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Ihalainen JK, Mikkonen RS, Ackerman KE, Heikura IA, Mjøsund K, Valtonen M, Hackney AC. Beyond Menstrual Dysfunction: Does Altered Endocrine Function Caused by Problematic Low Energy Availability Impair Health and Sports Performance in Female Athletes? Sports Med 2024:10.1007/s40279-024-02065-6. [PMID: 38995599 DOI: 10.1007/s40279-024-02065-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/13/2024]
Abstract
Low energy availability, particularly when problematic (i.e., prolonged and/or severe), has numerous negative consequences for health and sports performance as characterized in relative energy deficiency in sport. These consequences may be driven by disturbances in endocrine function, although scientific evidence clearly linking endocrine dysfunction to decreased sports performance and blunted or diminished training adaptations is limited. We describe how low energy availability-induced changes in sex hormones manifest as menstrual dysfunction and accompanying hormonal dysfunction in other endocrine axes that lead to adverse health outcomes, including negative bone health, impaired metabolic activity, undesired outcomes for body composition, altered immune response, problematic cardiovascular outcomes, iron deficiency, as well as impaired endurance performance and force production, all of which ultimately may influence athlete health and performance. Where identifiable menstrual dysfunction indicates hypothalamic-pituitary-ovarian axis dysfunction, concomitant disturbances in other hormonal axes and their impact on the athlete's health and sports performance must be recognized as well. Given that the margin between podium positions and "losing" in competitive sports can be very small, several important questions regarding low energy availability, endocrinology, and the mechanisms behind impaired training adaptations and sports performance have yet to be explored.
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Affiliation(s)
- Johanna K Ihalainen
- Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014, Jyväskylä, Finland.
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland.
| | - Ritva S Mikkonen
- Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014, Jyväskylä, Finland
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ida A Heikura
- Canadian Sport Institute-Pacific, Victoria, BC, Canada
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Katja Mjøsund
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland
- National Olympic Training Centre Helsinki, Helsinki, Finland
| | - Maarit Valtonen
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Vijayashankar U, Ramashetty R, Rajeshekara M, Vishwanath N, Yadav AK, Prashant A, Lokeshwaraiah R. Leptin and ghrelin dynamics: unraveling their influence on food intake, energy balance, and the pathophysiology of type 2 diabetes mellitus. J Diabetes Metab Disord 2024; 23:427-440. [PMID: 38932792 PMCID: PMC11196531 DOI: 10.1007/s40200-024-01418-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/12/2024] [Indexed: 06/28/2024]
Abstract
Purpose Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and impaired glucose homeostasis. In recent years, there has been growing interest in the role of hunger and satiety hormones such as ghrelin and leptin in the development and progression of T2DM. In this context, the present literature review aims to provide a comprehensive overview of the current understanding of how ghrelin and leptin influences food intake and maintain energy balance and its implications in the pathophysiology of T2DM. Methods A thorough literature search was performed using PubMed and Google Scholar to choose the studies that associated leptin and ghrelin with T2DM. Original articles and reviews were included, letters to editors and case reports were excluded. Results This narrative review article provides a comprehensive summary on mechanism of action of leptin and ghrelin, its association with obesity and T2DM, how they regulate energy and glucose homeostasis and potential therapeutic implications of leptin and ghrelin in managing T2DM. Conclusion Ghrelin, known for its appetite-stimulating effects, and leptin, a hormone involved in the regulation of energy balance, have been implicated in insulin resistance and glucose metabolism. Understanding the complexities of ghrelin and leptin interactions in the context of T2DM may offer insights into novel therapeutic strategies for this prevalent metabolic disorder. Further research is warranted to elucidate the molecular mechanisms underlying these hormone actions and to explore their clinical implications for T2DM prevention and management.
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Affiliation(s)
- Uma Vijayashankar
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, 570015 India
| | - Rajalakshmi Ramashetty
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, 570015 India
| | - Mahesh Rajeshekara
- Department of Surgical Gastroenterology, Bangalore Medical College and Research Institute, Bangalore, 560002 India
| | - Nagashree Vishwanath
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, 570015 India
| | - Anshu Kumar Yadav
- Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru-15, Mysuru, 570015 India
| | - Akila Prashant
- Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru-15, Mysuru, 570015 India
| | - Rajeshwari Lokeshwaraiah
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, 570015 India
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Męczekalski B, Niwczyk O, Battipaglia C, Troia L, Kostrzak A, Bala G, Maciejewska-Jeske M, Genazzani AD, Luisi S. Neuroendocrine disturbances in women with functional hypothalamic amenorrhea: an update and future directions. Endocrine 2024; 84:769-785. [PMID: 38062345 PMCID: PMC11208264 DOI: 10.1007/s12020-023-03619-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/17/2023] [Indexed: 01/31/2024]
Abstract
Functional hypothalamic amenorrhea (FHA) is one of the most common causes of both primary and secondary amenorrhea in women of reproductive age. It is characterized by chronic anovulation and the absence of menses that appear as a result of stressors such as eating disorders, excessive exercise, or psychological distress. FHA is presumed to be a functional disruption in the pulsatile secretion of hypothalamic gonadotropin-releasing hormone, which in turn impairs the release of gonadotropin. Hypoestrogenism is observed due to the absence of ovarian follicle recruitment. Numerous neurotransmitters have been identified which play an important role in the regulation of the hypothalamic-pituitary-ovarian axis and of which the impairment would contribute to developing FHA. In this review we summarize the most recent advances in the identification of contributing neuroendocrine disturbances and relevant contributors to the development of FHA.
