Femur 3D-DXA Assessment in Female Football Players, Swimmers, and Sedentary Controls.

Cortical and trabecular volumetric bone mineral density (vBMD), cortical thickness and surface BMD (sBMD, density-to-thickness ratio) were analyzed in the proximal femur of elite female football players and artistic swimmers using three-dimensional dual-energy X-ray absorptiometry (3D-DXA) software and compared to sedentary controls. Football players had significantly higher (p<0.05) vBMD (mg/cm3) in the trabecular (263±44) and cortical femur (886±69) than artistic swimmers (224±43 and 844±89) and sedentary controls (215±51 and 841±85). Football players had also higher (p<0.05) cortical thickness (2.12±0.19 mm) and sBMD (188±22 mg/cm2) compared to artistic swimmers (1.85±0.15 and 156±21) and sedentary controls (1.87±0.16 and 158±23). Artistic swimmers did not show significant differences in any parameter analyzed for 3D-DXA when compared to sedentary controls. The 3D-DXA modeling revealed statistical differences in cortical thickness and vBMD between female athletes engaged in weight-bearing (football) and non-weight bearing (swimming) sports and did not show differences between the non-weight bearing sport and the sedentary controls. 3D-DXA modeling could provide insight into bone remodeling in the sports field, allowing evaluation of femoral trabecular and cortical strength from standard DXA scans.

Jumping rope and whole-body vibration program effects on bone values in Olympic artistic swimmers.

INTRODUCTION: Artistic swimming seems not to benefit bone development like other out-of-water physical activities. To increase bone acquisition, artistic swimming should combine water training with weight-bearing impact or strength activities. Artistic swimmers can be a population at risk of developing osteopenia and osteoporosis in later life. The aim of the present study was to evaluate the effects of a training program on bone mineral density (BMD), bone mineral content (BMC) and body composition in an Olympic artistic swimming team. METHODS: Sixteen women aged 17-21 years, who train 30 h/week, at the Olympic Training Centre (Barcelona, Spain), were followed up over two seasons. The 1st season involved regular artistic swimming training without specific training to reduce the risk of osteopenia. The exercise intervention, jumping rope and whole-body vibration, was added in the 2nd season. The protocol included 20 min of training 2 days per week, over a 22-week period. Dual energy x-ray absorptiometry measured the bone variables and body composition. The daily diet, medical history and bone turnover markers were evaluated. RESULTS: The intervention program increased BMD on lumbar spine (2.10%, p = 0.002), total hip (2.07%, p = 0.001), and femoral neck (2.39%, p = 0.02). Lower limb's fat mass decreased (10.17%, p = 0.038). No significant differences were found for any of the measured anthropometric characteristics between both time points in the 1st season. In conclusions, combined jump rope and vibration should be considered to reduce the risk of bone damage in artistic swimmers.

Bone mineral density and bone mineral content among female elite athletes.

INTRODUCTION: Exercise is a protective factor for the appearance of osteoporosis, but not all physical activities have the same effect on bones. Low-impact sports, like swimming, may a have a negative or no effect. The aim of the present study is to evaluate bone mineral density (BMD, g/cm2) and bone mineral content (BMC, kg) among female high performance athletes from aquatic and non-aquatic sports and to assess possible differences with sedentary controls. METHODS: Participants are elite female athletes over 18 years, from the Spanish Olympic teams, with at least 12-15 h of weekly training on aquatic sports: swimming (n = 19), synchronized swimming (n = 24) and water polo (n = 14), and elite female athletes from non-aquatic sports: professional football players of Futbol Club Barcelona team (n = 92), Spanish national volleyball (n = 26) and field hockey teams (n = 29) as well as sedentary controls (n = 126). Bone mineral density scans was performed using dual-energy X-ray absorptiometry for whole body, segmental analysis, proximal femur and lumbar spine. RESULTS: Non-aquatic female athletes have total and segments BMC and BMD values higher than those of aquatic athletes, that in turn show similar BMD values compared to controls. BMD in lumbar spine and proximal femur was higher in non-aquatic sports compared to aquatic sports athletes and both were higher than controls. CONCLUSION: BMD is not negatively compromised by the practice of aquatic sports at a highly competitive level. However, non-aquatic female athletes show a higher BMD. Time training out of the water improves BMD. Our findings suggest that swimming and synchronized swimming should be combined with weight-bearing, impact or strength activities, as they do not seem to be osteogenic sports.

