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Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, D., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R. and Ljungqvist, A. (2014) The IOC Consensus Statement: Beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 48, 491-497.
https://doi.org/10.1136/bjsports-2014-093502

has been cited by the following article:

• TITLE: Bone Quality in Female Ballet Dancers: A Possible Determinant of Bone Health

  AUTHORS: Hiroki Funasaki, Mitsuru Saito, Mayumi Kuno-Mizumura, Hiroteru Hayashi, Keishi Marumo

  KEYWORDS: Bone Quality, Bone Mineral Density, Female Athletes, Ballet Dancer

  JOURNAL NAME: Open Journal of Orthopedics, Vol.7 No.9, September 25, 2017

  ABSTRACT: Hypotheses:Values of serum markers related to bone quality are abnormal in young female ballet dancers. Methods: In 13 elite Japanese female ballet dancers (average age, 22 years), markers related to bone quality were investigated. These included: serum homocystein (HC), a marker of increased oxidative stress; pentosidine (Pent), a marker of glycation- or oxidation-induced non-enzymatic cross-links; markers of bone metabolism (bone alkaline phosphatase, BAP; tartrate-resistant acid phosphatase 5b, TRAP5b) and bone mineral density (BMD). It was determined whether there is a relationship between bone quality markers’ levels are related to amenorrhea and/or fatigue fractures. Results: Two dancers had fatigue fractures and 3 had a history of secondary amenorrhea. The average BMD was 1.305 ± 0.12 (g/cm2), in all these cases the Z-score was higher than -1.0. Although the serum levels of BAP, TRAP5b, and HC were normal in all examined dancers, in 2 out of 3 dancers with a history of secondary amenorrhea, pentosidine serum levels were increased. No relationship between bone quality markers’ levels and fatigue fractures was found. Conclusion: Latent deterioration of bone quality may occur in female athletes with secondary amenorrhea and otherwise normal BMD and calcium metabolism markers.