闭经的优秀耐力运动员的神经肌肉表现降低

Reduced Neuromuscular Performance in Amenorrheic Elite Endurance Athletes.

作者信息

Tornberg Åsa B, Melin Anna, Koivula Fiona Manderson, Johansson Anders, Skouby Sven, Faber Jens, Sjödin Anders

机构信息

1Department of Health Sciences, Lund University, Lund, SWEDEN; 2Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, DENMARK; 3Endocrinological and Reproductive Unit, Department of Obstetrics and Gynecology, Herlev Hospital, Herlev, DENMARK; 4Faculty of Health and Medical Sciences, University of Copenhagen, Herlev, DENMARK; and 5Department Endocrinology, Herlev Hospital, Herlev, DENMARK.

出版信息

Med Sci Sports Exerc. 2017 Dec;49(12):2478-2485. doi: 10.1249/MSS.0000000000001383.

DOI:10.1249/MSS.0000000000001383

PMID:28723842

Abstract

INTRODUCTION

Secondary functional hypothalamic amenorrhea (SFHA) is common among female athletes, especially in weight-sensitive sports. The aim of this study was to investigate the link between SFHA and neuromuscular performance in elite endurance athletes.

METHODS

Sixteen eumenorrheic (EUM) and 14 SFHA athletes from national teams and competitive clubs participated. Methods included gynecological examination, body composition (dual-energy x-ray absorptiometry), resting metabolic rate and work efficiency, exercise capacity, knee muscular strength (KMS) and knee muscular endurance (KME), reaction time (RT), blood sampling performed on the third to fifth days of the menstrual cycle, and 7-d assessment of energy availability.

RESULTS

SFHA athletes had lower estrogen (0.12 ± 0.03 vs 0.17 ± 0.09 nmol·L, P < 0.05), triiodothyronine (T3) (1.4 ± 0.2 vs 1.7 ± 0.3 nmol·L, P < 0.01), and blood glucose (3.8 ± 0.3 vs 4.4 ± 0.3 mmol·L, P < 0.001) but higher cortisol levels (564 ± 111 vs 400 ± 140 nmol·L, P < 0.05) compared with EUM athletes. SFHA had a lower body weight (55.0 ± 5.8 vs 60.6 ± 7.1 kg, P < 0.05), but no difference in exercise capacity between groups was found (56.4 ± 5.8 vs 54.0 ± 6.3 mL O2·min·kg). RT was 7% longer, and KMS and KME were 11% and 20% lower compared with EUM athletes. RT was negatively associated with glucose (r = -0.40, P < 0.05), T3 (r = -0.37, P < 0.05), and estrogen (r = -0.43, P < 0.05), but positively associated with cortisol (r = 0.38, P < 0.05). KMS and KME correlated with fat-free mass in the tested leg (FFMleg; r = 0.52, P < 0.001; r = 0.58, P < 0.001) but were negatively associated with cortisol (r = -0.42, P < 0.05; r = -0.59, P < 0.001). FFMleg explained the differences in KMS, while reproductive function and FFMleg independently explained the variability in KME.

CONCLUSIONS

We found lower neuromuscular performance among SFHA compared with EUM athletes linked to a lower FFMleg, glucose, estrogen, T3, and elevated cortisol levels.

摘要

引言

继发性功能性下丘脑性闭经（SFHA）在女性运动员中很常见，尤其是在对体重敏感的运动项目中。本研究的目的是调查精英耐力运动员中SFHA与神经肌肉表现之间的联系。

方法

来自国家队和竞技俱乐部的16名月经正常（EUM）运动员和14名SFHA运动员参与了研究。方法包括妇科检查、身体成分（双能X线吸收法）、静息代谢率和工作效率、运动能力、膝关节肌肉力量（KMS）和膝关节肌肉耐力（KME）、反应时间（RT）、在月经周期的第3至5天进行血液采样以及能量可利用性的7天评估。

结果

与EUM运动员相比，SFHA运动员的雌激素水平较低（0.12±0.03对0.17±0.09nmol·L，P<0.05）、三碘甲状腺原氨酸（T3）水平较低（1.4±0.2对1.7±0.3nmol·L，P<0.01）、血糖水平较低（3.8±0.3对4.4±0.3mmol·L，P<0.001），但皮质醇水平较高（564±111对400±140nmol·L，P<0.05）。SFHA运动员的体重较低（55.0±5.8对60.6±7.1kg，P<0.05），但两组之间的运动能力没有差异（56.4±5.8对54.0±6.3mL O2·min·kg）。与EUM运动员相比，RT长7%，KMS和KME分别低11%和20%。RT与葡萄糖（r=-0.40，P<0.05）、T3（r=-0.37，P<0.05）和雌激素（r=-0.43，P<0.05）呈负相关，但与皮质醇呈正相关（r=0.38，P<0.05）。KMS和KME与受试腿的去脂体重（FFMleg；r=0.52，P<0.001；r=0.58，P<0.001）相关，但与皮质醇呈负相关（r=-0.42，P<0.05；r=-0.59，P<0.001）。FFMleg解释了KMS的差异，而生殖功能和FFMleg独立解释了KME的变异性。