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Cited by 14Bone health and osteoporosis researchLower Extremity Biomechanics and PathologiesEating Disorders and Behaviors

The Influence of Low Energy Availability on Bone Mineral Density and Trabecular Bone Microarchitecture of Pubescent Female Athletes: A Preliminary Study

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Ikegami, Nodoka, Samukawa, Mina, Sakamaki-Sunaga, Mikako, Sugawara, Makoto, Torashima, Shizuka, Ishida, Tomoya, Kasahara, Satoshi, Tohyama, Harukazu·2022·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph19095580PMC PMC9104925
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Abstract

The influence of low energy availability (LEA) on bone mineral density (BMD) and trabecular bone microarchitecture in pubescent female athletes is unclear. This study aimed to investigate the influence of LEA on BMD and trabecular bone microarchitecture in 21 pubescent female athletes (age, 12–15 years; 11 track and field athletes, 10 gymnasts). We used two indices to assess LEA: energy availability and the percent of ideal body weight. Dual-energy X-ray absorptiometry was used to obtain total body less head, lumbar spine BMD Z-scores, and lumbar trabecular bone scores (TBS). Pearson’s or Spearman’s correlation coefficients were used to assess the relationship among EA, percent of ideal body weight, and bone parameters. The threshold for statistical significance was set at p < 0.05. The percent of ideal body weight was significantly correlated with the BMD Z-scores of the total body less head (r = 0.61; p < 0.01), lumbar spine (r = 0.55; p < 0.01), and lumbar TBS (r = 0.47; p = 0.03). However, energy availability was not correlated with bone parameters. These findings suggest that screening for low ideal body weight may be a useful predictor of low BMD and insufficient trabecular bone microarchitecture in pubescent female athletes.

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  • Ikegami et al. found those with LEA had lower trabecular bone z-scores: 1.36 for those with <90% ideal body weight (n = 6) vs 1.45 for those with ≥90% ideal body weight (n = 15), p = 0.01.

    “Similarly, those with LEA had lower trabecular bone z-scores: 1.36 for those with < 90% ideal body weight (n = 6) vs. 1.45 for those with ≥ 90% ideal body weight (n = 15), p = 0.01 [66].”

    From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [66]

    The Results report that percent ideal body weight correlated with lumbar trabecular bone score (TBS; r = 0.47, p = 0.03), and Methods §2.4 defines <90% ideal body weight as an LEA criterion. Our copy does not provide the claimed group means, sample sizes, or p = 0.01 comparison. Methods §2.5 describes TBS as a score, not a Z-score; its Z-scores are for bone mineral density. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Ikegami et al. found young female athletes with LEA had significantly reduced lumbar BMD z-scores: -0.60 for those with <90% ideal body weight (n = 6) vs +0.79 for those with ≥90% ideal body weight (n = 15), p < 0.01.

    “However, Ikegami et al. found that young female athletes with LEA had significantly reduced lumbar BMD z-scores: -0.60 for those with < 90% ideal body weight (n = 6) vs. +0.79 for those with ≥ 90% ideal body weight (n = 15), p < 0.01 [66].”

    From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [66]

    The Results report that six of 21 pubescent female athletes were below 90% of ideal body weight and that ideal-body-weight percentage correlated significantly with lumbar BMD Z-score (r = 0.55; p < 0.01). The passages available from our copy do not give the claimed group means (−0.60 and +0.79) or establish that p < 0.01 applies to the difference between those two groups rather than to the correlation. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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References 40 · Cited by 14

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Authors
Ikegami, N., Samukawa, M., Sakamaki-Sunaga, M., Sugawara, M., Torashima, S., Ishida, T., Kasahara, S., & Tohyama, H.
Affiliations
  • Nippon Sport Science University (JP)
  • Hokkaido University (JP)
  • Department of Exercise Physiology, Nippon Sport Science University, Tokyo 158-8508, Japan
  • Matsuda Orthopedic Memorial Hospital, Sapporo 001-0018, Japan
  • Hokkaido University of Education (JP)
Corresponding author
Samukawa, Mina
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2022-05-04
Volume
19
Issue
9
Pages
5580
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph19095580
PMC
PMC9104925
OpenAlex
W4225401265
Cited by
14
References
40
Citations by year
2026: 5 · 2025: 3 · 2024: 4 · 2023: 2
FWCI
2.33
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Hokkaido University Collection of Scholarly and Academic Papers (Hokkaido University) (submittedVersion)
  • Institutional Repositories DataBase (IRDB) (submittedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Keywords
low energy availability, bone mineral density, trabecular bone microarchitecture, energy availability, lumbar spine, track and field athletes, gymnasts, bone health screening
MeSH terms
Cancellous Bone, Adolescent, Bone and Bones, Child, Female, Humans, Lumbar Vertebrae, Absorptiometry, Photon, Bone Density, Athletes

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