Analysis of Regional Differences in Bone Mineral Density Acquisition Factors in Young Women

Norie Funaki¹, Fumihiro Omasu^1,2*, Asami Endo², Minami Mashiko², Kana Okazaki³, Natsuki Ogata³, Kosuke Hiruma⁴, Tomomi Gotoh^3,5

¹Graduate School of Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yamagata, Japan.
²Department of Health and Nutrition, Faculty of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yamagata, Japan.
³Department of School Health, Faculty of Education, Kumamoto University, Kumamoto, Japan.
⁴Faculty of Social Information Science, Yamagata Prefectural Yonezawa Woman’s Junior College, Yamagata, Japan.
⁵Department of Lifelong Health Education, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

DOI: 10.4236/jbm.2023.1111010                

Abstract

Purpose: Obtaining high peak bone mass (PBM) and maintaining bone mass is important for the prevention of osteoporosis. This study aimed to examine the regional differences in bone mineral density and factors associated with its acquisition from exercise. Design: The study population included 75 women of 18 - 22 years of age in East Japan and 104 women of 18 - 27 years of age in West Japan. The speed of sound (SOS) of the calcaneus was measured, and the young adult mean (%YAM) was calculated from the SOS. The subjects’ medical history, family history of osteoporosis, and exercise habits were examined using a self-administered questionnaire. Results: There were a significantly greater number of subjects with low %YAM in West Japan. The exercise history and exercise time were significantly higher in West Japan, and the exercise intensity score tended to be higher in East Japan during junior high and high school. A multiple regression analysis by region revealed that the following factors had a significant positive association with the SOS: exercise intensity at elementary school and outdoor sports at junior high school in East Japan; and exercise time at elementary school, muscle mass, and outdoor sports at junior high school in West Japan. On the other hand, exercise time in junior high school in West Japan showed a negative association with the SOS. Conclusions: Regional differences in bone mineral density existed, suggesting a trend toward lower bone mineral density in West Japan. Exercise history and time tended to be higher in West Japan, and exercise intensity scores tended to be higher in East Japan, suggesting that exercise intensity may be more important than exercise time for obtaining bone mineral density.

Keywords

Bone Mineral Density, Exercise Intensity, Region Differences, Young Women

Table 1. Outdoor sports classification.

Table 2. Exercise intensity classification.

Table 3. Subject characteristics and correlation with SOS (East/West Japan).

Table 4. Experience of exercise/Outdoor sports experience/Exercise time/Exercise intensity (East and West Japan).

Table 5. Experience of exercise/Outdoor sports experience/Exercise time/Exercise intensity (East Japan).

Table 6. Experience of exercise/Outdoor sports experience/Exercise time/Exercise intensity (West Japan).

Table 7. Multiple Regression Analysis for SOS (East Japan).

Table 8. Multiple Regression Analysis for SOS (West Japan).

1. 1. National Institutes of Health Consensus Development Conference Statement (2001) Osteoporosis Prevention, Diagnosis, and Therapy. JAMA, 285, 785-795.


2. 2. Hernandez, C.J., Beaupré, G.S. and Carter, D.R. (2003) A Theoretical Analysis of the Relative Influences of Peak BMD, Age-Related Bone Loss and Menopause on the Development of Osteoporosis. Osteoporosis International, 14, 843-847. https://doi.org/10.1007/s00198-003-1454-8


3. 3. Faienza, M.F., Lassandro, G., Chiarito, M., Valente, F., Ciaccia, L. and Giordano, P. (2020) How Physical Activity across the Lifespan Can Reduce the Impact of Bone Ageing: A Literature Review. International Journal of Environmental Research and Public Health, 17, Article 1862. https://doi.org/10.3390/ijerph17061862


4. 4. Specker, B., Thiex, N.W. and Sudhagoni, R.G. (2015) Does Exercise Influence Pediatric Bone? A Systematic Review. Clinical Orthopaedics and Related Research, 473, 3658-3672. https://doi.org/10.1007/s11999-015-4467-7