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Affiliation(s)
- Błażej Męczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Olga Niwczyk
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Christian Battipaglia
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy
| | - Libera Troia
- Department of Gynecology and Obstetrics, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Anna Kostrzak
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Gregory Bala
- UCD School of Medicine University College Dublin, D04 V1W8, Dublin, Ireland
| | | | - Alessandro D Genazzani
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Luisi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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Almasi T, Exner-Grave E, Ohlendorf D, Groneberg DA, Wanke EM. [Dance-specific eligibility of vocational ballet students - examinations at a governmental training institution for classical ballet]. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2024; 38:79-88. [PMID: 38663438 DOI: 10.1055/a-2277-8400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
BACKGROUND During their training, pre-professional ballet students are confronted with physical stresses comparable to those of competitive sports. In competitive sports, there are mandatory and binding aptitude tests to ensure that the growing athlete meets the requirements. In ballet, there are no such mandatory examinations preceding the start of training. For adult professional dancers, musculoskeletal ideals could be isolated from the dance medicine literature. However, only a few studies describe musculoskeletal characteristics of pre-professional ballet students. It is neither known at what age a student should meet the ideal measurements for an adult nor what deviations from the ideal can be considered normal. This study aims to describe sociodemographic and musculoskeletal characteristics of pre-professional ballet students and discusses to what extent they already meet or deviate from dance-specific eligibility criteria for adult professional ballet dancers. MATERIAL AND METHODS In this study, n = 414 female and n = 192 male students of John Cranko School (JCS) were seen by an experienced orthopaedist and dance physician. Mean age was 13.9 years (SD 3.5, range 5-22 years). Their medical history was taken (age; nationality; start of ballet/training) and a physical examination was performed (height/weight; symmetry of shoulder girdle, spine, waist triangles; pelvic tilt; tibial torsion; range of motion of base of index finger joint, spine, hips, ankle and base of great toe joint). Subsequently, the results of this study were compared with suitability criteria for adult professional ballet dancers that had been isolated from the dance medicine literature for a previous article. RESULTS Examinees were from 49 different nations. 34.6% of the female subjects (≥16 years) were between 165 and 170 cm and 33.3% of the male subjects (≥18 years) were between 178 and 185 cm tall. 45.0% of those examined showed low body weight (<10th percentile, BMI <18.5 kg/m²). The trunk of 61.0-84.8% of those examined was erect and symmetrical. 25.2% had scoliosis. Half (53.5%) were found to have a bilateral external rotation of the hips of at least 60°, and 68.7% had a bilateral internal rotation between 20 and 50°. 87.3% exhibited a bilateral tibial torsion between 15 and 40°. A bilateral en dehors of 90° was calculated for 25.0%. In 9.1% of those examined, the upper ankle joints presented a dorsiflexion of at least 25°, and in 70.2%, a plantarflexion of at least 70° was seen. In 88.0%, the metatarsophalangeal joint of the great toe was 90° (f) and 80° (m) on both sides. CONCLUSION The results of this study showed that pre-professional ballet students fulfil many characteristics of adult professional ballet dancers. High values already among young age groups suggest a ballet-specific selection. Nevertheless, not all students fulfil the theoretical "ideal measurements" for professional classical ballet. These anatomical limits should be considered individually in training to protect the growing pre-professional ballet dancer. The high ballet-specific anatomical demands, but especially the large number of students with a low body weight, underline the necessity of mandatory aptitude tests at the beginning and regular check-ups in the course of training to avert compensatory mechanisms and their consequential damage and to screen for eating disorders and disorders of eating behaviour.
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Affiliation(s)
- Tobias Almasi
- Institut für Arbeits-, Sozial- und Umweltmedizin, Goethe-Universität Frankfurt am Main Fachbereich 16 Medizin, Frankfurt am Main, GERMANY
| | | | - Daniela Ohlendorf
- Institut für Arbeits-, Sozial- und Umweltmedizin, Goethe-Universität Frankfurt am Main Fachbereich 16 Medizin, Frankfurt am Main, GERMANY
| | - David A Groneberg
- Institut für Arbeits-, Sozial- und Umweltmedizin, Goethe-Universität Frankfurt am Main Fachbereich 16 Medizin, Frankfurt am Main, GERMANY
| | - Eileen M Wanke
- Institut für Arbeits-, Sozial- und Umweltmedizin, Goethe-Universität Frankfurt am Main Fachbereich 16 Medizin, Frankfurt am Main, GERMANY
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Cacciatore C, Cangiano B, Carbone E, Spagnoli S, Cid Ramirez MP, Polli N, Bonomi M, Persani L. Body weight variation is not an independent factor in the determination of functional hypothalamic amenorrhea in anorexia nervosa. J Endocrinol Invest 2024; 47:903-911. [PMID: 37812282 DOI: 10.1007/s40618-023-02207-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Functional hypothalamic amenorrhea (FHA) is one of the foremost manifestations in anorexia nervosa (AN), but a subset of patients have menses despite marked weight loss and underweight. The aim of our study was to investigate parameters potentially influencing FHA in AN. DESIGN AND METHODS In this observational retrospective study, we selected 114 female patients with AN who completed a 12 months semi-residential rehabilitation program and a subsequent 12 months outpatient follow-up. We divided our sample into three groups: "Group 0" patients who experienced FHA and recovered their menses, "Group 1" persistent FHA, "Group 2" never experienced FHA, and looked for clinical and hormonal correlations. RESULTS At the enrollment, the BMI was higher in Group 2 than in Group 1 (p = 0.0202), but the last follow-up weight was higher in Group 1 (p < 0.0001) despite persistent amenorrhea. At logistic regression, the higher BMI at which patients experienced amenorrhea was the main prediction factor for persistent FHA. Notwithstanding comparable leptin levels at admission, they improved significantly at discharge only in Groups 0 and 2 (p = 0.0054 and p = 0.0104, respectively). FT3 at admission was significantly higher in Group 2 than in Group 0 (p = 0.0249). CONCLUSIONS FHA does not correlate strictly with body weight variations in AN patients, indicating a multifactorial origin, likely including an individual predisposition. Higher FT3 levels identify patients who continue having menses at extremely low BMI. AN patients with persistent FHA constitute a subgroup in whom estroprogestins should be considered after significant weight recovery to prevent prolonged tissue hypoestrogenism.
