Short stature and delayed puberty in gymnasts: Influence of selection bias on leg length and the duration of training on trunk length☆,☆☆,★
Section snippets
Active and Retired Gymnasts
We studied 83 active prepubertal and peripubertal female gymnasts (bone age, 5.0-12.8 years; chronological age, 5.6-15.6 years), 110 healthy girls (bone age, 6.5-17.0 years; chronological age, 6.9-16.6 years), 42 retired gymnasts, and 44 age-matched control subjects (chronological age, 20.0-35.5 years). Twenty-one of the 83 gymnasts and the 110 control subjects were assessed every 6 months for 2 years. Thirteen of the 83 active gymnasts retired during the study and were followed up for 12.5 ±
Skeletal Maturation, Stature, and Dietary Intake in Active Gymnasts
In the cross-sectional analyses, skeletal maturation in the 83 active gymnasts was delayed by 1.3 ± 0.1 years (P < .001); there was no difference between bone age and chronological age in the control subjects. The delay in skeletal maturation in the gymnasts worsened with increasing years of training (r = –0.47, P < .0001). There were deficits in standing height (–1.32 ± 0.08 SD), sitting height (–1.24 ± 0.09 SD), and leg length (–1.25 ± 0.08 SD) (all P < .001). As shown in Fig 1, there was no
DISCUSSION
In our study the active gymnasts had short stature and a shift to the right and blunting of the growth velocity curve for total height; 2 mechanisms may have contributed to their deficits in stature. First, reduced leg length may be due to selection bias because the deficit in leg length was present at baseline in the cross-sectional data and did not worsen with increasing duration of gymnastic training. Leg length increased at the same rate as it did in control subjects during 2 years of
Acknowledgements
We thank the gymnasts and coaches from Victorian Institute of Sport, the students and staff from Ivanhoe Girls Grammar School, dietitian Kylie Andrews, and research nurse Jan Edmonds for making this work possible.
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Supported by the Dairy Research and Development Corporation of Australia.
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Reprint requests: Ego Seeman, MD, Endocrine Department, Austin and Repatriation Medical Center, Heidelberg, Melbourne, 3084, Australia.
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0022-3476/2000/$12.00 + 0 9/21/103354