5. 5. Daly, R.M. (2007) The Effect of Exercise on Bone Mass and Structural Geometry during Growth. Medicine and Sport Science, 51, 33-49. https://doi.org/10.1159/000103003


6. 6. Nagase, H., Hayashi, K., Nakamura, H., Yamada, A. and Ogino, K. (1999) Cross-Sectional Study of Factors Related to Achilles Bone Mineral Density Measured by an Ultrasound System. Japanese Journal of Public Health, 46, 799-810.


7. 7. Mase, T. (2005) Effects of Past Exercise Habits on Bone Mineral Density in Female Students—Examination by the Characteristics of the Exercise Type. Japan Journal of Test and Evaluation of Physical Education and Sports, 5, 15-20.


8. 8. Miyamoto, S. and Ishiko, T. (1993) Effect of Pubescent Habitual Exercise on Bone Mineral Density of University Students. Japanese Journal of Physical Fitness and Sports Medicine, 42, 37-45. https://doi.org/10.7600/jspfsm1949.42.37


9. 9. Tachi, Y., Sakamoto, Y., Sasaki-Fukatsu, K., Koike, A., Kita, T., Iida, K. and Wang, P.L. (2018) Impact of Exercise on Bone Mass in Female University Students. Bulletin of the Tokyo College of Domestic Science, 58, 71-77.


10. 10. Nakatani, A., Yoshida, T., Shimizu, C., Yoshioka, A. and Yamaguchi, K. (2020) Effects of Different Sports on Bone Mineral Density in Female College Students. The Journal of Kansai University of Social Welfare, 23, 75-79.


11. 11. Scofield, K.L. and Hecht, S. (2012) Bone Health in Endurance Athletes: Runners, Cyclists, and Swimmers. Current Sports Medicine Reports, 11, 328-334. https://doi.org/10.1249/JSR.0b013e3182779193


12. 12. Hirai, M., Watanabe, N., Yamasaki, T., et al. (1998) Regional Differences of Bone Density. Official Journal of Japan Society of Ningen Dock, 13, 29-32.


13. 13. Hervás, G., Ruiz-Litago, F., Irazusta, J., et al. (2019) Bone Health and Its Relationship with Impact Loading and the Continuity of Physical Activity throughout School Periods. International Journal of Environmental Research and Public Health, 16, Article 2834. https://doi.org/10.3390/ijerph16162834


14. 14. Nikander, R., Kannus, P., Rantalainen, T., Uusi-Rasi, K., Heinonen, A. and Sievanen, H. (2010) Cross-Sectional Geometry of Weight-Bearing Tibia in Female Athletes Subjected to Different Exercise Loadings. Osteoporosis International, 21, 1687-1694. https://doi.org/10.1007/s00198-009-1101-0


15. 15. Tamaki, J., Fujimori, K., Ikehara, S., et al. (2019) Estimates of Hip Fracture Incidence in Japan Using the National Health Insurance Claim Database in 2012-2015. Osteoporosis International, 30, 975-983. https://doi.org/10.1007/s00198-019-04844-8


16. 16. Nakajima, H. (2020) Vitamin D Synthesis in Human Body by Solar Ultraviolet-B (UV-B) Radiation. Vitamins, 94, 469-491.