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Affiliation(s)
- C Cacciatore
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - B Cangiano
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20100, Milan, Italy
| | - E Carbone
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - S Spagnoli
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - M P Cid Ramirez
- Secciòn Endocrinologia y Diabetes, Hospital Clìnico Universidad del Chile, Santiago, Chile
| | - N Polli
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - M Bonomi
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20100, Milan, Italy
| | - L Persani
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy.
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20100, Milan, Italy.
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Igonin PH, Cognasse F, Gonzalo P, Philippot P, Rogowski I, Sabot T, Boisseau N, Martin C. Monitoring of sprint and change of direction velocity, vertical jump height, and repeated sprint ability in sub-elite female football players throughout their menstrual cycle. SCI MED FOOTBALL 2024:1-9. [PMID: 38492212 DOI: 10.1080/24733938.2024.2328674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
AIMS The aim of this study was to investigate the associations between the early follicular (EF, i.e., menstruation), late follicular (LF), and middle luteal (ML) phases of the menstrual cycle and different factors that may influence football performance. METHODS To this end, 11 eumenorrheic sub-elite female football players underwent field tests to assess sprint speed, lower extremity power, repeated sprint ability, velocity on change of direction, and technical skills at each cycle phase. RESULTS Performance during the 15-m change of direction ability test, 15-m ball dribbling test, squat jump height, total sprint time [sum of 7 sprints] and decrement score [(mean sprint time/best sprint time × 100) - 100], maximum and mean heart rate, and perceived exertion did not significantly differ among menstrual cycle phases. Conversely, the linear sprint velocity over 10, 20, 30-m distances was decreased in EF vs LF (10-, 20- and 30-m) and in ML vs LF (10- and 20-m) (p < 0.05). The 40-m sprint velocity did not change in the different menstrual cycle phases. CONCLUSION Overall, our study suggests that sex hormone fluctuations during the menstrual cycle are not associated with vertical jump, velocity on change of direction, and repeated sprint ability, but may influence linear sprint velocity over short distances (10, 20, and 30 m).
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Affiliation(s)
- P H Igonin
- Laboratoire Inter-universitaire de Biologie de la Motricité (LIBM EA 7424), Université Claude Bernard Lyon I, Lyon, France
- Association Sportive de Saint-Etienne (ASSE), Saint-Etienne, France
| | - F Cognasse
- Institut National de la Santé et de la Recherche Médicale (INSERM U1059), Université Jean Monnet, Saint-Etienne, France
| | - P Gonzalo
- Laboratoire de Biochimie Pharmaco-Toxicologie, Centre Hospitalier Universitaire de Saint-Etienne (CHU), Saint-Etienne, France
| | - P Philippot
- Laboratoire Inter-universitaire de Biologie de la Motricité (LIBM EA 7424), Université Claude Bernard Lyon I, Lyon, France
- Association Sportive de Saint-Etienne (ASSE), Saint-Etienne, France
- Service de Chirurgie Orthopédique, Centre Hospitalier Universitaire de Saint-Etienne (CHU), Saint-Etienne, France
| | - I Rogowski
- Laboratoire Inter-universitaire de Biologie de la Motricité (LIBM EA 7424), Université Claude Bernard Lyon I, Lyon, France
| | - T Sabot
- Association Sportive de Saint-Etienne (ASSE), Saint-Etienne, France
| | - N Boisseau
- Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P), Université Clermont Auvergne, Clermont-Ferrand, France
| | - C Martin
- Laboratoire Inter-universitaire de Biologie de la Motricité (LIBM EA 7424), Université Claude Bernard Lyon I, Lyon, France
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De Martin Topranin V, Engseth TP, Hrozanova M, Taylor M, Sandbakk Ø, Noordhof DA. The Influence of Menstrual-Cycle Phase on Measures of Recovery Status in Endurance Athletes: The Female Endurance Athlete Project. Int J Sports Physiol Perform 2023; 18:1296-1303. [PMID: 37726100 DOI: 10.1123/ijspp.2022-0325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE To investigate the influence of menstrual-cycle (MC) phase on measures of recovery status, that is, resting heart rate, perceived sleep quality, and physical and mental readiness to train, among female endurance athletes. METHODS Daily data were recorded during 1 to 4 MCs (ie, duration ≥21 and ≤35 d, ovulatory, luteal phase ≥10 d) of 41 trained-to-elite-level female endurance athletes (mean [SD]: age 27 [8] y, weekly training: 9 [3] h). Resting heart rate was assessed daily using a standardized protocol, while perceived sleep quality and physical and mental readiness to train were assessed using a visual analog scale (1-10). Four MC phases (early follicular phase [EFP], late follicular phase, ovulatory phase, and midluteal phase [MLP]) were determined using the calendar-based counting method and urinary ovulation-prediction test. Data were analyzed using linear mixed-effects models. RESULTS Resting heart rate was significantly higher in MLP (1.7 beats·min-1, P = .006) compared with EFP without significant differences between the other MC phases. Perceived sleep quality was impaired in MLP compared with late follicular phase (-0.3, P = .035). Physical readiness to train was lower both in ovulatory phase (-0.6, P = .015) and MLP (-0.5, P = .026) compared with EFP. Mental readiness to train did not show any significant differences between MC phases (P > .05). CONCLUSIONS Although significant, the findings had negligible to small effect sizes, indicating that MC phase is likely not the main determinant of changes in measures of recovery status but, rather, one of the many possible stressors.
