Bone Mineral Density and Osteoporotic Vertebral Fractures in Traditional, Unassisted, Free-Diving Women (Haenyeos)

Abstract

BackgroundWater pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture.MethodsBetween January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured.ResultsThirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was 72.1 ± 4.7 years and that of the controls was 72.7 ± 4.0 years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers.ConclusionBMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.

Physiology, pathophysiology and (mal)adaptations to chronic apnoeic training: a state-of-the-art review

“…Abbreviations: BMC, bone mineral content; BMD, bone mineral density; CD, capillary density; CKD, chronic kidney disease; Hb, haemoglobin; Mb, myoglobin; MIT, mitochondria; RBC, red blood cell; RTC, reticulocyte; R 95 , diffusion distance. Supporting literature is denoted by the numbers, where; 1 = Bae et al ( 2003 ), 2 = Bouten et al ( 2019 ), 3 = Doerner et al ( 2018 ), 4 = Elia et al ( 2019b ), 5 = Elia et al ( 2020 ), 6 = Engan et al ( 2013 ), 7 = Fernandez et al ( 2017 ), 8 = Hwang et al ( 2006 ), 9 = Johansson and Schagatay ( 2012 ), 10 = Kjeld et al ( 2018 ), 11 = Kohshi et al ( 2014 ), 12 = Nygren-Bonnier et al ( 2007 ), 13 = Oh et al ( 2017 ), 14 = Potkin and Uzsler ( 2006 ), 15 = Seo et al ( 2018 ), 16 = Tanaka et al ( 2016 ). Figure created with BioRender.com …”

“…Furthermore, both of these studies measured total-body BMC and BMD, whereas the use of additional measurement sites, such as the proximal femur, may provide more information with relation to the risk of osteoporotic fracture (Lu et al 2001). Lumbar spine and femoral neck BMD and T-scores were similar in female Ama BHDs compared to NDs, yet these participants were postmenopausal and older (~ 70 years) than those in comparable literature (Seo et al 2018). Importantly, in both groups, the reported T-scores were suggestive of osteopenia (Karaguzel and Holick 2010) and approached the threshold for osteoporosis in this population [≤ −2.5; Kanis (1994), Park et al (2016)], thus indicating that substantial cumulative exposure to the diving environment does not confer benefits with regards to BMD at the lumbar spine and proximal femur.…”

Lumbar Lordosis Angle Value Analysis and Bone Tissue Density in the Ls Section in Women After 50 Years Old

“…The best example of weakening bone tissue is weightlessness. It is also assumed that a similar condition can be obtained during a dive, however water pressure and muscle contractions can have a positive effect on bone mineral density [15].…”