17. 17. Ducher, G., Bass, S.L., Saxon, L. and Daly, R.M. (2011) Effects of Repetitive Loading on the Growth-Induced Changes in Bone Mass and Cortical Bone Geometry: A 12-Month Study in Pre/Peri- and Postmenarcheal Tennis Players. Journal of Bone and Mineral Research, 26, 1321-1329. https://doi.org/10.1002/jbmr.323


18. 18. Kohri, T., Kaba, N., Murakami, T., et al. (2012) Search for Promotion Factors of Ultrasound Bone Measurement in Japanese Males and Pre/Post-Menarcheal Females Aged 8-14 Years. Journal of Nutritional Science and Vitaminology, 58, 263-271. https://doi.org/10.3177/jnsv.58.263


19. 19. Rosa, N., Simoes, R., Magalhaes, F.D. and Marques, A.T. (2015) From Mechanical Stimulus to Bone Formation: A Review. Medical Engineering & Physics, 37, 719-728. https://doi.org/10.1016/j.medengphy.2015.05.015


20. 20. Miyazaki, T., Zhao, Z., Ichihara, Y., et al. (2019) Mechanical Regulation of Bone Homeostasis through p130Cas-Mediated Alleviation of NF-κB Activity. Science Advances, 5, eaau7802. https://doi.org/10.1126/sciadv.aau7802


21. 21. Maimoun, L., Georgopoulos, N.A. and Sultan, C. (2014) Endocrine Disorders in Adolescent and Young Female Athletes: Impact on Growth, Menstrual Cycles, and Bone Mass Acquisition. The Journal of Clinical Endocrinology & Metabolism, 99, 4037-4050. https://doi.org/10.1210/jc.2013-3030


22. 22. Sosa, D.D. and Eriksen, E.F. (2016) Women with Previous Stress Fractures Show Reduced Bone Material Strength. Acta Orthopaedica, 87, 626-631. https://doi.org/10.1080/17453674.2016.1198883

Conflicts of Interest

The authors declare no conflicts of interest regarding the publication of this paper.

