Army Health and Performance Research, Army Headquarters, Andover, MA, UK.
Division of Surgery and Interventional Science, UCL, London, UK.
Br J Nutr. 2024 Feb 28;131(4):581-592. doi: 10.1017/S0007114523001812. Epub 2023 Sep 21.
This study investigated sex differences in Fe status, and associations between Fe status and endurance and musculoskeletal outcomes, in military training. In total, 2277 British Army trainees (581 women) participated. Fe markers and endurance performance (2·4 km run) were measured at the start (week 1) and end (week 13) of training. Whole-body areal body mineral density (aBMD) and markers of bone metabolism were measured at week 1. Injuries during training were recorded. Training decreased Hb in men and women (mean change (-0·1 (95 % CI -0·2, -0·0) and -0·7 (95 % CI -0·9, -0·6) g/dl, both < 0·001) but more so in women ( < 0·001). Ferritin decreased in men and women (-27 (95 % CI -28, -23) and -5 (95 % CI -8, -1) µg/l, both ≤ 0·001) but more so in men ( < 0·001). Soluble transferrin receptor increased in men and women (2·9 (95 % CI 2·3, 3·6) and 3·8 (95 % CI 2·7, 4·9) nmol/l, both < 0·001), with no difference between sexes ( = 0·872). Erythrocyte distribution width increased in men (0·3 (95 % CI 0·2, 0·4)%, < 0·001) but not in women (0·1 (95 % CI -0·1, 0·2)%, = 0·956). Mean corpuscular volume decreased in men (-1·5 (95 % CI -1·8, -1·1) fL, < 0·001) but not in women (0·4 (95 % CI -0·4, 1·3) fL, = 0·087). Lower ferritin was associated with slower 2·4 km run time ( = 0·018), sustaining a lower limb overuse injury ( = 0·048), lower aBMD ( = 0·021) and higher beta C-telopeptide cross-links of type 1 collagen and procollagen type 1 N-terminal propeptide (both < 0·001) controlling for sex. Improving Fe stores before training may protect Hb in women and improve endurance and protect against injury.
这项研究调查了军事训练中性别差异与铁状态之间的关系，以及铁状态与耐力和肌肉骨骼结果之间的关系。共有 2277 名英国陆军新兵（581 名女性）参加了研究。在训练开始时（第 1 周）和结束时（第 13 周），测量了铁标志物和耐力表现（2.4 公里跑）。在第 1 周测量了全身面积骨密度（aBMD）和骨代谢标志物。记录了训练期间的损伤。训练导致男性和女性的血红蛋白下降（平均变化分别为 -0.1（95%CI -0.2，-0.0）和 -0.7（95%CI -0.9，-0.6）g/dl，均 < 0.001），但女性降幅更大（ < 0.001）。男性和女性的铁蛋白均下降（分别为 -27（95%CI -28，-23）和 -5（95%CI -8，-1）µg/l，均 ≤ 0.001），但男性降幅更大（ < 0.001）。男性和女性的可溶性转铁蛋白受体均增加（分别为 2.9（95%CI 2.3，3.6）和 3.8（95%CI 2.7，4.9）nmol/l，均 < 0.001），但性别间无差异（ = 0.872）。男性红细胞分布宽度增加（0.3（95%CI 0.2，0.4）%， < 0.001），但女性无变化（0.1（95%CI -0.1，0.2）%， = 0.956）。男性平均红细胞体积减少（-1.5（95%CI -1.8，-1.1）fL， < 0.001），但女性无变化（0.4（95%CI -0.4，1.3）fL， = 0.087）。铁蛋白较低与 2.4 公里跑用时较慢（ = 0.018）、下肢过度使用损伤（ = 0.048）、较低的 aBMD（ = 0.021）和较高的 1 型胶原β C 端肽交联物和前胶原 1 N 端前肽有关（均 < 0.001），且校正了性别差异。在训练前改善铁储存可能有助于保护女性的血红蛋白，提高耐力并预防损伤。
