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[运动中的相对能量缺乏:诊断、治疗和预防的现代方法]

[Relative energy deficiency in sport: modern approaches to diagnostics, treatment and prevention].

作者信息

Samoilov A S, Zholinsky A V, Rylova N V, Bolshakov I V

机构信息

State Scientific Center - Federal Medical Biophysical Center named after A.I. Burnazyan of Federal Medical Biological Agency, 123098, Moscow, Russian Federation.

Federal Scientific and Clinical Center for Sports Medicine and Rehabilitation FMBA of Russia, 121059, Moscow, Russian Federation.

出版信息

Vopr Pitan. 2022;91(3):32-41. doi: 10.33029/0042-8833-2022-91-3-32-41. Epub 2022 May 4.

Abstract

In recent years, close attention has been paid to energy deficiency in professional athletes. More and more studies confirm the widespread prevalence of relative energy deficiency syndrome in sports and its relationship with various pathological conditions that lead to a decrease in the level of athletic performance. Nowadays the possibilities of early diagnosis and treatment of this syndrome are being carefully studied, and clinical protocols are being actively developed to facilitate the early detection of energy deficiency. of the study was to summarize the modern data on the influence of the syndrome of relative energy deficiency in sports on the health and performance of athletes, as well as to consider effective methods for the diagnosis, treatment and prevention of this syndrome. . The search was carried out using the Google Academy engine and electronic databases PubMed, MEDLINE, EMBASE, Scopus, Web of Science, eLIBRARY for the period from 2017 to 2021. For the search, we used keywords and their combinations: "relative energy deficit in sports", "female athlete triad", "menstrual dysfunction", "osteoporosis". . Based on our analysis, we can conclude that the syndrome of relative energy deficit in sports has a multicomponent negative effect on the athlete's organism and negatively affects his performance, well-being and sports results. Diagnosis of this condition is challenging due to the nonspecificity and variety of symptoms. Key diagnostic methods include physical examination, anamnesis gaining, dual energy X-ray absorptiometry, bioimpedance body composition analysis, and hormonal profile studies. Additional methods include: electrocardiography, study of the basal metabolic rate, hematological examination (hemoglobin, ferritin, etc.), determining the level of energy consumption using diaries of food and physical activity, determining blood vitamin level, etc. To facilitate the screening, diagnosis and follow-up of athletes, it is possible to use specially developed clinical protocols. Non-drug nutritional correction and optimal training plan are the main methods of treatment and prevention of energy deficiency. If this type of treatment is ineffective, hormone therapy should be considered. It is recommended to use transdermal estrogen therapy in combination with shortterm progestin therapy. In some cases, when very low bone mineral density or delayed fracture consolidation is detected, it is possible to use recombinant parathyroid hormone. . Due to the relatively high prevalence of relative energy deficiency syndrome in athletes of both sexes and its long-term negative impact on athlete health and performance, further research is needed to improve the effectiveness of early diagnosis, prevention and treatment of pathological conditions associated with malnutrition.

摘要

近年来,职业运动员的能量缺乏问题受到了密切关注。越来越多的研究证实了相对能量缺乏综合征在体育运动中的广泛存在,以及它与各种导致运动成绩水平下降的病理状况之间的关系。如今,正在仔细研究该综合征的早期诊断和治疗可能性,并积极制定临床方案以促进能量缺乏的早期发现。本研究的目的是总结关于运动中相对能量缺乏综合征对运动员健康和表现影响的现代数据,并探讨诊断、治疗和预防该综合征的有效方法。使用谷歌学术引擎以及电子数据库PubMed、MEDLINE、EMBASE、Scopus、科学网、eLIBRARY进行了2017年至2021年期间的检索。检索时,我们使用了关键词及其组合:“运动中的相对能量缺乏”、“女性运动员三联征”、“月经功能障碍”、“骨质疏松症”。基于我们的分析,我们可以得出结论,运动中相对能量缺乏综合征对运动员机体具有多方面的负面影响,并对其表现、幸福感和运动成绩产生不利影响。由于症状的非特异性和多样性,这种情况的诊断具有挑战性。关键诊断方法包括体格检查、病史采集、双能X线吸收法、生物电阻抗身体成分分析以及激素水平研究。其他方法包括:心电图检查、基础代谢率研究、血液学检查(血红蛋白、铁蛋白等)、通过饮食和身体活动日记确定能量消耗水平、测定血液维生素水平等。为便于对运动员进行筛查、诊断和随访,可以使用专门制定的临床方案。非药物营养纠正和优化训练计划是治疗和预防能量缺乏的主要方法。如果这种治疗方法无效,则应考虑激素治疗。建议采用经皮雌激素治疗联合短期孕激素治疗。在某些情况下,当检测到骨矿物质密度极低或骨折愈合延迟时,可以使用重组甲状旁腺激素。由于相对能量缺乏综合征在男女运动员中患病率相对较高,且对运动员健康和表现具有长期负面影响,因此需要进一步研究以提高与营养不良相关病理状况的早期诊断、预防和治疗效果。

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