Prevalence of fracture and low bone mineral density in competitive road cyclists

Low bone density is considered a risk factor for fracture. Recent studies have shown that competitive road cyclists have significantly lower bone mineral density (BMD) than matched controls. Objective(s): The aim of this study was to evaluate the possible association between BMD and fracture in competitive cyclists. Method(s): This was a case-control study design including 101 professional road cyclists as cases and 30 healthy males as controls. Result(s): The age-adjusted relative risk of fracture in cyclists was 4.24 (P = 0.002). Cyclists had lower BMD Z-scores at the femur (-0.8 SD 0.95, P < 0.001), lumbar (-0.9 SD 0.75, P < 0.001), and radius UD (-0.5 SD 1.1, P = 0.063) compared to controls. Amongst professional cyclists, 53% had a low lumbar BMD (-1.54 SD 0.35) while the proportion was 32% in elite (-1.49 SD 0.49) and 13% in controls. The number of fracture in cyclists was significantly though weakly correlated with Femoral neck BMD (r = -0.28, P = 0.02). Conclusion(s): While a high prevalence of fracture could be observed in competitive road cyclists as well as a widespread low BMD especially among professional cyclists, no clear relationship could be detected between fracture and low BMD in these well trained endurance athletes.