Conclusions of the Grupo Avilés Working Group Meeting of 2018 / Conclusiones de la Reunión de Trabajo del Grupo Avilés 2018

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Certificació de l'aptitud esportiva en l'edat pediàtrica / Certificación de la aptitud deportiva en la edad pediátrica / Preparticipation physical evaluation in children

Fonament: la certificació medicoesportiva té com a objectiu prevenir i diagnosticar possibles alteracions que poguessin condicionar la pràctica esportiva en l'infant i l'a-dolescent. L'aspecte més important és la prevenció de lamort sobtada, situació dramàtica que ha generat gran in-terès i al mateix temps ansietat, tant entre la població general com entre les diferents institucions esportives. Objectiu: establir un criteri de certificació medicoesportivaen l'edat pediàtrica, analitzant i argumentant la disparitatde criteris entre la proposta europea i l'americana. Mètode: revisió bibliogràfica. Conclusions: la pràctica esportiva en infants i adolescentsexigeix un control de salut portat a terme pel pediatre i unarevisió medicoesportiva que ha de fer l'especialista enmedicina de l'esport, i que permetrà la certificació de l'ap-titud esportiva. En aquesta revisió incidirem en l'historialclínic i en l'exploració dels aparells locomotor i cardiovascular, d'acord amb l'algoritme d'actuació de la propostacatalana de prevenció de la mort sobtada de l'esportista. Laresta de l'exploració mèdica per aparells no difereix de laque fa el pediatre de capçalera en els controls de salu

Fundamento. La certificación médico-deportiva tiene como objetivo prevenir y diagnosticar posibles alteraciones que pudieran condicionar la práctica deportiva en el niño/a y adolescente. El aspecto más importante radica en la prevención de la muerte súbita, situación dramática que ha generado gran interés y al mismo tiempo ansiedad, tanto en la población general como en las diferentes instituciones deportivas. Objetivo. Establecer un criterio de certificación médico-deportiva, analizando y argumentando la disparidad de criterios entre la propuesta europea y la americana. Método. Revisión bibliográfica. Conclusiones. La práctica deportiva en niños/as y adolescentes exige un control de salud llevado a cabo por el pediatra y una revisión médico-deportiva realizada por el especialista en medicina del deporte, que permitirá la certificación de la aptitud deportiva. En esta revisión, incidiremos en el historial clínico, la exploración de los aparatos locomotor y cardiovascular, según el algoritmo del consenso catalán de prevención de la muerte súbita en deportistas. El resto de la exploración médica por aparatos no difiere de la que realiza el pediatra de cabecera en los controles de salud (AU)

Background. The aim of preparticipation physical evaluation for thletics is to prevent and diagnose conditions that would contraindicate the practice of sports for children and adolescents. The most important objective is to prevent sudden death, a dramatic situation that has generated great interest and anxiety in the general population as well as among athletic institutions. Objective. To define consensus criteria for preparticipation physical evaluation, considering the disparities between the European and the American proposals. Method. Literature review. Conclusions. The practice of sports in children and adolescents requires a medical evaluation for fitness by the pediatrician and by sports medicine. In this review, we focus on medical history and musculoskeletal and cardiovascular examination, following the guidelines of the Catalan consensus for prevention of sudden death in athletes. The rest of the medical examination does not differ from the exploration performed by the pediatrician in the routine health checks (AU)

Evaluation of immunoassays for the measurement of insulin and C-peptide as indirect biomarkers of insulin misuse in sport: values in selected population of athletes.

