不同經期狀況大專女性運動員之性荷爾蒙、骨密度與骨代謝指標

Sex Hormones, Bone Mineral Density and Bone Biomarkers in Female Collegiate Athletes with Different Menstrual Status

10.5297/ser.1902.006

林書丞(Shu-Cheng Lin)；羅盛安(Sheng-An Lo)；侯建文(Chien-Wen Hou)；詹貴惠(Kuei-Hui Chan)

經期異常 ； 雌二醇 ； 骨鈣化素 ； 性荷爾蒙结合球蛋白 ； menstrual irregularities ； estradiol ； osteocalcin ； sex hormone binding globulin

大專體育學刊

19卷2期（2017 / 06 / 30）

170 - 182

繁體中文;英文

本研究目的在探討經期正常與異常之大專女性運動員的性荷爾蒙與骨密度、骨代謝指標之差異及相關性。研究以18 種運動項目大專甲組女性運動員為對象，先以問卷調查方式招募經期異常之運動員經期異常(menstrual irregularities, MI) 組 (n = 31) 為對象，並於其經期之中濾泡期抽血測量性荷爾蒙及骨代謝指標之濃度，一週內再以雙能X 光吸收儀測量身體組成與骨密度（測量骨密度及骨礦物質含量）。另招募同運動項目且年齡、身體質量指數相近之經期正常運動員為經期正常 (eumenorrhea, EM) 組 (n = 31) 進行相同之分析與檢測。研究結果顯示：血液值方面，MI 組血液之雌二醇及性荷爾蒙 合球蛋白等性爾蒙顯著低於EM 組，而游離雄性素指數則顯著高於EM 組；在骨密度方面，MI 組全髖骨部位的骨礦物質含量、骨密度皆顯著低於EM 組，股骨頸部位之骨礦物質含量亦顯著低於EM 組，其他指標間則無差異。在相關性方面，腰椎部位的骨密度與性荷爾蒙 合球蛋白達中度負相關，骨礦物質含量與促黃體素達中度正相關，而骨鈣化素則與促黃體素及雌二醇達中度正相關。本研究結論為：與正常者相比，國內經期異常之大專女性運動員其雌二醇、性荷爾蒙 合球蛋白的濃度顯著較低，且在部分骨質密度／含量的量測值也有較低的現象。

The purpose of this study was to investigate the differences and correlations of sex hormones, bone mineral density and bone biomarkers in female collegiate athletes with menstrual irregularities and eumenorrhea. Division I collegiate female athletes from 18 types of sports were recruited into this study. A questionnaire survey was used to select the female athletes with menstrual irregularities and considered them as MI group (n = 31). Fasting blood samples in follicular phase of menstrual cycle were collected from each participant to determine the concentrations of sex hormones and bone biomarkers. The body composition, bone mineral content (BMC) and bone mineral density (BMD) of subjects were assessed by the dual energy X-ray absorptiometry within one week after blood sampling. Athletes of eumenorrhea with similar characteristics of sport, age and body mass index to the MI group were recruited into the EM group (n = 31), and conducted the same procedures with MI group. The results showed that blood concentrations of estradiol (E_2) and sex hormone binding globulin (SHBG) of subjects in MI group were significantly lower than those in EM group. Moreover, the value of free androgen index of subjects in MI group was significantly higher than those in EM group. The BMC and BMD in total hip, as well as the BMC in femoral neck of the participants in MI group were significantly lower than those in EM group. We further noticed that there was a significant negative correlation between BMD in lumbar spine and SHBG. Nevertheless, there were significant positive relationships existed between BMC in lumbar spine and luteinizing hormone (LH), osteocalcin and LH, as well as osteocalcin and E_2. This study concludes that menstrual irregularities in female collegiate athletes showed significantly lower blood concentrations of E_2 and SHBG, as well as lower BMD and BMC in parts of the region area when compared with eumenorrhea female athletes.

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