Adolescentes jogadoras de handebol apresentam conteúdo mineral ósseo superior ao de adolescentes jogadoras de futebol: um estudo transversal
Data
2024-01-18
Autores
Fagundes, Ulysses 
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A adolescência é o período de vida em que se obtém entre 40 e 60% da
massa óssea, algo extremamente importante para prevenção de osteoporose na fase
adulta. Entre os vários fatores que podem estimular esse ganho de massa óssea está
a prática de atividade física. Entretanto, não está claro na literatura que tipo de
atividade física é capaz de gerar maiores ganhos. Objetivo: Comparar o conteúdo
mineral ósseo (CMO), a densidade mineral óssea (DMO) e a massa magra de
adolescentes atletas (jogadoras de futebol e jogadoras de handebol) e um padrão de
referência norte-americano com o intuito de verificar o efeito da modalidade esportiva
praticada sobre a massa óssea e massa magra. Métodos: Este estudo transversal
mediu o CMO, a DMO, a DMO total do corpo menos cabeça (TBLH) e a massa magra
usando absorciometria de raios-X de dupla energia (DXA) em 115 jogadoras de
handebol (15,5 ± 1,3 anos, 165,2 ± 5,6 cm e 61,9 ± 9,3 kg) e em 142 jogadoras de
futebol (15,5 ± 1,5 anos, 163,7 ± 6,6 cm e 56,5 ± 7,7 kg). Além disso, 136 adolescentes
mulheres formaram o grupo de valores padrão de referência norte-americano (15,1 ±
1,3 anos, 163,5 ± 5,8 cm e 67,2 ± 19,4 kg), cujos dados referentes à massa óssea
foram extraídos do estudo “National Health and Nutrition Survey” (NHANES).
Resultados: Observou-se que jogadoras de handebol, quando comparadas às
futebolistas, apresentaram valores maiores de CMO em membros superiores
(294,8±40,2 g e 270,7±45,7 g, p < 0,001), membros inferiores (1011,6±145,5 g e
967,7±144,3 g, p = 0,035), tronco (911,1±182,5 g e 841,6±163,7 g, p = 0,001), costelas
(312,4±69,9 g e 272,9±58,0 g, p < 0,001), vértebras (245,1±46,8 g e 222,0±45,1 g, p
< 0,001) e massa óssea total (2708,7±384,1 g e 2534,8±386,0 g, p < 0,001),
respectivamente. Os valores do padrão de referência norte-americano para o CMO
em membros inferiores (740,6±132,3 g, p < 0,001), tronco (539,7±98,6 g, p < 0,001),
costelas (138,2±29,9 g, p < 0,001), pelve (238,9±54,6 g, p < 0,001), vértebras
(152,8±26.4 g, p < 0,001) e massa óssea total (1987,5±311.3 g, p < 0,001) foram
inferiores quando comparadas às adolescentes das duas modalidades esportivas. As
jogadoras de handebol, quando comparadas às futebolistas, também apresentaram
valores maiores de DMO em tronco (1,02±0,87 g/cm2 e 0,99±0,83 g/cm2
, p=0,017),
costelas (0,77±0,06 g/cm2 e 0,74±0,05 g/cm2
, p<0,001) e vértebras (1,15±0,11 g/cm2
e 1,09±0,12 g/cm2
, p<0,001). As adolescentes atletas apresentaram DMO superior a
apresentada pelo padrão de referência norte-americano para todas as medidas
realizadas (membros superiores, inferiores, tronco, costelas, pelve, coluna e total)
(p<0,005). Com relação à massa magra, não houve diferença entre os 3 grupos com
relação à massa magra de membros superiores (p=0,112) e massa magra total
(p=0,524). Porém, a massa magra de membros inferiores foi menor no grupo do
ix
padrão de referência norte-americano do que nos grupos de jogadoras de futebol e
handebol (p=0,001). Conclusões: Meninas adolescentes que praticam handebol por
pelo menos um ano apresentam CMO superior ao encontrado em adolescente
praticantes de futebol. Além disso, as adolescentes atletas das duas modalidades
apresentam CMO e DMO superiores ao padrão de referência norte-americano. Esses
resultados podem ser usados por médicos, profissionais de saúde e educação física
para justificar a escolha de uma modalidade esportiva específica para aumento de
CMO e DMO em meninas adolescentes.
