Skull bone mass deficit in prepubertal highly-trained gymnast girls

It is known that impact loading sport can increase the bone mineral density in the stressed sites of the skeleton in athletes. However, non weight-bearing sites are seldom studied in healthy young girl athletes. In order to study the effects of a long term intensive training on the non-stressed region of the skeleton (skull), we investigated both highly-trained girl athletes, involved in sports requiring or not significant impact loading on the skeleton and a girl control group. Bone mineral content (BMC) and density (BMD) were measured in the whole body, at lumbar spine, femoral neck, trochanter, Ward's triangle, radius, head and ribs, in 60 prepubertal girls including 12 swimmers, 32 gymnasts and 16 controls. Measurements were made by DXA. There were no statistical differences between the groups as regards age, height, body weight, body mass index, lean tissue mass and dietary calcium intake. Mean BMD in gymnasts was statistically higher than in other groups for radius (p < 0.001), femoral neck (p < 0.05) and Ward's triangle (p < 0.05) while there was no difference between swimmers and controls. Head BMC was significantly lower in gymnasts compared to other groups (241.9+/-41 g vs. 285.8+/-34.7 g and 291.1+/-50.2 g respectively in swimmers and controls, p < 0.001). The same observation was made for head BMD (p < 0.01). When body weight was used as a covariant, the contribution of the head BMC to the whole body was significantly lower (p < 0.001) in gymnasts (24.97%) than in swimmers (27.88%) and controls (27.77%). When compared between groups, the slopes of the regressions for head/whole body BMC or BMD were significantly lower in gymnasts (p < 0.05) than in other groups. These data suggest that in prepubertal children the increased bone density induced by gymnastic training in the stressed sites of the body could be related to a decreased skull bone mass.