TY - JOUR T1 - Bone health in Norwegian female elite runners: a cross-sectional, controlled study JF - BMJ Open Sport & Exercise Medicine JO - BMJ OPEN SP EX MED DO - 10.1136/bmjsem-2022-001472 VL - 9 IS - 1 SP - e001472 AU - Karoline Holsen Kyte AU - Lene A H Haakstad AU - Jonny Hisdal AU - Andrine Sunde AU - Trine Stensrud Y1 - 2023/02/01 UR - http://bmjopensem.bmj.com/content/9/1/e001472.abstract N2 - Objective The primary objective was to compare bone mineral density (BMD) in Norwegian female elite long-distance runners with a control group of inactive females. Secondary objectives were to identify cases of low BMD, to compare the concentration of bone turnover markers, vitamin D and symptoms of low energy availability (LEA) between the groups, and to identify possible associations between BMD and selected variables.Methods Fifteen runners and fifteen controls were included. Assessments included dual-energy X-ray absorptiometry measurement of BMD in the total body, lumbar spine and dual proximal femur. Blood samples included endocrine analyses and circulating bone turnover markers. The risk of LEA was assessed through a questionnaire.Results Runners had higher Z-scores in the dual proximal femur (1.30 (0.20 to 1.80) vs 0.20 (−0.20 to 0.80), p<0.021) and total body (1.70 (1.20 to 2.30) vs 0.90 (0.80 to 1.00), p<0.001). The lumbar spine Z-score was similar between groups (0.10 (−0.70 to 0.60) vs −0.10(−0.50 to 0.50), p=0.983). Three runners had low BMD (Z-score <−1) in the lumbar spine. Vitamin D and bone turnover markers showed no differences between the groups. Forty-seven per cent of the runners were at risk of LEA. Dual proximal femur BMD showed a positive correlation to estradiol and a negative correlation to LEA symptoms in runners.Conclusion Norwegian female elite runners had higher BMD Z-score in the dual proximal femur and total body compared with controls, while no difference was observed in the lumbar spine. The advantages of long-distance running on bone health seem to be site specific, and there is still a need for the prevention of LEA and menstrual disorders in this group.Data set is available from the corresponding author on reasonable request. ER -