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. 2022 Feb 14;8:23. doi: 10.1186/s40798-022-00414-1

Table 2.

Comparison of bone parameter measurements and results in studies of male and female professional and retired jockeysa

Study (country) Participants Assessment method Bone parameters measured Results
Number (sex) Age
Greene et al. [10] (Australia) 11 (m) and 14 (f) app 20.1 ± 4.9 pQCT Tibial and radial bone variables: trabecular area and density, BMC, TBA, cortical area and density, SSI

Tibia: cortical area (mm2)—66% proximal: 311.4 ± 40.5

Cortical density (g cm2)—66% proximal: 1163.6 ± 38.1

SSI (mm3) 4% distal 1683.3 ± 123.7; 66% proximal 1953.9 ± 326.8

Radius: cortical area (mm2)—66% proximal 81.4 ± 16.7

SSI (mm3) 4% distal 391.9 ± 69.4; 66% proximal 297.3 ± 88.3

Silk et al. [55]b (Australia) 17 (m) app 22.3 ± 5.0 (supp) versus 19.3 ± 1.8 (pla) pQCT and bone markers

4% distal tibia: trabecular area, content and density, TD, TBA, bone strength index

66% proximal tibia: cortical content, area, density, thickness, TBA SSI tibia, P1NP, CTX

Trabecular density (mg cm2): 241.0 ± 28.1 (supp); 246.8 ± 33.9 (pla)

Trabecular area (mm2): 861.1 ± 160.2 (supp); 854.7 ± 126.7 (pla)

Cortical density (mg cm2): 1101.5 ± 24.7 (supp); 1113.4 ± 22.1 (pla)

Cortical area (mm2): 267.1 ± 29.3 (supp); 263.4 ± 43.8 (pla)

SSI tibia (mm3): 2100.5 ± 329.2 (supp); 2140.0 ± 489.6 (pla)

CTX (ng/L): 371.3 ± 201.0 (supp); 380.0 ± 141.1 (pla)

P1NP (μg/L): 104.2 ± 46.4 (supp); 108.9 ± 31.6 (pla)

Waldron-Lynch et al. [56] (Ireland) 9 (m) flat; 3 (m) NH 25.5 ± 5.0 Bone markers NTx, fDPD, P1NP, bone ALP, OC

NTx (nmol/mmol)c: 99.4 ± 72.6

fDPD (nmol/mmol)c: 6.98 ± 3.27

P1NP (μg/L): 118.8 ± 76.1

Bone ALP (μg/L): 18.8 ± 10.9

OC (μg/L): 20.8 ± 11.3

Dolan et al. [11] (Ireland) 20 (m) 25.9 ± 3.3 DXA and bone markers

BMD: WB

WB, LS (L2–4), FN

BMAD: LS (L2–4), FN

NTx, P1NP

BMD (g/cm2)

WB: 1.134 ± 0.05

LS: 1.11 ± 0.08

FN: 1.06 ± 0.09

BMAD (g/cm3)

LS: 0.137 ± 0.01

FN BMAD: 0.39 ± 0.04

NTx (nmol L−1): − 0.35 ± 0.88

P1NP (ng mL−1): 88.62 ± 46.69

Wilson et al. [3] (UK) 19 (m) flat; 18 (m) NH 27.0 ± 5.0 flat; 25.0 ± 5.0 NH DXA and bone markers

BMD T-score:

WB

CTx

T-score

WB: − 0.87 ± 0.77 flat; − 0.11 ± 1.00 NH

CTx (μg L−1): 0.46 ± 0.21 flat; 0.36 ± 0.14 NH
Jackson et al. [13] (UK) 79 (m) and 37 (f) app; 69 (m) con

18.5 ± 1.9 (m)

19.3 ± 2.0 (f) app; 20.7 ± 2.0 (m) con

DXA

BMD and BMC: LS (L1–L4), FN, TH

BMAD: LS (L1–L4), FN

Z-score ≤  − 1.0: LS (L1–L4), FN, TH

Z-score ≤  − 2.0: LS (L1–L4), FN

BMD (g/cm2)

LS: 0.876 ± 0.091 (m); 0.987 ± 0.083 (f) app; 0.969 ± 0.087 con

FN: 0.831 ± 0.070 (m); 0.840 ± 0.077 (f) app; 0.935 ± 0.093 con

TH: 0.924 ± 0.084 (m) 0.959 ± 0.075 (f) app; 1.017 ± 0.100 con

BMAD (g/cm3)

