Using High Resolution Peripheral Quantitative Computed Tomography to Evaluate Bone Health and Relative Energy Deficiency in Sport Risk in Elite Winter Sport Athletes

Smith, Emily Marie

Using High Resolution Peripheral Quantitative Computed Tomography to Evaluate Bone Health and Relative Energy Deficiency in Sport Risk in Elite Winter Sport Athletes

dc.contributor.advisor	Boyd, Steven
dc.contributor.advisor	Burt, Lauren
dc.contributor.author	Smith, Emily Marie
dc.contributor.committeemember	Roach, Koren
dc.contributor.committeemember	Gabel, Leigh
dc.contributor.committeemember	Kenny, Sarah
dc.date.accessioned	2024-08-28T16:10:53Z
dc.date.available	2024-08-28T16:10:53Z
dc.date.issued	2024-08-27
dc.description.abstract	Relative Energy Deficiency in Sport (REDs) is a syndrome resulting from problematic low energy availability (LEA). Low areal bone mineral density (aBMD) is a primary indicator of LEA and is measured at the hip or spine by dual X-ray absorptiometry (DXA). High-resolution peripheral quantitative computed tomography (HR-pQCT) measures volumetric BMD (vBMD), microarchitecture, geometry, and estimated strength reported as failure load. The objective of this study was to assess the differences in bone parameters using HR-pQCT in elite winter sport athletes identified as at-risk or not at-risk of REDs using the Clinical Assessment Tool (CAT2). Participants included 101 athletes (24.14.4 SD years; 53% female). HR-pQCT scans of the non-dominant radius and left tibia were analyzed and compared to DXA results. Seventeen athletes (17%; 71% female) were at-risk of REDs based on the CAT2. Bland-Altman plots suggested that compared to aBMD, Z-scores were more like failure load (ICC=0.420.10) than vBMD (ICC=0.250.07). After covarying for lean mass, odds ratios (OR) suggested increased likelihood of REDs risk classification for those with low cortical thickness (radius: OR=2.14, p=0.021; tibia: OR=1.89, p=0.037), and area (radius: OR=3.04, p=0.007; tibia: OR=2.74, p=0.006), total vBMD (tibia: OR=2.06, p=0.030), and failure load (tibia: OR=2.17, p=0.033). ROC-AUC analysis showed very poor to poor (0.50<AUC<0.69) discriminatory abilities at both the radius and tibia in identifying REDs risk based on the current threshold of Z-score <-1.0 standard deviations (SD). Bone parameters were lower in athletes at-risk of REDs and results agree with the new consensus statement that HR-pQCT may identify impaired bone health in athletes at-risk of REDs. These findings are novel in approaching REDs using HR-pQCT and in the population of elite winter sport athletes. Future directions should explore longitudinal studies utilizing bone change over time as this may provide greater insight into REDs risk.
dc.identifier.citation	Smith, E. M. (2024). Using high resolution peripheral quantitative computed tomography to evaluate bone health and relative energy deficiency in sport risk in elite winter sport athletes (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.uri	https://hdl.handle.net/1880/119528
dc.language.iso	en
dc.publisher.faculty	Graduate Studies
dc.publisher.institution	University of Calgary
dc.rights	University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subject	HR-pQCT
dc.subject	Medical Imaging
dc.subject	Elite Athletes
dc.subject	REDs
dc.subject	Bone Health
dc.subject.classification	Engineering--Biomedical
dc.subject.classification	Engineering
dc.title	Using High Resolution Peripheral Quantitative Computed Tomography to Evaluate Bone Health and Relative Energy Deficiency in Sport Risk in Elite Winter Sport Athletes
dc.type	master thesis
thesis.degree.discipline	Engineering – Biomedical
thesis.degree.grantor	University of Calgary
thesis.degree.name	Master of Science (MSc)
ucalgary.thesis.accesssetbystudent	I do not require a thesis withhold – my thesis will have open access and can be viewed and downloaded publicly as soon as possible.