Diagnosis of Osteopenia May Indicate the Presence of Increased Cardiovascular Risk in Female Athletes
Bibliographic record
Abstract
1913 Osteopenia is a clinical outcome of hypoestrogenism associated with the Female Athlete Triad. PURPOSE: To determine if osteopenia in female athletes is associated with reduced peripheral blood flow, which may indicate increased cardiovascular risk. METHODS: Thirty-six athletes of varying activity levels participated in this study. Eight were identified to have osteopenia at the L2-L4 lumbar spine and 28 had normal bone mineral density (BMD), as assessed by DEXA. RESULTS: The athletes with osteopenia were similar (p>0.05) with respect to age (24 ± 0.7 y), height (164.1 ± 9.4 cm), weight (57.2 ± 1.1 kg), percent body fat (22.9 ± 1.0), age of menarche (12.6 ± 0.2 y) and VO2 max (44.2 ± 0.9 ml/kg/min), compared to the normal BMD group. BMD was significantly lower (p<0.004) in the osteopenic group compared to the normal BMD group at all skeletal sites, including total body (1.08 ± 0.013 vs 1.19 ± 0.011 g/cm2, respectively), total hip (0.96 ± 0.029 vs 1.09 ± 0.022 g/cm2, respectively) and lumbar spine (1.04 ± 0.021 vs 1.28 ± 0.023 g/cm2, respectively). These BMD values were associated with t-scores in the osteopenic range only for the lumbar spine (−1.30 ± 0.18), but other t-scores did fall in the negative range for the total body (−0.51 ± 0.18) and total hip (−0.35 ± 0.28) as well, for this group only. Flow-mediated endothelialdependent vasodilation at rest and following peak ischemic exercise using strain-gauge plethysmography, was significantly lower (p<0.05) at rest (2.9 ± 0.4 vs 4.3 ± 0.3 ml/100ml/min, respectively) and at peak ischemic flow (45.2 ± 1.6 vs 50.1 ± 1.7 ml/100ml/min, respectively) in the osteopenic group, compared to the normal BMD group. These sequelae were apparent in the face of similar scores on the three factor eating questionnaire and the subscales of drive for thinness, body dissatisfaction and bulimia of the EDI2 scale, and notably the scores attained were not in the clinically significant range. Oligo/amenorrhea was present in 75% of the athletes with osteopenia, but only 28% of the athletes with normal BMD, demonstrating that osteopenia was dependent on menstrual status (χ2 = 6.6, p = 0.037). CONCLUSION: These data suggest that 1) it is neither necessary nor prudent to assume that all three endpoints of the Female Athlete Triad must appear simultaneously, as osteopenia was present without overt disordered eating, and 2) osteopenic athletes also present with markers of increased cardiovascular risk thus confirming the extension of the clinical concerns of the Female Athlete Triad to the cardiovascular system. Funded by the Arthur Thornton Cardiopulmonary Fund
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".