Rickenlund Anette, Eriksson Maria J, Schenck-Gustafsson Karin, Hirschberg Angelica Lindén
Research Laboratory for Reproductive Health, Department of Obstetrics and Gynecology, C4-U1, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
J Clin Endocrinol Metab. 2005 Jun;90(6):3162-7. doi: 10.1210/jc.2004-1964. Epub 2005 Mar 15.
Athletic amenorrhea has been associated with endothelial dysfunction and unfavorable lipid profile. Estrogen substitution may reverse these metabolic consequences. The aim of this study was to evaluate the effects of oral contraceptives (OCs) on endothelial function measured as flow-mediated dilatation (FMD) of the brachial artery, the lipid profile, and blood markers of endothelial activation (inflammation) in amenorrheic athletes. Age- and body mass index-matched groups of young endurance athletes with amenorrhea (n = 11), regularly cycling athletes (n = 13), and sedentary controls (n = 12) were examined before and after 9 months of treatment with a low dose, monophasic, combined OC (30 mug ethinyl estradiol and 150 mug levonorgestrel). The amenorrheic athletes displayed the lowest FMD at baseline and the largest increase after OC treatment. FMD also increased in the control group, but not in the regularly menstruating athletes, who had the highest values of FMD before treatment. All three groups, particularly the controls, showed moderate unfavorable changes in the lipid profile in accordance with previous known effects of a second generation OC. Furthermore, there was an overall increase in some inflammatory markers (high sensitive C-reactive protein and TNF-alpha) and a decrease in one of the markers (vascular cell adhesion molecule-1). We conclude that amenorrheic athletes benefit from treatment with OC with respect to endothelial function. OC treatment is also associated with some modest alterations in the lipid profile and in markers of inflammation.
运动性闭经与内皮功能障碍及不良血脂谱有关。雌激素替代可能会逆转这些代谢后果。本研究的目的是评估口服避孕药（OCs）对闭经运动员肱动脉血流介导的扩张（FMD）所测量的内皮功能、血脂谱以及内皮激活（炎症）血液标志物的影响。对年龄和体重指数匹配的闭经年轻耐力运动员组（n = 11）、定期骑自行车的运动员组（n = 13）和久坐对照组（n = 12）在使用低剂量单相复方OC（30 μg炔雌醇和150 μg左炔诺孕酮）治疗9个月前后进行检查。闭经运动员在基线时FMD最低，OC治疗后增加幅度最大。对照组的FMD也增加了，但在治疗前FMD值最高的规律月经运动员中未增加。所有三组，尤其是对照组，根据第二代OC的先前已知作用，血脂谱出现了中度不良变化。此外，一些炎症标志物（高敏C反应蛋白和TNF-α）总体增加，而其中一种标志物（血管细胞黏附分子-1）减少。我们得出结论，闭经运动员在内皮功能方面从OC治疗中获益。OC治疗还与血脂谱和炎症标志物的一些适度改变有关。