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Affiliation(s)
- Virginia De Martin Topranin
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Maria Hrozanova
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Madison Taylor
- School of Sport Sciences, UiT Arctic University of Norway, Tromsø, Norway
| | - Øyvind Sandbakk
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- School of Sport Sciences, UiT Arctic University of Norway, Tromsø, Norway
| | - Dionne A Noordhof
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Dupuit M, Meignié A, Chassard T, Blanquet L, LeHeran J, Delaunay T, Bernardeau E, Toussaint JF, Duclos M, Antero J. On-Field Methodological Approach to Monitor the Menstrual Cycle and Hormonal Phases in Elite Female Athletes. Int J Sports Physiol Perform 2023; 18:1169-1178. [PMID: 37666497 DOI: 10.1123/ijspp.2022-0287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 05/17/2023] [Accepted: 06/15/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Currently, there are no guidelines for implementing the monitoring of menstrual status, including the natural menstrual cycle (NC) or oral contraception (OC), in a sport setting. We aimed to provide a feasible, on-field methodological approach for monitoring NC and OC in female athletes. METHODS We developed a smartphone app with daily questionnaires to monitor both NC and OC phases in 19 elite female soccer players (23.7 [4.4] y) over 7 months. Adherence and compliance were evaluated. The NC and OC phases were based on calendar data to establish an individual menstrual profile for each athlete. RESULTS The initial questionnaire revealed that the vast majority of female players (80%) were interested in monitoring their menstrual status. The online monitoring yielded high athlete adherence (87.0% [14.2%]) with a slight decrease over the winter break and at the end of the championship, which necessitated adaptations to promote compliance. Monitoring identified the specific menstrual pattern of each athlete and highlighted large interindividual variability. CONCLUSION This study assesses, for the first time, the interest of female players in monitoring their menstrual status. It provides a new methodological approach, as well as guidelines for optimizing on-field monitoring. It also anticipates some obstacles sport staff may encounter when trying to implement such follow-up. It is essential to better understand the menstrual profile of athletes and determine its potential impacts on well-being and performance.
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Affiliation(s)
- Marine Dupuit
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne (UCA), Clermont-Ferrand, France
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
| | - Alice Meignié
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
| | - Tom Chassard
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
| | - Ludivine Blanquet
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
| | | | | | | | - Jean-François Toussaint
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
- CIMS, Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, Paris, France
| | - Martine Duclos
- Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
- Unité de Nutrition Humaine (UNH), Université Clermont Auvergne (UCA), INRA, Clermont-Ferrand, France
| | - Juliana Antero
- Institute for Research in Medicine and Epidemiology of Sports (IRMES, EA7329), INSEP, Paris, France
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9
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Energy and Macronutrients Intake in Indoor Sport Team Athletes: Systematic Review. Nutrients 2022; 14:nu14224755. [PMID: 36432438 PMCID: PMC9696016 DOI: 10.3390/nu14224755] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Indoor team sports are characterized by matches that are shorter in duration and with frequent substitution (high-intensity intermittent). The main goal of teams is to best cover athletes' physiological demands, while meeting their dietary intake needs is critical. The aim of this study is to conduct a systematic review of the dietary intake of indoor team sports athletes and to analyze whether they comply with nutritional recommendations. A search of PubMed-MEDLINE, Web of Science, and Scopus databases from 2008 to July 2022 was conducted and 2727 documents were identified. The studies focused on adult professional or semi-professional volleyball, basketball, handball, or futsal athletes. Two independent researchers screened and extracted the data, with 20 documents included after they met the inclusion criteria. Most of the athletes, both men and women, did not meet the official recommendations based on under-consumption (energy and carbohydrates) or over-consumption (fats). In relation to protein, 28.6% of studies met the recommendations, with 50% of those who did not meet it being due to under-consumption. Although there are references on athletes' dietary intakes, there are no references considering sexes or types of sport. More adapted recommendations are needed in order to more precisely evaluate athletes' intake to know if they meet their real nutritional requirements.
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Westerman R, Kuhnt AK. Metabolic risk factors and fertility disorders: A narrative review of the female perspective. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2022; 14:66-74. [PMID: 34765754 PMCID: PMC8569630 DOI: 10.1016/j.rbms.2021.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/05/2021] [Accepted: 09/06/2021] [Indexed: 05/12/2023]
Abstract
Metabolic risk factors such as obesity are considered major obstacles to female fertility. Chronic infertility imposes psychological and social burdens on women because infertility violates societal gender roles. Although the prevalence of obesity among women is expected to increase in the future, the relevance of metabolic status for fertility is still underestimated. However, the assessment of metabolic risk factors is highly relevant for understanding fertility disorders and improving infertility treatment. This narrative review discusses the associations of metabolic risk factors (e.g. obesity, female athlete triad, oxidative stress) with significant infertility. An electronic search was conducted for studies published between 2006 and 2020 in Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, PubMed, Scopus, Google Scholar and related databases. In total, this search identified 19,309 results for polycystic ovary syndrome, 28,969 results for endometriosis, and only 1611 results for idiopathic and/or unknown infertility. For the present narrative review, 50 relevant studies were included: 19 studies were on obesity, 24 studies investigated the female athlete triad, and seven studies addressed other risk factors, including reactive oxygen species. This narrative review confirms the direct impact of obesity on female infertility, while the effect of other risk factors needs to be confirmed by large-scale population studies.
