Friday K E, Drinkwater B L, Bruemmer B, Chesnut C, Chait A
Department of Medicine, Pacific Medical Center, Seattle, Washington.
J Clin Endocrinol Metab. 1993 Dec;77(6):1605-9. doi: 10.1210/jcem.77.6.8263148.
To determine the interactive effects of hormones, exercise, and diet on plasma lipids and lipoproteins, serum estrogen and progesterone levels, nutrient intake, and plasma lipid, lipoprotein, and apolipoprotein concentrations were measured in 24 hypoestrogenic amenorrheic and 44 eumenorrheic female athletes. When compared to eumenorrheic athletes, amenorrheic athletes had higher levels of plasma cholesterol (5.47 +/- 0.17 vs. 4.84 +/- 0.12 mmol/L, P = 0.003), triglyceride (0.75 +/- 0.06 vs. 0.61 +/- 0.03 mmol/L, P = 0.046), low-density lipoprotein (LDL; 3.16 +/- 0.15 vs. 2.81 +/- 0.09 mmol/L, P = 0.037), high-density lipoprotein (HDL; 1.95 +/- 0.07 vs. 1.73 +/- 0.05 mmol/L, P = 0.007), and HDL2 (0.84 +/- 0.06 vs. 0.68 +/- 0.04 mmol/L, P = 0.02) cholesterol. Plasma LDL/HDL cholesterol ratios, very low-density lipoprotein and HDL3 cholesterol, and apolipoprotein A-I and A-II levels were similar in the two groups. Amenorrheic athletes consumed less fat than eumenorrheic subjects (52 +/- 5 vs. 75 +/- 3 g/day, P = 0.02), but similar amounts of calories, cholesterol, protein, carbohydrate, and ethanol. HDL cholesterol levels in amenorrheic subjects correlated positively with the percent of dietary calories from fat (r = 0.42, n = 23, P = 0.045) but negatively with the percent from protein (r = -0.49, n = 23, P = 0.017). Thus, exercise-induced amenorrhea may adversely affect cardiovascular risk by increasing plasma LDL and total cholesterol. However, cardioprotective elevations in plasma HDL and HDL2 cholesterol may neutralize the risk of cardiovascular disease in amenorrheic athletes.
为了确定激素、运动和饮食对血浆脂质和脂蛋白的交互作用，对24名雌激素水平低的闭经女运动员和44名月经正常的女运动员测量了血清雌激素和孕酮水平、营养摄入以及血浆脂质、脂蛋白和载脂蛋白浓度。与月经正常的运动员相比，闭经运动员的血浆胆固醇（5.47±0.17对4.84±0.12 mmol/L，P = 0.003）、甘油三酯（0.75±0.06对0.61±0.03 mmol/L，P = 0.046）、低密度脂蛋白（LDL；3.16±0.15对2.81±0.09 mmol/L，P = 0.037）、高密度脂蛋白（HDL；1.95±0.07对1.73±0.05 mmol/L，P = 0.007）和HDL2（0.84±0.06对0.68±0.04 mmol/L，P = 0.02）胆固醇水平更高。两组的血浆LDL/HDL胆固醇比值、极低密度脂蛋白和HDL3胆固醇以及载脂蛋白A-I和A-II水平相似。闭经运动员比月经正常的受试者摄入的脂肪更少（52±5对75±3 g/天，P = 0.02），但卡路里、胆固醇、蛋白质、碳水化合物和乙醇的摄入量相似。闭经受试者的HDL胆固醇水平与饮食中来自脂肪的卡路里百分比呈正相关（r = 0.42，n = 23，P = 0.045），但与来自蛋白质的百分比呈负相关（r = -0.49，n = 23，P = 0.017）。因此，运动引起的闭经可能通过增加血浆LDL和总胆固醇对心血管风险产生不利影响。然而，血浆HDL和HDL2胆固醇的心脏保护性升高可能会抵消闭经运动员患心血管疾病的风险。