LS: 0.114 ± 0.011 (m); 0.132 ± 0.013 (f) app; 0.118 ± 0.011 con

FN: 0.155 ± 0.113 (m); 0.176 ± 0.023 (f) app; 0.168 ± 0.023 con

Z-score ≤  − 1.0 n [%]

LS: 60 [76.0] (m); 6 [16.2] (f) app; 36 [52.2] con

FN: 27 [34.2] (m); 3 [8.1] (f) app; 6 [8.7] con

TH: 33 [41.8] (m); 1 [2.7] (f) app; 7 [10.1] con

Z-score ≤  − 2.0 n [%]

LS: 23 [29.1] (m); 1 [2.7] (f) app; 9 [13.0] con

FN: 1 [1.3] (m) app

Leydon and Wall [20] (New Zealand) 2 (m) and 9 (f) app; 4 (m) and 5 (f) sen 20.5 ± 3.8 app; 28.7 ± 5.0 sen DXA BMD T-scores: WB, LS, TH

T-scores:

WB: − 1.80 ± 0.76

LS: − 0.36 ± 1.0

TH: − 0.54 ± 1.1

Wilson et al. [12] (UK) 8 (m) and 8 (f) flat 25.0 ± 5.0 (m); 29.0 ± 8.0 (f) DXA

BMD: LS, TH

BMD Z-score: LS, TH

BMD (g/cm2)

LS: 0.90 ± 0.14 (m); 1.02 ± 0.13 (f)

TH: 0.89 ± 0.1 (m); 0.87 ± 0.15 (f)

Z-score

LS: − 1.6 ± 1.3 (m); − 0.3 ± 0.8 (f)

TH: − 1.2 ± 1.0 (m); − 0.02 ± 0.8 (f)

Wilson et al. [23] (UK) 17 (m) app; 14(m) sen flat 19.0 ± 2.0 app; 32.0 ± 7.0 sen Z-score: LS, TH

Z-score

LS: − 1.3 ± 1.4 app; − 1.5 ± 1.0 sen

TH: − 0.9 ± 1.1 app; − 0.8 ± 0.7 sen

Hitchens et al. [25] (Australia) 5 (m and f) app and sen 28.8 ± 10.1 DXA BMD: WB

BMD (g/cm2)

WB: 1.157 ± 0.07

Warrington et al. [2] (Ireland) 17 (m) flat; 10 (m) NH 26.7 ± 7.6 flat; 28.3 ± 5.3 NH DXA

BMD: WB, LS, TH

BMD T-score: WB, LS, TH

BMD (g/cm2)

WB: 1.05 ± 0.07 flat; 1.21 ± 0.06 NH

LS: 1.12 ± 0.11 flat; 1.22 ± 0.15 NH

TH: 0.99 ± 0.1 flat; 1.08 ± 0.13 NH

T-score

WB: − 1.23 ± 0.99 flat; − 0.16 ± 0.82 NH

LS: − 0.91 ± 0.84 flat; − 0.3 ± 1.18 NH

TH: − 0.67 ± 0.87 flat; − 0.11 ± 1.01 NH

Dolan et al. [26] (Ireland) 14 (m) flat; 16 (m) NH 25.0 ± 7.0 flat; 24.0 ± 4.0 NH DXA

BMD, BMC and BA: WB, LS (L2–4), FN

BMAD: LS (L2–4), FN

BMD (g/cm2)

WB: 1.09 ± 0.6 flat; 1.17 ± 0.05 NH

LS: 1.10 ± 0.09 flat; 1.15 ± 0.1 NH

FN: 1.05 ± 0.07 flat; 1.07 ± 0.11 NH

BMAD (g/cm3)

LS: 0.14 0.01 flat; 0.14 0.01 NH

FN: 0.39 ± 0.04 flat; 0.38 ± 0.05 NH

Wilson et al. [29]b (UK) 10 (m and f) flat and NH 32.0 ± 6.0 DXA Z-score: LS, TH

Z-score

LS: − 1.32 ± 0.76 (Pre)

TH: − 1.04 ± 1.2 (Pre)

O’Reilly et al. [30] (Hong Kong) 20 (m) flat 29.3 ± 7.8 DXA

BMD: forearm, calcaneus

T and Z-score: forearm, calcaneus

BMD (g/cm2)