References

[1]	National Institutes of Health Consensus Development Conference Statement (2001) Osteoporosis Prevention, Diagnosis, and Therapy. JAMA, 285, 785-795.
[2]	Hernandez, C.J., Beaupré, G.S. and Carter, D.R. (2003) A Theoretical Analysis of the Relative Influences of Peak BMD, Age-Related Bone Loss and Menopause on the Development of Osteoporosis. Osteoporosis International, 14, 843-847. https://doi.org/10.1007/s00198-003-1454-8
[3]	Faienza, M.F., Lassandro, G., Chiarito, M., Valente, F., Ciaccia, L. and Giordano, P. (2020) How Physical Activity across the Lifespan Can Reduce the Impact of Bone Ageing: A Literature Review. International Journal of Environmental Research and Public Health, 17, Article 1862. https://doi.org/10.3390/ijerph17061862
[4]	Specker, B., Thiex, N.W. and Sudhagoni, R.G. (2015) Does Exercise Influence Pediatric Bone? A Systematic Review. Clinical Orthopaedics and Related Research, 473, 3658-3672. https://doi.org/10.1007/s11999-015-4467-7
[5]	Daly, R.M. (2007) The Effect of Exercise on Bone Mass and Structural Geometry during Growth. Medicine and Sport Science, 51, 33-49. https://doi.org/10.1159/000103003
[6]	Nagase, H., Hayashi, K., Nakamura, H., Yamada, A. and Ogino, K. (1999) Cross-Sectional Study of Factors Related to Achilles Bone Mineral Density Measured by an Ultrasound System. Japanese Journal of Public Health, 46, 799-810.
[7]	Mase, T. (2005) Effects of Past Exercise Habits on Bone Mineral Density in Female Students—Examination by the Characteristics of the Exercise Type. Japan Journal of Test and Evaluation of Physical Education and Sports, 5, 15-20.
[8]	Miyamoto, S. and Ishiko, T. (1993) Effect of Pubescent Habitual Exercise on Bone Mineral Density of University Students. Japanese Journal of Physical Fitness and Sports Medicine, 42, 37-45. https://doi.org/10.7600/jspfsm1949.42.37
[9]	Tachi, Y., Sakamoto, Y., Sasaki-Fukatsu, K., Koike, A., Kita, T., Iida, K. and Wang, P.L. (2018) Impact of Exercise on Bone Mass in Female University Students. Bulletin of the Tokyo College of Domestic Science, 58, 71-77.
[10]	Nakatani, A., Yoshida, T., Shimizu, C., Yoshioka, A. and Yamaguchi, K. (2020) Effects of Different Sports on Bone Mineral Density in Female College Students. The Journal of Kansai University of Social Welfare, 23, 75-79.
[11]	Scofield, K.L. and Hecht, S. (2012) Bone Health in Endurance Athletes: Runners, Cyclists, and Swimmers. Current Sports Medicine Reports, 11, 328-334. https://doi.org/10.1249/JSR.0b013e3182779193
[12]	Hirai, M., Watanabe, N., Yamasaki, T., et al. (1998) Regional Differences of Bone Density. Official Journal of Japan Society of Ningen Dock, 13, 29-32.
[13]	Hervás, G., Ruiz-Litago, F., Irazusta, J., et al. (2019) Bone Health and Its Relationship with Impact Loading and the Continuity of Physical Activity throughout School Periods. International Journal of Environmental Research and Public Health, 16, Article 2834. https://doi.org/10.3390/ijerph16162834
[14]	Nikander, R., Kannus, P., Rantalainen, T., Uusi-Rasi, K., Heinonen, A. and Sievanen, H. (2010) Cross-Sectional Geometry of Weight-Bearing Tibia in Female Athletes Subjected to Different Exercise Loadings. Osteoporosis International, 21, 1687-1694. https://doi.org/10.1007/s00198-009-1101-0
[15]	Tamaki, J., Fujimori, K., Ikehara, S., et al. (2019) Estimates of Hip Fracture Incidence in Japan Using the National Health Insurance Claim Database in 2012-2015. Osteoporosis International, 30, 975-983. https://doi.org/10.1007/s00198-019-04844-8
[16]	Nakajima, H. (2020) Vitamin D Synthesis in Human Body by Solar Ultraviolet-B (UV-B) Radiation. Vitamins, 94, 469-491.
[17]	Ducher, G., Bass, S.L., Saxon, L. and Daly, R.M. (2011) Effects of Repetitive Loading on the Growth-Induced Changes in Bone Mass and Cortical Bone Geometry: A 12-Month Study in Pre/Peri- and Postmenarcheal Tennis Players. Journal of Bone and Mineral Research, 26, 1321-1329. https://doi.org/10.1002/jbmr.323
[18]	Kohri, T., Kaba, N., Murakami, T., et al. (2012) Search for Promotion Factors of Ultrasound Bone Measurement in Japanese Males and Pre/Post-Menarcheal Females Aged 8-14 Years. Journal of Nutritional Science and Vitaminology, 58, 263-271. https://doi.org/10.3177/jnsv.58.263
[19]	Rosa, N., Simoes, R., Magalhaes, F.D. and Marques, A.T. (2015) From Mechanical Stimulus to Bone Formation: A Review. Medical Engineering & Physics, 37, 719-728. https://doi.org/10.1016/j.medengphy.2015.05.015
[20]	Miyazaki, T., Zhao, Z., Ichihara, Y., et al. (2019) Mechanical Regulation of Bone Homeostasis through p130Cas-Mediated Alleviation of NF-κB Activity. Science Advances, 5, eaau7802. https://doi.org/10.1126/sciadv.aau7802
[21]	Maimoun, L., Georgopoulos, N.A. and Sultan, C. (2014) Endocrine Disorders in Adolescent and Young Female Athletes: Impact on Growth, Menstrual Cycles, and Bone Mass Acquisition. The Journal of Clinical Endocrinology & Metabolism, 99, 4037-4050. https://doi.org/10.1210/jc.2013-3030
[22]	Sosa, D.D. and Eriksen, E.F. (2016) Women with Previous Stress Fractures Show Reduced Bone Material Strength. Acta Orthopaedica, 87, 626-631. https://doi.org/10.1080/17453674.2016.1198883