Background: Adolescence is the period of life in which between 40 and 60% of bone mass is obtained, which is extremely important for the prevention of osteoporosis in adulthood. Among the various factors that can stimulate this gain in bone mass is the practice of physical activity, however it is not clear in the literature which type of physical activity is capable of generating greater gains. Objective: To compare bone mineral content (BMC), bone mineral density (BMD) and lean mass among adolescent athletes (soccer players and handball players) and north american reference values in order to verify the effect of the sport modality on bone mass and lean mass. Methods: This cross-sectional study measured BMC, BMD, total body less head BMD (TBLH) and lean body mass using dual-energy X-ray absorptiometry (DXA) in 115 female handball players (15.5 ± 1. 3 years, 165.2 ± 5.6 cm and 61.9 ± 9.3 kg) and in 142 soccer players (15.5 ± 1.5 years, 163.7 ± 6.6 cm and 56.5 ± 7 .7 kg). Moreover, 136 adolescent female composed the north american reference values group (15.1 ± 1.32 years, 163.5 ± 5.8 cm and 67.2 ± 19.4 kg). Data referring to the bone mass of non athletes were obtained from the “National Health and Nutrition Survey” (NHANES) study. Results: It was observed that handball players, when compared to soccer players, had higher values of BMC in the upper limbs (294.8±40.2 g and 270.7±45.7 g, p < 0.001), lower limbs ( 1011.6±145.5 g and 967.7±144.3 g, p = 0.035), trunk (911.1±182.5 g and 841.6±163.7 g, p = 0.001), ribs (312, 4±69.9 g and 272.9±58.0 g, p < 0.001), spine (245.1±46.8 g and 222.0±45.1 g, p < 0.001) and total bone mass (2708, 7±384.1g and 2534.8±386.0g, p < 0.001). The north american reference values group had BMC in the lower limbs (740.6±132.3 g, p < 0.001), trunk (539.7 ± 98.6 g, p < 0.001), ribs (138.2 ± 29, 9 g, p < 0.001), pelvis (238.9±54.6 g, p < 0.001), spine (152.8±26.4 g, p < 0.001) and total bone mass (1987.5±311.3 g, p < 0.001) lower when compared to adolescent players of both handball and soccer. Handball players, when compared to soccer players, also had higher values of BMD in the trunk (1.02±0.87 g/cm2 and 0.99±0.83 g/cm2, p=0.017), ribs (0. 77±0.06 g/cm2 and 0.74±0.05 g/cm2, p<0.001) and spine (1.15±0.11 g/cm2 and 1.09±0.12 g/cm2, p<0.001). Adolescent athletes presented higher BMD than north american reference values for all measurements (upper limbs, lower limbs, trunk, ribs, pelvis, spine and total body) (p<0.005). Regarding lean mass, there was no difference between the 3 groups regarding lean mass of upper limbs (p=0.112) and total lean mass (p=0.524). However, xi the lean mass of the lower limbs was lower for north american reference values than for soccer and handball players (p=0.001). Conclusions: Adolescent females engaged in handball training for at least one year present higher bone mass contents than those who are engaged in soccer training, which, in turn, present higher bone mass contents than north american reference values. These results might be used by physicians and healthcare providers to justify the choice of a particular sport to enhance bone mass gain in female adolescents.
Background: Adolescence is the period of life in which between 40 and 60% of bone mass is obtained, which is extremely important for the prevention of osteoporosis in adulthood. Among the various factors that can stimulate this gain in bone mass is the practice of physical activity, however it is not clear in the literature which type of physical activity is capable of generating greater gains. Objective: To compare bone mineral content (BMC), bone mineral density (BMD) and lean mass among adolescent athletes (soccer players and handball players) and north american reference values in order to verify the effect of the sport modality on bone mass and lean mass. Methods: This cross-sectional study measured BMC, BMD, total body less head BMD (TBLH) and lean body mass using dual-energy X-ray absorptiometry (DXA) in 115 female handball players (15.5 ± 1. 3 years, 165.2 ± 5.6 cm and 61.9 ± 9.3 kg) and in 142 soccer players (15.5 ± 1.5 years, 163.7 ± 6.6 cm and 56.5 ± 7 .7 kg). Moreover, 136 adolescent female composed the north american reference values group (15.1 ± 1.32 years, 163.5 ± 5.8 cm and 67.2 ± 19.4 kg). Data referring to the bone mass of non athletes were obtained from the “National Health and Nutrition Survey” (NHANES) study. Results: It was observed that handball players, when compared to soccer players, had higher values of BMC in the upper limbs (294.8±40.2 g and 270.7±45.7 g, p < 0.001), lower limbs ( 1011.6±145.5 g and 967.7±144.3 g, p = 0.035), trunk (911.1±182.5 g and 841.6±163.7 g, p = 0.001), ribs (312, 4±69.9 g and 272.9±58.0 g, p < 0.001), spine (245.1±46.8 g and 222.0±45.1 g, p < 0.001) and total bone mass (2708, 7±384.1g and 2534.8±386.0g, p < 0.001). The north american reference values group had BMC in the lower limbs (740.6±132.3 g, p < 0.001), trunk (539.7 ± 98.6 g, p < 0.001), ribs (138.2 ± 29, 9 g, p < 0.001), pelvis (238.9±54.6 g, p < 0.001), spine (152.8±26.4 g, p < 0.001) and total bone mass (1987.5±311.3 g, p < 0.001) lower when compared to adolescent players of both handball and soccer. Handball players, when compared to soccer players, also had higher values of BMD in the trunk (1.02±0.87 g/cm2 and 0.99±0.83 g/cm2, p=0.017), ribs (0. 77±0.06 g/cm2 and 0.74±0.05 g/cm2, p<0.001) and spine (1.15±0.11 g/cm2 and 1.09±0.12 g/cm2, p<0.001). Adolescent athletes presented higher BMD than north american reference values for all measurements (upper limbs, lower limbs, trunk, ribs, pelvis, spine and total body) (p<0.005). Regarding lean mass, there was no difference between the 3 groups regarding lean mass of upper limbs (p=0.112) and total lean mass (p=0.524). However, xi the lean mass of the lower limbs was lower for north american reference values than for soccer and handball players (p=0.001). Conclusions: Adolescent females engaged in handball training for at least one year present higher bone mass contents than those who are engaged in soccer training, which, in turn, present higher bone mass contents than north american reference values. These results might be used by physicians and healthcare providers to justify the choice of a particular sport to enhance bone mass gain in female adolescents.