Gymnasts exhibit higher bone mass than runners despite similar prevalence of amenorrhea and oligomenorrhea
Gymnasts exhibit higher bone mass than runners despite similar prevalence of amenorrhea and oligomenorrhea
复制标题
尽管闭经和月经过少的患病率相似，但体操运动员的骨量高于跑步者
DOI：
--
复制
发表时间：
1995
影响因子：
6.2
通讯作者：
R. Marcus
中科院分区：
文献类型：
--
作者：
T. Robinson;C. Snow;D. Taaffe;D. Gillis;J. Shaw;R. Marcus
与不运动的女性相比，女性运动员表现出更高的运动相关闭经和月经减少的患病率，这两种情况都与骨密度（BMD）降低有关，特别是在脊柱。本研究调查了两组具有不同骨骼负荷模式的竞技女运动员：体操运动员和跑步运动员的骨量和月经少经和闭经。采用双能X射线吸收仪（QDR‐1000/W, Hologic Inc., Waltham， MA）对大学体操运动员（n = 21）、跑步运动员（n = 20）和非运动女大学生（n = 19）的股骨颈、腰椎（L2-4）和全身的骨密度（g/cm2）进行了评估。跑步运动员和体操运动员体脂百分比（14.7±2.2%和15.6±2.9%）与对照组（223±3.0%）比较，差异有统计学意义（p < 0.001）。瘦体重（LBM）在各组之间没有差异，但当调整体表面积时，体操运动员的LBM/身高比跑步者和对照组高（p = 0.0001）。与跑步者和对照组相比，体操运动员的四头肌、二头肌和髋内收肌力量的肌肉力量明显更大（p < 0.05）。体操运动员的月经初潮年龄（16.2±1.7年）明显晚于跑步运动员（14.4±1.7年）和对照组（13.0±1.2年）。体操运动员少经和闭经的发生率为47%（6例闭经，4例少经），跑步运动员为30%（3例闭经，3例少经），对照组为0%。此外，运动组有相似的月经史，因为体操运动员经历原发性闭经的比例更高。然而，当从初潮开始评估时，由于初潮的年龄更早，年龄稍大，跑步者的病史更长。各组之间的膳食钙摄入量没有差异，尽管平均值低于RDA 1200毫克/天。从运动组来看，闭经、少经和痛经女性的任何部位的骨密度都没有差异，尽管两组中规律月经的运动员的骨密度都有略高的趋势。与体操运动员和对照组（分别为1.17±0.13和1.11±0.11 g/cm2）相比，跑步运动员的腰椎骨密度（0.98±0.11 g/cm2）较低（p = 0.0001）。各组股骨颈骨密度差异（p = 0.0001）：体操运动员= 1.09±0.12 g/cm2，对照组= 0.97±0.10 g/cm2，跑步运动员= 0.88±0.11 g/cm2。跑步运动员的全身骨密度（1.04±0.06 g/cm2）低于体操运动员（1.11±0.08 g/cm2）和对照组（1.09±0.06 g/cm2） （p < 0.01）。当调整估计的骨大小时，所有组之间腰椎和股骨颈骨矿物质表观密度（BMAD, g/cm3）差异（p = 0.0001）：体操运动员>控制>跑步者。综上所述：(1)体操运动员股骨颈骨密度高于跑步运动员和对照组，月经初潮年龄晚，少经和闭经发生率略高（无统计学意义）；(2)尽管当前和历史月经周期相似，跑步者的骨密度值比体操运动员低；(3)体操训练中由高冲击负荷和肌肉收缩产生的机械力具有强大的成骨作用，这似乎抵消了由少经和闭经引起的骨吸收增加。
Female athletes exhibit a higher prevalence of exercise‐associated amenorrhea and oligomenorrhea compared with nonathletic women, and both conditions are related to reduced bone mineral density (BMD), particularly at the spine. This study investigated bone mass and oligomenorrhea and amenorrhea in two groups of competitive female athletes with different skeletal loading patterns: gymnasts and runners. Bone mineral density (g/cm2) of the femoral neck, lumbar spine (L2–4), and whole body was assessed by dual energy X‐ray absorptiometry (QDR‐1000/W, Hologic Inc., Waltham, MA) in collegiate gymnasts (n = 21) and runners (n = 20), and nonathletic college women (n = 19). The runners and gymnasts had similar values for percent body fat (14.7 ± 2.2% and 15.6 ± 2.9%, respectively), which were lower (p < 0.001) than controls (223 ± 3.0%). Lean body mass (LBM) did not differ among the groups, but when adjusted for body surface area, gymnasts had a higher LBM/height2 (p = 0.0001) compared with runners and controls. Muscle strength was significantly greater (p < 0.05) in gymnasts for quadriceps, biceps, and hip adductor force, compared with runners and controls. Gymnasts had a significantly later menarche age (16.2 ± 1.7 years) compared with runners (14.4 ± 1.7 years) and controls (13.0 ± 1.2 years). The prevalence of oligo‐ and amenorrhea was 47% for gymnasts (6 amenorrheic, 4 oligomenorrheic), 30% for runners (3 amenorrheic, 3 oligomenorrheic), and 0% for controls. Furthermore, athletic groups had similar menstrual histories given the higher proportion of gymnasts who had experienced primary amenorrhea. When evaluated since menarche, however, runners had somewhat longer histories due to an earlier age at menarche and slightly older ages. Dietary calcium intake did not differ among groups, although mean values were below the RDA of 1200 mg/day. By athletic group, BMD at any site did not differ among women with amenorrhea versus oligomenorrhea versus eumenorrhea, although there was a trend for the regularly menstruating athletes in both groups to have slightly higher values. Lumbar spine BMD was lower (p = 0.0001) in runners (0.98 ± 0.11 g/cm2) compared with both gymnasts and controls (1.17 ± 0.13 and 1.11 ± 0.11 g/cm2, respectively). Femoral neck BMD differed among all groups (p = 0.0001): gymnasts = 1.09 ± 0.12 g/cm2 > controls = 0.97 ± 0.10 g/cm2 > runners = 0.88 ± 0.11 g/cm2. Whole body BMD was lower (p < 0.01) in runners (1.04 ± 0.06 g/cm2) compared with gymnasts and controls (1.11 ± 0.08 and 1.09 ± 0.06 g/cm2, respectively). When adjusted for estimated bone size, lumbar spine and femoral neck bone mineral apparent density (BMAD, g/cm3) differed (p = 0.0001) among all groups: gymnasts > controls > runners. In conclusion: (1) gymnasts exhibited higher femoral neck BMD than runners and controls as well as a later age at menarche and a slightly higher (nonsignificant) prevalence of oligo‐and amenorrhea; (2) runners exhibited lower BMD values compared with gymnasts despite similar current and historical menstrual cycle patterns; and (3) the mechanical forces generated from high impact loading and muscular contraction during gymnastics training have powerful osteogenic effects, which appear to counteract the increased bone resorption that has been shown to result from oligo‐ and amenorrhea.
影响因子：
158.5
作者：
DRINKWATER, BL;NILSON, K;SOUTHWORTH, MB
通讯作者：
SOUTHWORTH, MB
闭经运动员中轴和四肢部位的骨矿物质密度低。
影响因子：
4.1
作者：
Myburgh,KH;Bachrach,LK;Lewis,B;Kent,K;Marcus,R
通讯作者：
Marcus,R