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Affiliation(s)
- Ronny Westerman
- Federal Institute of Population Research, Wiesbaden, Germany
| | - Anne-Kristin Kuhnt
- Department of Sociology and Demography, University of Rostock, Rostock, Germany
- Corresponding author.
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Abstract
PURPOSE OF REVIEW Adolescence and young adulthood are a critical period in the life of women for optimizing long-term bone health. Young athletes lead a demanding lifestyle with increased dietary requirements to meet the robust demands of energy expenditure to maintain a state of energy balance. During a time of fast paced changes and unpredictable societal demands on young athletes, it is important to review the severe consequences of energy deficiency and options for adequate management. RECENT FINDINGS This review focuses on hormonal adaptations that occur in energy deficient female athletes that lead to menstrual irregularities and impaired bone health, increasing the risk for stress and other fractures. We also describe management strategies to mitigate the consequences of limited energy availability on bone and other outcomes. SUMMARY These strategies should help guide the management of young female athletes to prevent irreversible changes to their bone health. Identifying current knowledge should help increase awareness among medical providers, which can then be communicated to the sports community, parents, and athletes.
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Affiliation(s)
- Jacqueline Maya
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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12
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Has Menstruation Disappeared? Functional Hypothalamic Amenorrhea-What Is This Story about? Nutrients 2021; 13:nu13082827. [PMID: 34444987 PMCID: PMC8401547 DOI: 10.3390/nu13082827] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/10/2021] [Accepted: 08/14/2021] [Indexed: 01/14/2023] Open
Abstract
Functional hypothalamic amenorrhea (FHA) is a very common condition affecting women of procreative age. There are many reasons for this disorder, including a low availability of energy in the diet, low micro- and macronutrient intake, overly intensive physical activity, disturbed regeneration processes, sleep disorders, stress, and psychological disorders. The main determinant is long-term stress and an inability to handle the effects of that stress. FHA is a very complex disorder and often goes undiagnosed. Moreover, therapeutic interventions do not address all the causes of the disorder, which could have implications for women’s health. As shown by scientific reports, this condition can be reversed by modifying its causes. This review of the literature aims to update the current knowledge of functional hypothalamic amenorrhea and underscores the complexity of the disorder, with particular emphasis on the nutritional aspects and potential interventions for restoring balance.
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Kreisman MJ, Tadrousse KS, McCosh RB, Breen KM. Neuroendocrine Basis for Disrupted Ovarian Cyclicity in Female Mice During Chronic Undernutrition. Endocrinology 2021; 162:bqab103. [PMID: 34037744 PMCID: PMC8272537 DOI: 10.1210/endocr/bqab103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Indexed: 11/19/2022]
Abstract
Chronic undernutrition is a type of metabolic stress that impairs reproduction in multiple species. Although energy balance and female reproductive capacity is recognized as tightly coupled, the neuroendocrine loci and molecular mechanisms that mediate ovarian cycle dysfunction during chronic undernutrition in adult females remain poorly understood. Here, we present a series of studies in which we tested the hypothesis that inhibition of kisspeptin (Kiss1) neurons, which are critical for controlling luteinizing hormone (LH) pulses and the preovulatory LH surge in females, underlies the impairment of the ovarian cycle by undernutrition. We first investigated the effect of chronic undernutrition (70% of unrestricted feed intake) on estrous cyclicity in intact female c57bl6 mice. Undernutrition caused a rapid cessation of ovarian cyclicity during the 2-week treatment, suppressing ovarian steroidogenesis and inhibiting ovulation. Using 2 well-defined estradiol-replacement paradigms, we directly tested the hypothesis that undernutrition inhibits Kiss1 neurons in the arcuate nucleus (ARCKiss1), which are required for LH pulses and in the anteroventral periventricular nucleus (AVPVKiss1), which are necessary for LH surge secretion. Undernutrition prevented LH pulses and impaired ARCKiss1 neuronal activation, using c-Fos as a marker, in ovariectomized females subcutaneously implanted with a pellet containing a diestrus-like level of estradiol. In addition, undernutrition completely blocked the estradiol-induced LH surge and diminished Kiss1 messenger RNA abundance, without decreasing estradiol receptor α (Erα), in micropunches of the AVPV. Collectively, these studies demonstrate that undernutrition disrupts ovarian cyclicity in females via impairment both of ARCKiss1 control of LH pulses and AVPVKiss1 induction of the LH surge.
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Affiliation(s)
- Michael J Kreisman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California 92093-0674, USA
| | - Kirollos S Tadrousse
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California 92093-0674, USA
| | - Richard B McCosh
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California 92093-0674, USA
| | - Kellie M Breen
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California 92093-0674, USA
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Growth Hormone (GH) Treatment Decreases Plasma Kisspeptin Levels in GH-Deficient Adults with Prader-Willi Syndrome. J Clin Med 2021; 10:jcm10143054. [PMID: 34300220 PMCID: PMC8306252 DOI: 10.3390/jcm10143054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 12/27/2022] Open
Abstract
Obesity and growth hormone (GH)-deficiency are consistent features of Prader-Willi syndrome (PWS). Centrally, kisspeptin is involved in regulating reproductive function and can stimulate hypothalamic hormones such as GH. Peripherally, kisspeptin signaling influences energy and metabolic status. We evaluated the effect of 12-month GH treatment on plasma kisspeptin levels in 27 GH-deficient adult PWS patients and analyzed its relationship with metabolic and anthropometric changes. Twenty-seven matched obese subjects and 22 healthy subjects were also studied. Before treatment, plasma kisspeptin concentrations in PWS and obese subjects were similar (140.20 (23.5-156.8) pg/mL vs. 141.96 (113.9-165.6) pg/mL, respectively, p = 0.979)) and higher (p = 0.019) than in healthy subjects (124.58 (107.3-139.0) pg/mL); plasma leptin concentrations were similar in PWS and obese subjects (48.15 (28.80-67.10) ng/mL vs. 33.10 (20.50-67.30) ng/mL, respectively, p = 0.152) and higher (p < 0.001) than in healthy subjects (14.80 (11.37-67.30) ng/mL). After GH therapy, lean body mass increased 2.1% (p = 0.03), total fat mass decreased 1.6% (p = 0.005), and plasma kisspeptin decreased to levels observed in normal-weight subjects (125.1(106.2-153.4) pg/mL, p = 0.027). BMI and leptin levels remained unchanged. In conclusion, 12-month GH therapy improved body composition and decreased plasma kisspeptin in GH deficient adults with PWS. All data are expressed in median (interquartile range).
