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基于大样本的病例对照研究:冬奥会背景下女运动员月经紊乱的多因素分析与干预研究。

Multifactor Analysis and Intervention Study on Menstrual Disorders of Female Athletes in the Context of the Winter Olympic Games: A Case-Control Study Based on a Large Sample.

机构信息

1 The First Affiliated Hospital of Hebei North University Department of Obstetrics and Gynecology, Hebei, Zhangjiakou 075000, China.

2 The First Affiliated Hospital of Hebei North University Department of Laboratory Medicine, Hebei, Zhangjiakou 075000, China.

出版信息

Comput Intell Neurosci. 2022 May 14;2022:2985557. doi: 10.1155/2022/2985557. eCollection 2022.

Abstract

A case-control study was conducted to explore the multifactor analysis and intervention of menstrual disorders in female athletes under the background of the Winter Olympic Games, which is based on a large sample. For this purpose, from January 2020 to September 2021, 381 female athletes in long-term ice and snow sports were investigated by random sampling. All of them promoted gynecological examination and counted the incidence of menstrual disorders. The subjects were assigned into two groups according to their menstrual status: abnormal ( = 163) and normal menstrual state groups ( = 218). The basic and clinical data of the two groups were compared, and univariate analysis and multivariate logistic regression analysis were employed to explore the risk factors of menstrual disorders in female athletes. According to the random number table method, the menstrual disorder group was again assigned into the intervention group and the control group. The intervention group received health education and glucose supplement intervention to correct EAMDs, while the control group only received health education. The improvement of patients' ability balance and the changes of reproductive hormones were compared after intervention. The results of univariate analysis indicated that there exhibited no significant differences in age, menarche age, smoking history, drinking history, grade, sexual life history, abortion history, BMI, and location of household registration, but there were significant differences in family history, sleep quality, diet regularity, and mental health status ( < 0.05). The results of univariate analysis indicated that there exhibited no significant differences in age, menarche, smoking, drinking, grade, sexual life history, abortion history, family history, sleep quality, diet regularity, and mental health status. Logistic regression analysis indicated that family history of menstrual disorders, poor sleep quality, irregular diet, and mental health status all affected women's menstrual disorders (OR: 1.411, 95% CI: 1.378∼1.444; OR: 1.501, 95% CI: 1.030∼2.187; OR: 1.554, 95% CI: 1.086∼2.225; OR: 1.383, 95% CI: 1.018∼1.877, respectively) independent risk factors. According to the comparison of menstrual cycle, in the intervention group, 12 patients had menstrual cycle 21-28 days, 12 patients had menstrual cycle 28-38 days, and 58 patients were irregular and had no amenorrhea, while in the control group, 36 patients had menstrual cycle 21-28 days, 24 patients had 28-38 days, 12 patients had amenorrhea, and 11 patients had irregular menstruation, and there exhibited no significant difference ( > 0.05). There exhibited no significant difference in energy balance before and after intervention ( > 0.05); after intervention, the ability balance of the two groups was significantly promoted, and the degree of improvement in the study group was better ( < 0.05). The indexes of reproductive hormones in the follicular phase were compared before and after glucose supplement intervention, and there exhibited no significant difference before intervention ( > 0.05); after intervention, the serum LH and GnRH of the two groups decreased, while FSH and P increased. The improvement degree of the intervention group was better than that of the control group, but there exhibited no significant difference ( > 0.05). Before intervention, there exhibited no significant difference in the serum E2 level in the follicular phase ( > 0.05); after the intervention, the serum E2 of the two groups increased significantly, and the improvement of the intervention group was better ( < 0.05). Before intervention, there exhibited no significant difference in the serum E2 level in the follicular phase ( > 0.05); after the intervention, the serum E2 of the two groups increased significantly, and the improvement of the intervention group was better ( < 0.05). Before intervention, there exhibited no significant difference in serum E2 and P levels in the luteal phase ( > 0.05); after intervention, the level of serum E2 decreased and the level of serum P increased in the two groups. There exhibited no significant difference in the level of serum E2 ( > 0.05). There exhibited significant difference in the serum P level ( < 0.05). Female athletes have a high rate of menstrual disorders. Family history of menstrual disorders, poor sleep quality, irregular diet, and poor mental health are the main risk factors of menstrual disorders. Health education and sugar supplement intervention measures for female athletes play a positive role in the improvement of their ability balance and the regulation of reproductive hormones.

