Vitamin D levels and bone mineral density of middle-aged premenopausal female football and volleyball players in Japan: a cross-sectional study

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Abstract

Background

The number of football teams in senior categories has increased. As outdoor sports entail players being exposed to sunlight, playing football may contribute to maintaining vitamin D stores and body mineral density while preventing osteoporosis. This study aimed to determine the bone mineral density and vitamin D levels in middle-aged premenopausal female football players.

Methods

Participants were premenopausal females in their 40s. We evaluated bone mineral density of the second to the fourth lumbar vertebrae and femoral neck, serum 25-hydroxy vitamin D (25-OHD) levels, which is an indicator of vitamin D stores, and body composition. In addition, we administered a questionnaire survey on exercise habits and lifestyle. Ninety-two participants were categorised into three groups: the football group ( n = 27), volleyball group ( n = 40), and non-exercise group ( n = 25).

Results

Bone mineral density was higher in the football and volleyball groups than in the non-exercise group ( P < 0.01). The volleyball group had a significantly higher bone mineral density of the lumbar spine and femoral neck than the non-exercise group ( P < 0.01). The football group had a significantly higher bone mineral density of the femoral neck than the non-exercise group ( P < 0.01). Although the football group had played fewer years than the volleyball group ( P < 0.01), serum 25-OHD levels were the highest in the football group and were significantly higher than those in the volleyball and non-exercise groups ( P < 0.01).

Conclusions

Middle-aged premenopausal football players had higher body vitamin D levels and bone mineral densities than non-active females. These results suggest that playing football may contribute to the prevention of osteoporosis.

Trial registration

UMIN Clinical Trials Registry UMIN000054235. 2024/04/23. Retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-024-00938-x.

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Most cited references 34

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Osteoporosis Prevention, Diagnosis, and Therapy

NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy (2001)

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Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover.

Chu-Han Cheng, Li-Ru Chen, Kuo-Hu Chen (2022)

Osteoporosis is a serious health issue among aging postmenopausal women. The majority of postmenopausal women with osteoporosis have bone loss related to estrogen deficiency. The rapid bone loss results from an increase in bone turnover with an imbalance between bone resorption and bone formation. Osteoporosis can also result from excessive glucocorticoid usage, which induces bone demineralization with significant changes of spatial heterogeneities of bone at microscale, indicating potential risk of fracture. This review is a summary of current literature about the molecular mechanisms of actions, the risk factors, and treatment of estrogen deficiency related osteoporosis (EDOP) and glucocorticoid induced osteoporosis (GIOP). Estrogen binds with estrogen receptor to promote the expression of osteoprotegerin (OPG), and to suppress the action of nuclear factor-κβ ligand (RANKL), thus inhibiting osteoclast formation and bone resorptive activity. It can also activate Wnt/β-catenin signaling to increase osteogenesis, and upregulate BMP signaling to promote mesenchymal stem cell differentiation from pre-osteoblasts to osteoblasts, rather than adipocytes. The lack of estrogen will alter the expression of estrogen target genes, increasing the secretion of IL-1, IL-6, and tumor necrosis factor (TNF). On the other hand, excessive glucocorticoids interfere the canonical BMP pathway and inhibit Wnt protein production, causing mesenchymal progenitor cells to differentiate toward adipocytes rather than osteoblasts. It can also increase RANKL/OPG ratio to promote bone resorption by enhancing the maturation and activation of osteoclast. Moreover, excess glucocorticoids are associated with osteoblast and osteocyte apoptosis, resulting in declined bone formation. The main focuses of treatment for EDOP and GIOP are somewhat different. Avoiding excessive glucocorticoid use is mandatory in patients with GIOP. In contrast, appropriate estrogen supplement is deemed the primary treatment for females with EDOP of various causes. Other pharmacological treatments include bisphosphonate, teriparatide, and RANKL inhibitors. Nevertheless, more detailed actions of EDOP and GIOP along with the safety and effectiveness of medications for treating osteoporosis warrant further investigation.