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Lane AR, Hackney AC, Smith-Ryan AE, Kucera K, Register-Mihalik JK, Ondrak K. Energy Availability and RED-S Risk Factors in Competitive, Non-elite Male Endurance Athletes. TRANSLATIONAL MEDICINE AND EXERCISE PRESCRIPTION 2021; 1:25-32. [PMID: 34296227 PMCID: PMC8294781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Relative Energy Deficiency in Sport (RED-S) is predicated on the assumption that low energy availability (EA) induces deficiencies-dysfunction in multiple physiologic systems. However, research on RED-S and EA in male athletes is limited in comparison to women. The aim of this study is to investigate EA and the risk factors for RED-S, and their potential associations in non-elite male endurance athletes. Laboratory assessments for resting metabolic rate (RMR), bone mineral density (BMD), blood hormonal biomarkers and maximal aerobic capacity were conducted on 60 competitive, recreationally trained male endurance athletes (age=43.4±11.6 years [mean±SD], training=10.9±2.7 h/wk, 7.1±8.8 years). Participants provided 7-days of training logs and 4-days of diet records. Diet and training records were used to calculate EA. Correlations were used to examine associations between EA and RMR, BMD, stress fractures and reproductive, metabolic and bone biomarkers. Mean EA was 28.7±13.4 kcal/kg fat free mass (FFM), which categorized our sample as low EA (based upon published criterion, < 30 kcal/kg FFM) and at a high risk for RED-S. Hormonal and bone biomarkers were in normal clinical ranges, even though EA was low. The only interesting significant association was EA being negatively associated with total body BMD (r = -0.360, P =0.005), opposite of expectations. On average our subjects displayed a state of low EA based upon the criterion which has been primarily developed from female-based research. Nonetheless, our participants displayed no major hormonal or bone health disturbances found in athletes diagnosed with RED-S. A value of < 30 kcal/kg FFM to diagnose low EA may not be appropriate for non-elite endurance trained men.
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Affiliation(s)
- Amy R Lane
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Abbie E Smith-Ryan
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kristen Kucera
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Johna K Register-Mihalik
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kristin Ondrak
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
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16
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Stincic TL, Rønnekleiv OK, Kelly MJ. Membrane and nuclear initiated estrogenic regulation of homeostasis. Steroids 2021; 168:108428. [PMID: 31229508 PMCID: PMC6923613 DOI: 10.1016/j.steroids.2019.108428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/08/2019] [Accepted: 06/18/2019] [Indexed: 11/23/2022]
Abstract
Reproduction and energy balance are inextricably linked in order to optimize the evolutionary fitness of an organism. With insufficient or excessive energy stores a female is liable to suffer complications during pregnancy and produce unhealthy or obesity-prone offspring. The quintessential function of the hypothalamus is to act as a bridge between the endocrine and nervous systems, coordinating fertility and autonomic functions. Across the female reproductive cycle various motivations wax and wane, following levels of ovarian hormones. Estrogens, more specifically 17β-estradiol (E2), coordinate a triumvirate of hypothalamic neurons within the arcuate nucleus (ARH) that govern the physiological underpinnings of these behavioral dynamics. Arising from a common progenitor pool of cells, this triumvirate is composed of the kisspeptin (Kiss1ARH), proopiomelanocortin (POMC), and neuropeptide Y/agouti-related peptide (AgRP) neurons. Although the excitability of these neuronal subpopulations is subject to genomic and rapid estrogenic regulation, kisspeptin neurons are the most sensitive, reflecting their integral function in female fertility. Based on the premise that E2 coordinates autonomic functions around reproduction, we will review the recent findings on the synaptic interactions between Kiss1, AgRP and POMC neurons and how the rapid membrane-initiated and intracellular signaling cascades activated by E2 in these neurons are critical for control of homeostatic functions supporting reproduction.
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Affiliation(s)
- Todd L Stincic
- Department of Physiology and Pharmacology, Oregon Health and Science University, Portland, OR 97239, United States
| | - Oline K Rønnekleiv
- Department of Physiology and Pharmacology, Oregon Health and Science University, Portland, OR 97239, United States; Division of Neuroscience, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, United States
| | - Martin J Kelly
- Department of Physiology and Pharmacology, Oregon Health and Science University, Portland, OR 97239, United States; Division of Neuroscience, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, United States.
