Peripheral QCT sector analysis reveals early exercise-induced increases in tibial bone mineral density.

OBJECTIVES: The purpose of this controlled trial was to determine whether subtle changes in mineralization and geometry of the tibia were evident following short term exercise interventions. METHODS: Fifty-seven female volunteers (age 20.1±1.6) were randomized to one of four, 13-week training groups: sedentary control, resistance training, aerobic training, or combined aerobic-resistance. A pQCT image analysis software was developed and used to analyze images taken at sites 4%, 38% and 66% from the distal tibia at baseline and at completion of training. Parameters of bone mineral density, geometry and strength were determined for the entire scan cross-section and for each of six 60° polar sectors. Repeated-measures ANOVA and Fisher's LSD post hoc tests analyzed the effects of training over time. RESULTS: Trabecular density (TrDn) at the 4% site increased from 279.8±37.1 to 283.1±36.0 mg/cm(3) in the aerobic group, and from 285.1±24.6 to 287.5±22.9 mg/cm(3) in the combined group over the study period (P≤0.001). Regional sector analyses revealed that impact exercises resulted in localized changes to the medial aspect of the tibia. Small increases in total bone area were observed in the diaphysis (38% site) (P<0.05). CONCLUSIONS: Subtle, regional increases in trabecular density may be an early measurable manifestation of bone quality changes.

Female recruits sustaining stress fractures during military basic training demonstrate differential concentrations of circulating IGF-I system components: a preliminary study.

OBJECTIVE: Stress fracture injuries sustained during military basic combat training (BT) are a significant problem and occur at a higher rate in female recruits than male recruits. Insulin-like growth factor-I (IGF-I) is an easily measured biomarker that is involved in bone formation and positively correlated with bone mineral density, especially in women. This study examined the response of the IGF-I system between female soldiers that sustained a stress fracture (SFX, n=13) during BT and female soldiers who did not (NSFX, n=49). DESIGN: Female soldiers (n=62, 18.8 ± 0.6 yr) from 2 companies of a gender-integrated combat battalion in the Israeli Defense Forces participated in this study. Height, weight and blood draws were taken upon entry to BT (preBT) and after a four-month BT program (postBT). Stress fractures were diagnosed by bone scan. Serum was analyzed for total IGF-I, free IGF-I, IGF binding proteins (IGFBP)1-6, BAP, calcium, CTx, IL1ß, IL6, PINP, PTH, TNFα, TRAP, and 25(OH)D. Statistical differences between SFX and NSFX groups and time points were assessed by RM ANOVA with Fisher post-hoc (p≤0.05). RESULTS: The SFX group was significantly taller and had lower BMI than NSFX (p≤0.05). Serum concentrations of total IGF-I, bioavailable IGF-I, other bone biomarkers, and cytokines were not significantly different between SFX and NSFX preBT. Serum IGFBP-2 and IGFBP-5 were significantly higher in the SFX compared to the NSFX preBT (p≤0.05). In both groups, total IGF-I increased pre to postBT (p≤0.05). Additionally, a significant difference was observed in the bioavailable IGF-I response pre to postBT for both groups. The SFX group demonstrated a significant decrease in bioavailable IGF-I pre to postBT (preBT: 0.58 ± 0.58 ng/mL; postBT 0.39 ± 0.48; p≤0.05) whereas the NSFX group demonstrated a significant increase in bioavailable IGF-I pre to postBT (preBT: 0.53 ± 0.37 ng/mL; postBT: 0.63 ± 0.45; p≤0.05). CONCLUSIONS: Our study demonstrated that serum IGF-I changes during basic training and that women sustaining stress fractures during BT significantly decreased bioavailable IGF-I, whereas their uninjured counter parts increased bioavailable IGF-I. These results suggest that stress fracture susceptibility may be related to differential IGF-I system concentrations and response to physical training.