Beyond hypoestrogenism in amenorrheic athletes: Energy deficiency as a contributing factor for bone loss

Beyond hypoestrogenism in amenorrheic athletes: Energy deficiency as a contributing factor for bone loss
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除了闭经运动员雌激素低下之外:能量缺乏是骨质流失的一个促成因素

DOI:
--
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发表时间:
2005
影响因子:
1.8
通讯作者:
N. Williams
N. Williams
中科院分区:
医学4区
文献类型:
--
作者:
Mary Jane De Souza;N. Williams

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运动女性闭经的病因与热量摄入和高水平运动能量消耗之间的不匹配有关,从而导致慢性能量不足。这反过来又刺激了补偿机制,如体重减轻,代谢激素改变,或能量守恒,随后导致生殖功能的中枢抑制和伴随的雌激素水平低下。这种生殖功能的抑制与应力性骨折、骨矿物质密度损失、未能达到峰值骨量、骨质减少和骨质疏松症有关。目前普遍认为,慢性雌激素水平低下是运动妇女骨丢失的主要原因。然而,食物限制和能量缺乏对骨密度的影响可能代表了一种非雌激素依赖性的骨丢失机制,该机制涉及运动相关闭经改变的一些代谢相关激素。这些激素(IGF-1和瘦素)在调节这些妇女的骨转换和骨密度中起重要作用。
The etiology of amenorrhea in exercising women is linked to a mismatch between caloric intake and high levels of exercise energy expenditure that results in a chronic energy deficit. This in turn stimulates compensatory mechanisms such as weight loss, metabolic hormone alterations, or energy conservation that subsequently causes a central suppression of reproductive function and concomitant hypoestrogenism. This suppression of reproductive function is associated with stress fractures, loss of bone mineral density, the failure to achieve peak bone mass, osteopenia, and osteoporosis. It has generally been accepted that the chronic hypoestrogenism is the major cause of bone loss in exercising women. However, the effects of food restriction and energy deficiency on bone mineral density likely represents an estrogen-independent mechanism for bone loss that involves some of the metabolic-related hormones altered with exercise-associated amenorrhea. These hormones (IGF-1 and leptin) play an important role in modulating bone turnover and bone mineral density in these women.
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