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Percent (%) total femoral bone, quadriceps muscle and subcutaneous fat cross-sectional area change in adolescent and mature volleyball athletes: bar graph showing mean change and 95% confidence interval in females vs. males.
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Significant longitudinal SCF changes occurred in both adolescent and mature athletic women, but not in men. These results, combined with the significant increases in muscle and bone observed in adolescent males only, suggest some sex-specific patterns of change in bone, muscle and adipose tissue, despite examining men and women with very high levels of physical activity. Previous research suggests that healthy women tend to increase SCF with increasing age even in the presence of stable weight[40,43]. Although we evaluated SCF in an anatomical location where women, more so than men, deposit adiposity, results of the current study reveal that increases in SCF occur even in highly active athletes, likely reflecting a crucial role that the SCF appears to play in metabolic homeostasis in women[44]. Despite increases in SCF in young and mature female athletes, no increase in IMF was observed in any group. These findings are inconsistent with data from older women (>50 years of age), where 2-year change in IMF CSA was observed and related to aging[33]. Maintaining physical activity may thus prevent IMF deposits, and in turn potentially prevent detrimental implications of IMF on physical function and performance[17,18].
The lack of correlation of longitudinal change in adipose tissue with that in bone in adolescent males and females, and in mature men, contrasts with the relatively high correlations in longitudinal growth of muscle and bone. These findings appear to suggest that, in terms of bone apposition and growth, there is a tighter relationship between muscle and bone than between adipose tissue and bone in physically highly active subjects, with the potential exception of mature women. It is also important to note that no correlation between muscle and bone growth was observed in adolescent female athletes. That the adolescent females gained the most SCF, which trended strongly towards being correlated with less muscle growth (Table 5), may partly explain the only lack of relationship observed between muscle and bone growth (i.e., due to the mediating influence of increased SCF). Nevertheless, the coupling of muscle and bone change in mature athletes extends previous findings of muscle forces being a strong determinant of bone structure during peak musculoskeletal growth[1,22], by providing evidence of a muscle-bone unit many years after peak growth has ceased. The weak relationship between adipose tissue and bone may be due to the relatively small amounts of body fat observed in the highly active athletes, despite a significant longitudinal SCF increase in adolescent and mature women, or may indicate that leptin and other adipokines influence trabecular bone density and mineral content more so than cortical bone mass and diaphyseal bone size.
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