Micklesfield L K, Reyneke L, Fataar A, Myburgh K H
Department of Physiology, University of Cape Town Medical School, South Africa.
Clin J Sport Med. 1998 Jul;8(3):155-63. doi: 10.1097/00042752-199807000-00002.
To investigate change in bone mineral density (BMD) in premenopausal women (age, 29-46 years), some of whom were marathon runners with a history of menstrual irregularity.
Longitudinal follow-up.
University medical school.
We investigated 8 sedentary controls (SC) and 19 marathon runners (12 with regular menses (R) and 7 with a history of irregularity (OA) 11.7 +/- 7.9 years before follow-up).
BMD (g/cm2) of lumbar spine (LS) and proximal femur were determined at baseline and follow-up (3-5 years later). We calculated a menstrual history index (MHI) (estimated periods/year since age 13).
Body mass, age at menarche, and femoral BMD were not statistically different. Follow-up LS BMD (g/cm2) was lower (p < 0.01) in OA (0.936 +/- 0.060) than in R (1.043 +/- 0.103) and SC (1.094 +/- 0.077), even when covarying for age or both age and mass. No group changed BMD significantly with time. Current MHI was lower (p < 0.001) in OA (9.7 +/- 1.4) than in R (11.3 +/- 0.5) and SC (11.8 +/- 0.4). MHI for the teenage years was lower in OA than in SC but not in R. OA had significantly lower MHI than did R and SC for the third and fourth decades. Only MHI during the third decade correlated significantly with LS BMD for all subjects.
Restoration of LS BMD deficit in women with prior menstrual irregularity aged over 30 is slow and may never reach the same level as age-related controls; secondly, this may be the result of both bone loss in the third decade of life and reduced acquisition during adolescence.
研究绝经前女性（年龄29 - 46岁）的骨密度（BMD）变化，其中部分女性为有月经不规律史的马拉松运动员。
纵向随访。
大学医学院。
我们调查了8名久坐不动的对照者（SC）和19名马拉松运动员（12名月经规律（R），7名有月经不规律史（OA），随访前11.7±7.9年）。
在基线和随访时（3 - 5年后）测定腰椎（LS）和股骨近端的骨密度（g/cm²）。我们计算了月经史指数（MHI）（自13岁起每年估计的月经周期数）。
体重、初潮年龄和股骨骨密度无统计学差异。即使对年龄或年龄与体重进行协变量调整后，随访时OA组的腰椎骨密度（g/cm²）（0.936±0.060）仍低于R组（1.043±0.103）和SC组（1.094±0.077）（p < 0.01）。没有一组骨密度随时间有显著变化。当前OA组的MHI（9.7±1.4）低于R组（11.3±0.5）和SC组（11.8±0.4）（p < 0.001）。青少年时期OA组的MHI低于SC组，但不低于R组。在第三和第四个十年中，OA组的MHI显著低于R组和SC组。仅第三个十年期间的MHI与所有受试者的腰椎骨密度显著相关。
30岁以上既往有月经不规律的女性腰椎骨密度缺陷的恢复缓慢，可能永远无法达到与年龄匹配对照组相同的水平；其次，这可能是由于生命第三个十年的骨质流失以及青春期骨量获取减少共同导致的。