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Brunet J, Del Duchetto F, Wurz A. Physical activity behaviors and attitudes among women with an eating disorder: a qualitative study. J Eat Disord 2021; 9:20. [PMID: 33568228 PMCID: PMC7877068 DOI: 10.1186/s40337-021-00377-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) is an integral part of healthcare for the general population and individuals with psychiatric disorders. However, PA is significantly more complex for and related to both healthy (e.g., reduced anxiety and depressive symptoms) and unhealthy outcomes (e.g., intrusive, repetitive thoughts that lead to abnormally high levels of PA) among women with an eating disorder (ED). Consequently, many healthcare professionals recommend abstinence from PA during ED treatment. Despite this, women may remain engaged in PA during ED treatment or resume PA shortly thereafter. Little has been done to understand women's PA behaviors and attitudes and to explore how they integrate PA into their lives during and after ED treatment. Thus, this study sought to explore PA behaviors and attitudes among women with an ED. METHODS Nine women who self-reported receiving an ED diagnosis participated in semi-structured interviews, which were transcribed and analysed thematically. RESULTS Six interrelated themes were constructed to represent participants' PA experiences: PA as a lifestyle, PA can be beneficial, How I feel when I can't do PA, Being cautious about PA, Reactions to healthcare professionals' practice of recommending abstinence from PA during ED treatment, and PA programming thoughts. CONCLUSIONS Overcoming dysfunctional PA behaviors (e.g., engaging in abnormally high levels of PA) and attitudes (e.g., associating PA with caloric expenditure) can be a long and complicated journey for women with an ED. Nevertheless, women with an ED want PA to be integrated into their ED treatment protocol for two key reasons, namely to accrue the benefits associated with PA and to learn how to engage in PA in adaptive and healthy ways.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, Ontario, K1N 6N5, Canada. .,Cancer Therapeutics Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada. .,Institut du savoir Montfort, Hôpital Montfort, 713 Montreal Road, Ottawa, Ontario, K1K 0T2, Canada.
| | - Francis Del Duchetto
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, Ontario, K1N 6N5, Canada.,Present address: Université du Québec à Trois-Rivières, 3351 Boulevard des Forges, Trois-Rivières, Québec, G8Z 4M3, Canada
| | - Amanda Wurz
- Faculty of Kinesiology, University of Calgary, 2500 University Drive, Calgary, Alberta, T2N 1N4, Canada
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Mollah ML, Yang HS, Jeon S, Kim K, Cheon YP. Overaccumulation of Fat Caused Rapid Reproductive Senescence but not Loss of Ovarian Reserve in ob/ob Mice. J Endocr Soc 2020; 5:bvaa168. [PMID: 33324862 PMCID: PMC7722705 DOI: 10.1210/jendso/bvaa168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Indexed: 12/30/2022] Open
Abstract
Ovarian reserve and fertility are reduced by aging and a poor energy balance. To date, the relationships of high energy accumulation and aging with the ovarian reserve have not been elucidated. Here, the effects of obesity on the aging ovarian reserve were evaluated in a leptin-deficient (ob/ob) mouse model. Abnormal estrous cyclicity appeared as early as 6 weeks and worsened with aging. The blood level patterns of 17β-estradiol (E2), testosterone (T), and progesterone (P4) with aging were similar between lean and ob/ob mice. The blood level of E2 but not P4 or T was similar at 24 weeks. Many more atretic follicles but fewer corpora lutea were observed in ob/ob mice than in lean mice within all age groups. Anti-Müllerian hormone (Amh) mRNA levels were similar between genotypes. Dazl, Stra8, and ZP3 mRNAs were highly expressed in ob/ob mice after 12 weeks. Sohlh1 and Ybx2 mRNAs were highly expressed at 24 weeks in ob/ob compared with lean mice. In addition, SOHLH1-positive primordial follicle counts were significantly increased in ob/ob mice at 24 weeks. The proportions of AMH-positive secondary and small antral follicles were similar between genotypes. Together, these results show that the ovarian reserve lasts longer in ob/ob mice than in lean mice, suggesting that the loss of normal physiological or physical status causes decreased fertility at a young age in ob/ob mice and that an increase in adipocytes without leptin, as in ob/ob mice, can improve the ovarian reserve. Such knowledge can be applied to understanding reproductive dysfunction.
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Affiliation(s)
- Mohammad Lalmoddin Mollah
- Division of Development and Physiology, School of Bioscience and Chemistry, Sungshin Women University, Seoul, South Korea
| | - Hee-Seon Yang
- Division of Development and Physiology, School of Bioscience and Chemistry, Sungshin Women University, Seoul, South Korea
| | - SoRa Jeon
- Division of Development and Physiology, School of Bioscience and Chemistry, Sungshin Women University, Seoul, South Korea
| | - KilSoo Kim
- College of Veterinary Medicine, Kyungpook National University, Daegu, Korea
| | - Yong-Pil Cheon
- Division of Development and Physiology, School of Bioscience and Chemistry, Sungshin Women University, Seoul, South Korea
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Choi I, Rickert E, Fernandez M, Webster NJG. SIRT1 in Astrocytes Regulates Glucose Metabolism and Reproductive Function. Endocrinology 2019; 160:1547-1560. [PMID: 31127273 PMCID: PMC6542483 DOI: 10.1210/en.2019-00223] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 04/19/2019] [Indexed: 12/13/2022]
Abstract
Sirtuin 1 (Sirt1) is an NAD-dependent class III deacetylase that functions as a cellular energy sensor. In addition to its well-characterized effects in peripheral tissues, evidence suggests that SIRT1 in neurons plays a role in the central regulation of energy balance and reproduction, but no studies have addressed the contribution of astrocytes. We show here that overexpression of SIRT1 in astrocytes causes markedly increased food intake, body weight gain, and glucose intolerance, but expression of a deacetylase-deficient SIRT1 mutant decreases food intake and body weight and improves glucose tolerance, particularly in female mice. Paradoxically, the effect of these SIRT1 mutants on insulin tolerance was reversed, with overexpression showing greater insulin sensitivity. The mice overexpressing SIRT1 were more active, generated more heat, and had elevated oxygen consumption, possibly in compensation for the increased food intake. The female overexpressing mice were also more sensitive to diet-induced obesity. Reproductively, the mice expressing the deacetylase-deficient SIRT1 mutant had impaired estrous cycles, decreased LH surges, and fewer corpora lutea, indicating decreased ovulation. The GnRH neurons were responsive to kisspeptin stimulation, but hypothalamic expression of Kiss1 was reduced in the mutant mice. Our results showed that SIRT1 signaling in astrocytes can contribute to metabolic and reproductive regulation independent of SIRT1 effects in neurons.
