Dual-energy X-ray absorptiometry per cent fat Z-score as a predictor of menstrual status in adolescent and young adult female athletes

The authors aimed to determine whether the dual-energy X-ray absorptiometry (DXA)-derived %fat Z-score can more effectively predict menstrual status in female athletes compared to traditional measures like body mass index (BMI) and percent expected body weight (%EBW). Their findings indicate that a %fat Z-score cut-off of < -1.0 significantly improves sensitivity for identifying amenorrhoea and oligomenorrhoea in athletes, suggesting it may be a more appropriate target for treatment than conventional BMI or %EBW thresholds. However, the %fat Z-score did not enhance specificity compared to traditional measures.