Haid tidak teratur dan gangguan pemakanan merupakan faktor risiko yang dikenal pasti untuk ketumpatan mineral tulang (KMT) yang rendah dalam kalangan atlet wanita. Oleh itu, lebih banyak kajian bagi faktor yang berpotensi dikaitkan dengan KMT yang rendah dalam kalangan atlet wanita Malaysia diperlukan. Tujuan kajian ini adalah untuk menilai perkaitan antara KMT dengan ketersediaan tenaga, berat badan, lemak badan, paras estrogen dan status bebanan tulang dalam atlet wanita dan seterusnya faktor-faktor yang meramalkan KMT. Pengambilan dan penggunaan tenaga, berat badan, Soalselidik Aktiviti Fizikal Tulang (SAFT) dan tahap estrogen telah dikaji daripada 85 atlet wanita berusia 18-30 tahun dalam kajian keratan rentas ini. Kepadatan tulang mineral diukur dengan menggunakan alat densitometri ultrasound tulang pada tulang kalkaneus. Berat badan dan peratusan lemak atlet wanita masing-masing adalah 56±9 kg dan 27±6% dan mereka adalah eumenorrheic. 53% daripada atlet wanita mempunyai KMT (skor z <0) yang rendah. Min pengambilan tenaga (1291±33 kcal / hari) adalah lebih rendah daripada penggunaan tenaga (1807±34 kcal/hari) yang menghasilkan ketersediaan tenaga yang rendah (29±1 kcal/hari/kg FFM). KMT berkait secara positif dengan skor SAFT (r= 0.4, p=0.000) dan berat badan (r=0.3, p=0.005) tetapi berkait secara negatif dengan penggunaan tenaga (r=-0.4, p=0.000). Tidak ada perkaitan KMT dengan pengambilan tenaga, ketersediaan tenaga, peratusan lemak badan dan tahap estrogen. Secara kesimpulan, KMT adalah berkait dengan penggunaan tenaga, berat badan dan skor SAFT dalam kalangan atlet wanita. Analisa regresi menunjukkan bahawa penggunaan tenaga dan skor SAFT merupakan faktor utama untuk menjangkakan KMT.

Kata kunci: Aktiviti fizikal; hormon; latihan; nutrien; pengambilan tenaga

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*Corresponding author; email: sunsinar@hotmail.com