运动性脑震荡后全身代谢、碳水化合物利用和热量能量平衡：一项初步研究。
Whole-Body Metabolism, Carbohydrate Utilization, and Caloric Energy Balance After Sport Concussion: A Pilot Study.
机构信息
Department of Kinesiology, University of Virginia, Charlottesville, Virginia.
Center for the Study of Retired Athletes and Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
出版信息
Sports Health. 2020 Jul/Aug;12(4):382-389. doi: 10.1177/1941738120923869. Epub 2020 Jun 10.
BACKGROUND
Sport concussion (SC) causes an energy crisis in the brain by increasing energy demand, decreasing energy supply, and altering metabolic resources. Whole-body resting metabolic rate (RMR) is elevated after more severe brain injuries, but RMR changes are unknown after SC. The purpose of this study was to longitudinally examine energy-related changes in collegiate athletes after SC.
HYPOTHESIS
RMR and energy consumption will increase acutely after SC and will return to control levels with recovery.
STUDY DESIGN
Case-control study.
LEVEL OF EVIDENCE
Level 4.
METHODS
A total of 20 collegiate athletes with SC (mean age, 19.3 ± 1.08 years; mean height, 1.77 ± 0.11 m; mean weight, 79.6 ± 23.37 kg; 55% female) were compared with 20 matched controls (mean age, 20.8 ± 2.17 years; mean height, 1.77 ± 0.10 m; mean weight, 81.9 ± 23.45 kg; 55% female). RMR, percentage carbohydrate use (%CHO), and energy balance (EBal; ratio between caloric consumption and expenditure) were assessed 3 times: T, ≤72 hours after SC; T, 7 days after T; and T, after symptom resolution. A 2 × 2 × 3 (group × sex × time) multivariate analysis of variance assessed RMR, %CHO, and EBal. Changes in RMR, %CHO, and EBal (T to T) were correlated with days to symptom-free and days to return to play in the concussed group.
RESULTS
Women reported being symptom-free (median, 6 days; range, 3-10 days) sooner than men (median, 11 days; range, 7-16 days). RMR and %CHO did not differ across time between groups or for group × sex interaction. SC participants had higher EBal than controls at T ( = 0.016) and T ( = 0.010). In men with SC, increasing %CHO over time correlated with days to symptom-free ( = 0.735 and = 0.038, respectively) and days to return to play ( = 0.829 and = 0.021, respectively).
CONCLUSION
Participants with SC were in energy surplus acutely after injury. Although women recovered more quickly than men, men had carbohydrate metabolism changes that correlated with recovery time.
CLINICAL RELEVANCE
This pilot study shows that male and female student-athletes may have differing physiologic responses to SC and that there may be a role for dietary intervention to improve clinical outcomes after SC.
背景
运动性脑震荡 (SC) 通过增加能量需求、减少能量供应和改变代谢资源导致大脑出现能量危机。全身静息代谢率 (RMR) 在更严重的脑损伤后会升高，但 SC 后的 RMR 变化尚不清楚。本研究的目的是纵向研究 SC 后大学生运动员的与能量相关的变化。
假设
RMR 和能量消耗会在 SC 后急性增加，并随着恢复而恢复到对照水平。
研究设计
病例对照研究。
证据水平
4 级。
方法
共有 20 名患有 SC 的大学生运动员（平均年龄 19.3 ± 1.08 岁；平均身高 1.77 ± 0.11 m；平均体重 79.6 ± 23.37 kg；55%为女性）与 20 名匹配的对照组（平均年龄 20.8 ± 2.17 岁；平均身高 1.77 ± 0.10 m；平均体重 81.9 ± 23.45 kg；55%为女性）进行比较。共评估了 RMR、碳水化合物利用率（%CHO）和能量平衡（EBal；热量摄入与消耗的比值）3 次：T，SC 后≤72 小时；T，T 后 7 天；T，症状缓解后。采用 2×2×3（组×性别×时间）多元方差分析评估 RMR、%CHO 和 EBal。RMR、%CHO 和 EBal 的变化（从 T 到 T）与 SC 组症状缓解的天数和恢复运动的天数呈正相关。
结果
女性报告的无症状时间（中位数为 6 天；范围为 3-10 天）早于男性（中位数为 11 天；范围为 7-16 天）。组间或组间性别交互作用在任何时间点 RMR 和%CHO 均无差异。与对照组相比，SC 参与者在 T（=0.016）和 T（=0.010）时的 EBal 更高。在患有 SC 的男性中，随着时间的推移，%CHO 的增加与症状缓解的天数（=0.735 和=0.038，分别）和恢复运动的天数（=0.829 和=0.021，分别）呈正相关。
结论
受伤后，SC 参与者立即出现能量过剩。尽管女性比男性恢复得更快，但男性的碳水化合物代谢变化与恢复时间相关。
临床相关性
这项初步研究表明，男性和女性运动员可能对 SC 有不同的生理反应，并且饮食干预可能在改善 SC 后的临床结果方面发挥作用。
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