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Affiliation(s)
- Irene Choi
- VA San Diego Healthcare System, San Diego, California
| | - Emily Rickert
- Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California
| | - Marina Fernandez
- Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California
| | - Nicholas J G Webster
- VA San Diego Healthcare System, San Diego, California
- Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California
- Moores Cancer Center, University of California San Diego, La Jolla, California
- Correspondence: Nicholas J. G. Webster, PhD, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093. E-mail:
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La Vignera S, Condorelli RA, Cannarella R, Duca Y, Calogero AE. Sport, doping and female fertility. Reprod Biol Endocrinol 2018; 16:108. [PMID: 30449281 PMCID: PMC6241032 DOI: 10.1186/s12958-018-0437-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 10/24/2018] [Indexed: 01/02/2023] Open
Abstract
This article is a review that addresses the following topics, divided by paragraphs. The first paragraph investigates the effects of physical activity on ovarian function, analyzing in particular the changes concerning the serum concentrations of follicle-stimulating hormone, luteinizing hormone, prolactin, growth hormone, thyroid hormones, leptin, ghrelin, neuropeptide Y. The second paragraph analyzes the effects of doping on the hypothalamic-pituitary-ovarian axis. Finally, the last paragraph analyzes the PCOS category, evaluating the effects of hyperandrogenism in relation to athletic performance.
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Affiliation(s)
- Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy.
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Ylenia Duca
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
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21
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The Role of Lifestyle in Male Infertility: Diet, Physical Activity, and Body Habitus. Curr Urol Rep 2018; 19:56. [DOI: 10.1007/s11934-018-0805-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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22
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International Olympic Committee (IOC) Consensus Statement on Relative Energy Deficiency in Sport (RED-S): 2018 Update. Int J Sport Nutr Exerc Metab 2018; 28:316-331. [PMID: 29771168 DOI: 10.1123/ijsnem.2018-0136] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Aurigemma NC, Koltun KJ, VanEvery H, Rogers CJ, De Souza MJ. Linking the Gut Microbiota to Bone Health in Anorexia Nervosa. Curr Osteoporos Rep 2018; 16:65-75. [PMID: 29417446 DOI: 10.1007/s11914-018-0420-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to examine the anorexia nervosa-microbiota-bone relationship, offering a compilation of the relevant human and animal studies that may contribute to a more comprehensive understanding of potential mechanisms involved. RECENT FINDINGS Recent studies have implicated fermentation by-products of the gut microbiota in bone metabolism. Compromised bone health often accompanies anorexia nervosa due to energy deficiency and hypoestrogenism. The gut microbiome has been implicated as a link between these conditions and impaired bone growth phenotypes. Current research supports decrements in Firmicutes and short-chain fatty acids with increases in Methanobrevibacter smithii and Proteobacteria in anorexia nervosa. A potential mechanism for microbiome-regulated bone growth is through modulation of insulin-like growth factor-1. Future research should aim to examine short-chain fatty acids, probiotics, and prebiotics as alternative therapies to treat low bone density in anorexia nervosa.
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Affiliation(s)
- Nicole C Aurigemma
- Women's Health and Exercise Lab, Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Kristen J Koltun
- Women's Health and Exercise Lab, Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Hannah VanEvery
- Departments of Nutritional Sciences and Clinical and Translational Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Connie J Rogers
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Mary Jane De Souza
- Women's Health and Exercise Lab, Department of Kinesiology and Physiology, The Pennsylvania State University, University Park, PA, 16802, USA
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Southmayd EA, Hellmers AC, De Souza MJ. Food Versus Pharmacy: Assessment of Nutritional and Pharmacological Strategies to Improve Bone Health in Energy-Deficient Exercising Women. Curr Osteoporos Rep 2017; 15:459-472. [PMID: 28831686 DOI: 10.1007/s11914-017-0393-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW The review aims to summarize our current knowledge surrounding treatment strategies aimed at recovery of bone mass in energy-deficient women suffering from the Female Athlete Triad. RECENT FINDINGS The independent and interactive contributions of energy status versus estrogen status on bone density, geometry, and strength have recently been reported, highlighting the importance of addressing both energy and estrogen in treatment strategies for bone health. This is supported by reports that have identified energy-related features (low body weight and BMI) and estrogen-related features (late age of menarche, oligo/amenorrhea) to be significant risk factors for low bone mineral density and bone stress injury in female athletes and exercising women. Nutritional therapy is the recommended first line of treatment to recover bone mass in energy-deficient female athletes and exercising women. If nutritional therapy fails after 12 months or if fractures or significant worsening in BMD occurs, pharmacological therapy may be considered in the form of transdermal estradiol with cyclic oral progestin (not COC).
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Affiliation(s)
- Emily A Southmayd
- Women's Health and Exercise Laboratory, Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Adelaide C Hellmers
- Women's Health and Exercise Laboratory, Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Mary Jane De Souza
- Women's Health and Exercise Laboratory, 104 Noll Laboratory, Department of Kinesiology and Physiology, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA.
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Plasma kisspeptin and ghrelin levels are independently correlated with physical activity in patients with anorexia nervosa. Appetite 2017; 108:141-150. [DOI: 10.1016/j.appet.2016.09.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/01/2016] [Accepted: 09/27/2016] [Indexed: 12/22/2022]
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