PhD Scientific Days 2026

Cardiovascular Medicine and Research 2.

Sex differences in the impact of body composition and bone mineral density on cardiopulmonary performance in elite youth water polo athletes

Name of the presenter

Benkő, Regina

Institute/workplace of the presenter

Heart and Vascular Center, Semmelweis University

Authors

Regina Benko¹, Mark Zamodics^1,2, Mate Babity^1,2, Gusztav Schay³, Tamas Leel-Ossy⁴, Zsuzsanna Ladanyi¹, Timea Turschl¹, Dorottya Balla¹, Csongor Mesko¹, Hajnalka Vago^1,2, Attila Kovacs¹, Eva Hosszu⁵, Szilvia Meszaros⁴, Csaba Horvath⁴, Bela Merkely^1,2, Orsolya Kiss^1,2
1: Heart and Vascular Center, Semmelweis University
2: Department of Sports Medicine, Semmelweis University
3: Department of Biophysics and Radiation Biology, Semmelweis University
4: Department of Internal Medicine and Oncology, Semmelweis University
5: Pediatric Center, Tűzoltó Street Department, Semmelweis University

Text of the abstract

Introduction: Body composition, bone mineral density measurements and cardiopulmonary exercise testing (CPET) are valuable tools for monitoring athletes’ aerobic fitness. However, the relationships between these resting and exercise-related indicators remain unclear.
Aims: To compare these parameters by sex, as well as to analyse the correlations in elite athletes.
Method: Our study included 145 elite youth water polo players (age: 15.7±1.6 y; male: 75). Body composition was measured by DEXA, and treadmill CPET was performed using a sport-specific protocol. Multivariate linear regression was used to examine the correlations between lean body mass (LBM), body fat mass (BFM), percent body fat (PBF), bone mineral content (BMC), lumbar, femoral, and radial bone mineral density (LBMD, FNBMD, FTBMD, RBMD), and CPET parameters, including exercise time, absolute and relative maximal oxygen uptake (VO2absmax, VO2relmax), and maximal ventilation (VEmax). Sex differences were evaluated using two-sample t-tests.
Results: In males, LBM, BMC, exercise time, VO2absmax, VO2relmax, and VEmax were higher, while BFM and PBF were lower than in females (p<0.001). Exercise time and VO2relmax negatively correlated with BFM (Est:-2.4e-1,SE:6.1e-2,p<0.001;Est:-4.5e-1,SE:8.7e-2,p<0.001). The VO2absmax positively correlated with BFM (Est:4.6e-2,SE:8.0e-3,p<0.001), LBM (Est:7.3e-2,SE:5.5e-3,p<0.001), BMC (Est:8.9e-1,SE:1.2e-1,p<0.001), FNBMD (Est:1.2,SE:2.7e-1,p<0.001) and RBMD (Est:2.6,SE:4.8e-1,p<0.001). The VEmax positively correlated with LBM (Est:2.3,SE:3.6e-1,p<0.001). Correlations between bone density and CPET proved to be stronger in males.
Conclusion: Our results indicate that body composition and bone density parameters influence CPET outcomes, and their combined evaluation can support the development of personalized diagnostics and athletes’ health.
Funding: This research was supported by the European Union project RRF-2.3.1-21-2022-00004 within the framework of the Artificial Intelligence National Laboratory. This project was supported by a grant from the National Research, Development and Innovation Office (NKFIH) of Hungary (K 135076). Project no. TKP2021-NKTA-46 has been implemented with the support provided by the Ministry of Innovation and Technology of Hungary from the National Research, Development and Innovation Fund, financed under the TKP2021-NKTA funding scheme.