Insulin and C-peptide have been proposed as possible biomarkers of human insulin hormone misuse in sport. An extended intra- and inter-laboratory validation of commercially available immunoassays was performed. Enzyme Amplified Sensitivity Immunoassay (EASIA) assays (Human Insulin-EASIA and C-peptide EASIA kits from BioSource) were evaluated for insulin and C-peptide in serum. The intra- and inter-laboratory precision and accuracy values were good for the evaluated assays with maximum imprecision and inaccuracy of 16% and 23%, respectively, obtained just for one day C-peptide assay evaluation. The range of concentrations found in serum samples under investigation was always covered by the calibration curves of the studied immunoassays. However, a 19.7% of the samples felt below the estimated insulin limit of quantification. High concordance between laboratory results was obtained for insulin assay (intraclass correlation coefficient -ICC=0.857), whereas that for C-peptide was lower (ICC=0.539). Evaluated immunoassays were used to measure serum concentrations of insulin and C-peptide in elite athletes of various sport disciplines at different moment of training season, in recreational athletes at baseline conditions and finally in sedentary individuals. Serum insulin was statistically lower both in recreational and elite athletes when compared to sedentary individuals. Among elite athletes, the specific sport affected serum insulin (e.g., weightlifting) and C-peptide (e.g., triathlon) concentrations. Over the training season, a within athletes variability was observed for taekwondo, swimming and weightlifting athletes. Variations due to those aspects should be taken in careful consideration in the hypothesis of setting reference concentration ranges for doping detection.

Immunoassays for the measurement of IGF-II, IGFBP-2 and -3, and ICTP as indirect biomarkers of recombinant human growth hormone misuse in sport. Values in selected population of athletes.

Insulin-like growth factor-II (IGF-II), insulin-like growth factor binding proteins (IGFBPs) -2 and -3 and C-terminal telopeptide of type I collagen (ICTP) have been proposed, among others, as indirect biomarkers of the recombinant human growth hormone misuse in sport. An extended intra- and inter-laboratory validation of commercially available immunoassays for biomarkers detection was performed. ELISA assays for total IGF-II, IGFBP-2 and IGFBP-3 (IGF-II/ELISA1: DSLabs, IGFBP-2/ELISA2: Biosource, and IGFBP-3/ELISA3: BioSource) and an EIA assay for ICTP (ICTP/EIA: Orion Diagnostica) were evaluated. The inter- and intra-laboratory precision values were acceptable for all evaluated assays (maximum imprecision of 30% and 66% were found only for the lowest quality control samples of IGF-II and IGFBP-3). Correct accuracy was obtained for all inter-laboratory immunoassays and for IGFBP-2 intra-laboratory immunoassay. The range of concentrations found in serum samples under investigation was always covered by the calibration curves of the studied immunoassays. However, 11% and 15% of the samples felt below the estimated LOQ for IGF-II and ICTP, respectively, in the zone where lower precision was obtained. Although the majority of evaluated assays showed an overall reliability not always suitable for antidoping control analysis, relatively high concordances between laboratory results were obtained for all assays. Evaluated immunoassays were used to measure serum concentrations of IGF-II, IGFBP-2 and -3 and ICTP in elite athletes of various sport disciplines at different moments of the training season; in recreational athletes at baseline conditions and finally in sedentary individuals. Serum IGF-II was statistically higher both in recreational and elite athletes compared to sedentary individuals. Elite athletes showed lower IGFBP-2 and higher IGFBP-3 concentration with respect to recreational athletes and sedentary people. Among elite athletes, serum IGFBP-3 (synchronized swimming), and ICTP (rhythmic gymnastics) concentrations were sport-dependent. Over the training season, within athlete variability was observed for IGFBP-2 in case of taekwondo and IGFBP-2 and -3 in case of weightlifting. Variations due to those aspects should be taken in careful consideration in the hypothesis of setting reference concentration ranges for doping detection.