Forearm: 0.57 ± 0.07 (left); 0.56 ± 0.06 (right)

Calcaneus: 0.46 ± 0.12 (left); 0.51 ± 0.06 (right)

Z-score

Forearm: 0.02 ± 0.99 (left); − 0.16 ± 1.15 (right)

Calcaneus: − 1.43 ± 0.77 (left); − 1.22 ± 0.79 (right)

Poon et al. [9] (Hong Kong) 14 (m) flat 29.1 ± 6.1 DXA

BMD: calcaneus, forearm

T and Z-score: calcaneus, forearm

BMD (g/cm2)

Calcaneus: 0.50 ± 0.06 (left); 0.51 ± 0.07 (right)

Forearm: 0.58 ± 0.08 (left); 0.56 ± 0.06 (right)

Z-score

Calcaneus: − 1.60 ± 0.90 (left); − 1.42 ± 0.94 (right)

Forearm: − 0.01 ± 1.06 (left); − 0.22 ± 0.92 (right)

Jeon et al. [31] (Korea) 10 (m) flat 31.8 ± 3.7 DXA

BMD: WB

BMC T and Z-score: WB

BMD (g/cm2)

WB: 1.155 ± 0.126

BMC Z-score

WB: 0.00 ± 1.35

Dunne et al. [32] (Ireland) 39 (m) flat; 46 (m) NH 27.7 ± 5.9 NH; 26.8 ± 9.6 flat DXA

BMD and BMC: WB, LS (L1–4), FN, TH

BMAD: LS (L1–4), FN

Z-score ≤  − 1.0: LS (L1–4), FN, TH

Z-score ≤  − 2.0: LS (L1–4), FN

BMD (g/cm2)

WB: 1.115 ± 0.081 flat; 1.244 ± 0.075 NH

LS: 1.072 ± 0.113 flat; 1.163 ± 0.109 NH

FN: 1.026 ± 0.115 flat; 1.100 ± 0.118 NH

TH: 0.985 ± 0.106 flat; 1.057 ± 0.111 NH

BMAD (g/cm3)

LS: 0.125 ± 0.014 flat; 0.124 ± 0.012 NH

FN: 0.389 ± 0.048 flat; 0.395 ± 0.044 NH

Z-score ≤  − 1.0 n [%]

LS: 23 [59] flat; 14 [30] NH

FN: 10 [26] flat; 3 [7] NH

TH: 19 [49] flat; 6 [13] NH

Z-score ≤  − 2.0 n [%]

LS: 8 [21] flat; 3 [7] NH

TH: 2 [5] flat; 1 [2] NH

Cullen et al. [33] (Ireland) 28 (m) flat and NH retired 59.0 ± 6.0 DXA and bone markers

BMD: WB, LS, PF

T-score: WB, LS, PF

P1NP, CTx

BMD (g/cm2)

WB: 1.113 ± 0.142

LS: 1.008 ± 0.163

PF: 0.989 ± 0.154

T-score

WB: − 1.1 ± 0.8

LS: − 0.7 ± 1.1

PF: − 0.8 ± 0.9

CTx: 0.395 ± 0.207

P1NP: 39.66 ± 14.43

Mackinnon et al. [34] (UK) 135 (m) retired 50+ 64.7 ± 9.9 Questionnaire Self-reported osteoporosis 7.4% of the retired jockeys reported as having osteoporosis compared to 1.6% of the reference population

Values are mean ± SD, f female, m male, NH national hunt, app apprentice, con conditional, sen senior, tra trainee, WB whole body, LS lumbar spine, TH total hip, PF proximal femur, FN femoral neck, BMC bone mineral content, BMD bone mineral density, BMAD bone mineral apparent density, CTx C-terminal telopeptide of type I collagen, P1NP procollagen type 1 amino terminal propeptide, Bone ALP bone alkaline phosphate, OC intact osteocalcin, NTx-1 N-telopeptides of type 1 collagen, pQCT peripheral Quantitative Computed Tomography, TBA total bone area, fDPD free deoxypyridinoline cross-links, Supp supplement group, Pla placebo group, RCT randomised controlled trial, SSI strain strength index, 50+ jockeys ≥ 50 years of age

aTable is arranged based on assessment method and racing licence with studies of pQCT first followed by bone turnover markers and DXA in present-day jockeys then retired jockeys

bBaseline measurement of jockeys recruited for study intervention

cExpressed as a ratio with urine creatinine concentration