摘要

一项病例对照研究旨在探讨在冬奥会背景下,对长期从事冰雪运动的女性运动员的月经紊乱进行多因素分析和干预。为此,本研究于 2020 年 1 月至 2021 年 9 月,通过随机抽样的方法对 381 名长期从事冰雪运动的女性运动员进行了调查。所有女性运动员都接受了妇科检查,并统计了月经紊乱的发生率。根据月经状况将受试者分为两组:异常组(n=163)和正常月经状态组(n=218)。比较两组的基本临床资料,采用单因素分析和多因素 logistic 回归分析探讨女性运动员月经紊乱的危险因素。根据随机数字表法,将月经紊乱组再次分为干预组和对照组。干预组接受健康教育和葡萄糖补充干预,以纠正 EAMD,而对照组仅接受健康教育。比较干预后患者平衡能力的改善和生殖激素的变化。单因素分析结果表明,两组在年龄、初潮年龄、吸烟史、饮酒史、年级、性生活史、流产史、BMI、户籍所在地方面无显著差异,但在家族史、睡眠质量、饮食规律和心理健康状况方面存在显著差异(<0.05)。单因素分析结果表明,两组在年龄、初潮、吸烟、饮酒、年级、性生活史、流产史、家族史、睡眠质量、饮食规律和心理健康状况方面均无显著差异。Logistic 回归分析表明,家族史、睡眠质量差、饮食不规律和心理健康状况均影响女性月经紊乱(OR:1.411,95%CI:1.378∼1.444;OR:1.501,95%CI:1.030∼2.187;OR:1.554,95%CI:1.086∼2.225;OR:1.383,95%CI:1.018∼1.877,分别)是独立的危险因素。根据月经周期的比较,在干预组中,12 例患者月经周期为 21-28 天,12 例患者月经周期为 28-38 天,58 例患者月经不规律,无闭经;而在对照组中,36 例患者月经周期为 21-28 天,24 例患者月经周期为 28-38 天,12 例患者闭经,11 例患者月经不规律,两组之间无显著差异(>0.05)。干预前后能量平衡无显著差异(>0.05);干预后,两组平衡能力均显著提高,研究组改善程度较好(<0.05)。比较葡萄糖补充干预前后卵泡期生殖激素指标,干预前无显著差异(>0.05);干预后两组血清 LH 和 GnRH 下降,而 FSH 和 P 升高。干预组的改善程度优于对照组,但无显著差异(>0.05)。干预前卵泡期血清 E2 水平无显著差异(>0.05);干预后两组血清 E2 均显著升高,干预组改善程度较好(<0.05)。干预前卵泡期血清 E2 水平无显著差异(>0.05);干预后两组血清 E2 均显著升高,干预组改善程度较好(<0.05)。干预前卵泡期血清 E2 和 P 水平无显著差异(>0.05);干预后两组血清 E2 水平降低,血清 P 水平升高,血清 E2 水平无显著差异(>0.05)。血清 P 水平有显著差异(<0.05)。女性运动员月经紊乱发生率较高。家族史、睡眠质量差、饮食不规律、心理健康状况差是月经紊乱的主要危险因素。对女性运动员进行健康教育和糖补充干预措施,对提高其平衡能力和生殖激素调节有积极作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f11d/9124078/b6f239fe2817/CIN2022-2985557.001.jpg

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