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Relationships between hematological variables and bone metabolism in elite female trail runners

hematology
womens-health
sports-injury
sports-medicine

Abstract

Purpose: This study aimed to investigate the relationships between hematological and bone metabolism variables in 35 elite female trail runners, focusing on identifying key predictors of bone health. Methods: A total of 44 hematological variables, including biochemical, hormonal, metabolic, liver enzyme, and iron profiles, as well as complete blood count and platelet indices, were analyzed. Bone mineral density (BMD) and bone mineral content (BMC) were assessed using dual-energy X-ray absorptiometry (DXA) across multiple skeletal regions. A cross-sectional design was employed, utilizing descriptive statistics, correlation analyses, and multiple linear regression to evaluate the impact of hematological markers on BMC and BMD. Results: Significant but moderate associations were identified: magnesium consistently emerged as a negative predictor, particularly influencing BMC and BMD in the lumbar spine (L1-L4) and total body, potentially reflecting mineral mobilization during chronic physical stress. Follicle-stimulating hormone showed positive associations with BMD, suggesting its potential protective role in bone turnover regulation. Additionally, calcium and thyroid hormones contributed to regional bone properties, highlighting site-specific skeletal vulnerabilities. Conclusions: These findings suggest a complex interplay between mineral homeostasis and hormonal balance that may influence skeletal integrity in elite female trail runners, and provide a foundation for developing evidence-based guidelines to support the health and performance of female endurance athletes. However, further research is warranted to confirm these results, explore individual and longitudinal changes, and evaluate the effectiveness of tailored interventions.
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