Bone mineral density in collegiate female athletes: Comparisons among sports

Context: Some female athletes may have decreased bone mineral density (BMD), which puts them at higher risk for stress fractures and future osteoporosis. Objective: To compare site-specific BMD among National Collegiate Athletic Association Division I varsity female athletes and to determine predictor variables of BMD measurements. Design: Between-groups design. Setting: University health care system. Patients or Other Participants: All women varsity athletes were invited to participate in a cross-sectional study. Of 12 sports, we obtained complete data from 99 women (mean age = 20.2 +/- 1.3 years) representing gymnastics, softball, crosscountry, track, field hockey, soccer, crew, and swimming/diving. Main Outcome Measure(s): Each participant was weighed, measured, and questioned about her menstrual status. Using dual-energy x-ray absorptiometry, we measured total-body BMD and region-of-interest scores for lumbar spine, pelvis, and average leg (average from right and left leg measurements) BMD. Using analyses of covariance, we compared BMD mea-surements among sports at each site while controlling for menstrual status and mass, and we performed a stepwise regression analysis to determine significant predictors of BMD at each site. Results: Twenty-three athletes were oligomenorrheic or amenorrheic. Runners had the lowest total-body (1.079 0.055 g.cm(-2)) and site-specific (P < .01) BMD values for every site except average leg score when compared with gymnasts and softball players. Swimmers and divers had significantly lower average leg BMD (1.117 +/- 0.086 g.cm(-2)) than athletes in every other sport except runners and rowers (P < .01). Regression analysis revealed only mass and sport as significant predictors of total-body BMD. Conclusions: Runners and swimmers and divers demonstrated some deficits in site-specific BMD values when compared with athletes in other sports. When treating a female varsity athlete, athletic trainers should consider her mass and sport type with regard to her bone health.