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Context: Military personnel engage in vigorous exercise, often resulting in higher bone mineral density; however, leg bone injuries occur frequently in this population. Predictors of change in tibial bone quality and strength need to be characterized in this high-risk population.

Objectives: To examine the effects of an 8-week military training intervention on total body and site-specific bone density and tibial bone quality, serum biomarkers (parathyroid hormone and sclerostin), body composition, and physical performance and to investigate which outcome variables (biomarkers, body composition, and physical performance) predict estimated tibial bone strength in college-aged Reserve Officers' Training Corps (ROTC) participants.

Design: Prospective cohort study.

Setting: University of Oklahoma.

Patients or other participants: The ROTC participants (14 males, 4 females) were matched for sex, age, and mass to physically active control participants (14 males, 4 females). The ROTC participants engaged in an 8-week training intervention, while the physically active control group made no changes to their exercise routines.

Main outcome measure(s): Preintervention general health questionnaires were completed. Pre-, mid-, and postintervention bone scans (dual-energy x-ray absorptiometry and peripheral quantitative computed tomography); serum blood draws (parathyroid hormone and sclerostin); and physical performance measures (muscle strength and aerobic capacity) were obtained.

Results: The ROTC participants exhibited increased hip bone density mineral and content (both P values ≤ .02) after the 8-week intervention. Sclerostin, but not parathyroid hormone, was a positive correlate and predictor in all ROTC models for estimated bone strength at the fracture-prone 38% tibial site (ie, 38% of the tibial length proximal to the distal end of the tibia). Both groups displayed decreased total body and regional fat mass, and ROTC participants' aerobic capacity increased (all P values ≤ .05).

Conclusions: All bone, body composition, and performance measures either improved or were maintained in response to ROTC training. Sclerostin should be further investigated as a potential early indicator of changes in estimated tibial bone strength in military cohorts.


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