UK Athletics, Hospital of St. John and St. Elizabeth, and Middlesex University, London, UK.
Int J Sport Nutr Exerc Metab. 2010 Oct;20(5):418-26. doi: 10.1123/ijsnem.20.5.418.
Low bone-mineral density (BMD) is associated with menstrual dysfunction and negative energy balance in the female athlete triad. This study determines BMD in elite female endurance runners and the associations between BMD, menstrual status, disordered eating, and training volume. Forty-four elite endurance runners participated in the cross-sectional study, and 7 provided longitudinal data. Low BMD was noted in 34.2% of the athletes at the lumbar spine, and osteoporosis in 33% at the radius. In cross-sectional analysis, there were no significant relationships between BMD and the possible associations. Menstrual dysfunction, disordered eating, and low BMD were coexistent in 15.9% of athletes. Longitudinal analysis identified a positive association between the BMD reduction at the lumbar spine and training volume (p=.026). This study confirms the presence of aspects of the female athlete triad in elite female endurance athletes and notes a substantial prevalence of low BMD and osteoporosis. Normal menstrual status was not significantly associated with normal BMD, and it is the authors' practice that all elite female endurance athletes undergo dual-X-ray absorptiometry screening. The association between increased training volume, trend for menstrual dysfunction, and increased loss of lumbar BMD may support the concept that negative energy balance contributes to bone loss in athletes.
低骨密度（BMD）与女性运动员三联征中的月经功能障碍和能量负平衡有关。本研究旨在确定精英女性耐力跑运动员的 BMD 以及 BMD、月经状况、饮食紊乱和训练量之间的关系。44 名精英耐力跑运动员参与了横断面研究，其中 7 名提供了纵向数据。34.2%的运动员腰椎骨密度低，33%的运动员桡骨骨质疏松。在横断面分析中，BMD 与可能的关联之间没有显著关系。月经功能障碍、饮食紊乱和低 BMD 在 15.9%的运动员中同时存在。纵向分析发现腰椎 BMD 减少与训练量呈正相关（p=.026）。本研究证实了女性运动员三联征在精英女性耐力运动员中的存在，并指出低 BMD 和骨质疏松症的发病率相当高。正常的月经状况与正常的 BMD 没有显著关联，作者的做法是所有精英女性耐力运动员都要接受双能 X 线吸收仪筛查。训练量增加、月经功能障碍趋势和腰椎 BMD 丢失增加之间的关联可能支持能量负平衡导致运动员骨质流失的概念。