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Secondary Osteoporosis

Peter R Ebeling, Hanh Nguyen, Jasna Aleksova … (2022)

Osteoporosis is a global public health problem, with fractures contributing to significant morbidity and mortality. Although postmenopausal osteoporosis is most common, up to 30% of postmenopausal women, > 50% of premenopausal women, and between 50% and 80% of men have secondary osteoporosis. Exclusion of secondary causes is important, as treatment of such patients often commences by treating the underlying condition. These are varied but often neglected, ranging from endocrine to chronic inflammatory and genetic conditions. General screening is recommended for all patients with osteoporosis, with advanced investigations reserved for premenopausal women and men aged < 50 years, for older patients in whom classical risk factors for osteoporosis are absent, and for all patients with the lowest bone mass (Z-score ≤ −2). The response of secondary osteoporosis to conventional anti-osteoporosis therapy may be inadequate if the underlying condition is unrecognized and untreated. Bone densitometry, using dual-energy x-ray absorptiometry, may underestimate fracture risk in some chronic diseases, including glucocorticoid-induced osteoporosis, type 2 diabetes, and obesity, and may overestimate fracture risk in others (eg, Turner syndrome). FRAX and trabecular bone score may provide additional information regarding fracture risk in secondary osteoporosis, but their use is limited to adults aged ≥ 40 years and ≥ 50 years, respectively. In addition, FRAX requires adjustment in some chronic conditions, such as glucocorticoid use, type 2 diabetes, and HIV. In most conditions, evidence for antiresorptive or anabolic therapy is limited to increases in bone mass. Current osteoporosis management guidelines also neglect secondary osteoporosis and these existing evidence gaps are discussed.

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Author and article information

Contributors

Takayuki Miyamori: t.miyamori.hi@juntendo.ac.jp

Journal

Journal ID (nlm-ta): BMC Sports Sci Med Rehabil

Journal ID (iso-abbrev): BMC Sports Sci Med Rehabil

Title: BMC Sports Science, Medicine and Rehabilitation

Publisher: BioMed Central (London )

ISSN (Electronic): 2052-1847

Publication date (Electronic): 2 July 2024

Publication date PMC-release: 2 July 2024

Publication date Collection: 2024

Volume: 16

Electronic Location Identifier: 147

Affiliations

[1 ]Graduate School of Health and Sports Science, Juntendo University, ( https://ror.org/01692sz90) Chiba, Japan

[2 ]Department of Physical Therapy, Faculty of Health Science, Juntendo University, ( https://ror.org/01692sz90) Tokyo, Japan

[3 ]Graduate School of Health Science, Juntendo University, ( https://ror.org/01692sz90) Tokyo, Japan

[4 ]Graduate School of Health and Sports Science, Juntendo University, ( https://ror.org/01692sz90) Chiba, Japan

[5 ]Department of Orthopedic Surgery, Faculty of Medicine, Juntendo University, ( https://ror.org/01692sz90) Tokyo, Japan

[6 ]Medical Technology Innovation Center, Juntendo University, ( https://ror.org/01692sz90) Tokyo, Japan

[7 ]School of Science and Technology for Future Life, Tokyo Denki University, ( https://ror.org/01pa62v70) Tokyo, Japan

[8 ]J Medical Oyumino, Chiba, Japan

[9 ]Department of Sports Science, Faculty of Health and Sports Science, Juntendo University, ( https://ror.org/01692sz90) Chiba, Japan

[10 ]Japan Football Association, Tokyo, Japan

Article

Publisher ID: 938

DOI: 10.1186/s13102-024-00938-x

PMC ID: 11221148

PubMed ID: 38956731

SO-VID: 270ead17-d70e-4dec-b4be-2f3f8157aa4c

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 15 April 2024

Date accepted : 28 June 2024

Custom metadata

Keywords: bone mineral density,25-hydroxy vitamin d,middle-aged,premenopausal,football,volleyball,exercise habits

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Keywords: bone mineral density, 25-hydroxy vitamin d, middle-aged, premenopausal, football, volleyball, exercise habits

Vitamin D levels and bone mineral density of middle-aged premenopausal female football and volleyball players in Japan: a cross-sectional study

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Abstract

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Methods

Results

Conclusions

Trial registration

Supplementary Information

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NTT Journal for Theology and the Study of Religion

Most cited references 34

Osteoporosis Prevention, Diagnosis, and Therapy

Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover.

Secondary Osteoporosis

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