The authors thoroughly review what is known about how such activity effects the endocrine system and how in turn these hormonal responses affect many other organs and systems of the body.
In addition, aspects of endocrinology in non-glandular tissue which have endocrine actions are addressed; for example, adipocytes and the release of leptin and related adipocytokines. Further, a wide range of clinically related topics such as athletic amenorrhea, osteopenia, sarcopenia, and hypogonadism are included. This new edition critically integrates what is known about the complex interaction of the endocrine system in the sports context and will again prove immensely valuable to all physicians and clinical investigators treating those active in sports today.
Show more Show less. From the book reviews: "This is an update of a comprehensive book The target audience includes clinicians prescribing exercise for patients and caring for patients who are athletes, as well as scientists investigating metabolism or the impact of physical activity on endocrine axes.
This is a comprehensive and valuable reference that is well organized and generally well written. Hackney Abbie E. Ovulatory Adaptations 34 Moira A. Petit Jerilynn C. Lebrun Sarah M. Learn how and when to remove these template messages. This article needs attention from an expert in Medicine.
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Endocrinology of Physical Activity and Sport: Second Edition (Contemporary Endocrinology)
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Clinical laboratory sciences. However, it is expensive, limited to imaging extremities and currently mainly used for research purposes Another method used to measure peripheral bone geometry and density is digital X-ray radiogrammetry, which estimates BMD by hand radiographs in children However, this technique, as well as quantitative ultrasound and magnetic resonance imaging, are less commonly used in clinical practice since validation studies establishing their association with VF or non-VF are missing.
Trans-iliac bone biopsy with tetracycline labeling provides the ultimate, invasive diagnostic information on bone material properties, bone formation and resorption activities as well as histomorphometry. Biopsies are useful in establishing the diagnosis and defining bone tissue characteristics and metabolic activity in some cases such as Idiopathic juvenile osteoporosis IJO 30 , However, it is used infrequently as a treatment-monitoring tool in children since it requires general anaesthesia, and response to therapy, in most cases, can be adequately assessed using imaging or fracture history.
As such, biopsies are limited to highly specialized centres and research. Increasing emphasis is being placed on improving functional outcomes, muscle strength and mobility in children with osteoporosis. There are various functional tests used, for example the 6-min walk test 32 , Bruininks Oseretsky Test of Motor Proficiency 33 , gross-motor function measure 34 , Childhood Health Assessment Questionnaire score 35 and the widely used faces pain scale Specific muscle force and power tests include the chair-rise test, mechanography legs 37 , 38 and grip force testing by dynamometry 39 , among others.
Since these tests measure different functional variables, selection depends on disease-specific or case-specific deficits and protocols need to be established. Primary osteoporosis occurs due to an intrinsic skeletal defect of genetic or idiopathic origin.
Endocrinology of Physical Activity and Sport: Second Edition
Recent genetic advances have identified many new subtypes of this condition that are caused by quantitative or qualitative type I collagen defects, with various new classification attempts 41 , 42 , The original classification by Sillence 44 is still used on a clinical basis, as it categorizes the severity of the condition in the individual child quite well: type I mild , IV moderate , II lethal and III severe. Whereas type I patients have an increased fracture rate but deformity or final height reduction is uncommon, more severe perinatal forms type III present with multiple intrauterine fractures that heal with residual bony deformity leading to significant disability.
The most severe form type II is not compatible with life due to pulmonary hypoplasia. Children with OI can have both skeletal as well as extra-skeletal manifestations such as blue sclera, hypermobility, abnormalities of the cranio-cervical junction including basilar invagination, flat feet, dentinogenesis imperfecta and hearing loss. Diagnosis of OI is primarily based on clinical and radiological findings. Material bone density on biopsy in OI is, however, high 45 , and the low BMD on DXA is only a reflection of the deficit in bone volume and mass low tissue density , rather than a problem with bone mineralization.
Genetic confirmation of the condition is not routinely sought when there is a typical family history of autosomal dominant inheritance 46 , as genetic confirmation remains expensive and currently would not change medical management. Recent advances in genetics have identified a number of gene defects causing early onset osteoporosis. Mutations in PLS3 , which encodes plastin 3, a bone regulatory protein, were reported in five families with early onset X-linked osteoporosis with axial and appendicular fractures developing during childhood.
Although the exact mechanism remains unknown, osteoporosis is proposed to occur secondary to defects in mechanosensing in the osteocytes, resulting in effects on bone remodeling Other forms of early-onset osteoporosis involve the WNT signaling pathway, which is essential for normal skeletal homeostasis by inducing osteoblast proliferation and differentiation. Defects in this complex signaling pathway predominantly affect bone formation Low-density lipoprotein receptor-related protein 5 LRP5 , a coreceptor of WNT located on the osteoblast membrane, is the most widely studied.