大學生「女運動員三症候群」之相關探討

Abstract

本研究目的是探討女學生運動員體型意識、運動訓練與「女運動員三症候群」之相關。研究對象為大學女生（18~22歲），依運動訓練及月經週期之規律性分四組：經期規律運動組20人、經期不規律運動組20人、經期規律靜態組21人及經期不規律靜態組20人；分別進行「飲食、運動與生活習慣問卷」、飲食態度問卷調查、身體組成、跟骨廣頻超音波衰減率之測量、血清雌激素濃度分析、維生素D 受器基因BsmI多型性，及尿液羥基脯胺酸、3-甲基組胺酸、鈣等濃度及其酸鹼值檢測。 結果發現，長期從事運動訓練對女學生運動員之雌激素濃度並未造成干擾，但有延遲初經年齡之趨勢。運動組之期望體型較靜態組纖細，體型不滿意度較高 (p＜.05)，飲食態度得分≧20分者之比例也高於靜態組 (15% vs. 4.8%)。四組受試者之熱量攝取皆未達建議量，但對自我食量有高估之錯誤認知。受試者食物攝取及身體組成之差異，源於運動訓練 (p＜.05)。運動組非正餐之熱量攝取高於靜態組 (p＜.05)，但三餐之熱量攝取則低於靜態組 (p＜.005)，並有較多飲食異常之行為。同體重下，運動組之除脂體重較高，而靜態組則是體脂重較高。運動組之跟骨廣頻超音波衰減率顯著高於不規律靜態組 (p＜.05)，顯示運動對雌激素濃度低下者之骨骼具有保護作用。本研究受試者之BsmI基因多型性頻度分配為BB (4.9%)、Bb (1.2%)與bb (93.8%)，故無法藉由統計探討基因與骨骼健全之關連性。尿液之羥基脯胺酸、3-甲基組胺酸、鈣等濃度，於各組之間無顯著差異。 受試者之體型意識影響其飲食態度，但不影響飲食攝取；長期運動訓練影響身體組成，但不影響血清雌激素濃度。儘管飲食攝取不當，飲食態度扭曲，但本研究受試者目前並未有明顯之「女運動員三症候群」症狀。The purpose of this study was to explore the correlation among body image, exercise training, and ‘female athlete triad’ of university students. Based on exercise training and menstrual status, the university female students (aged 18~22 years) were divided into four groups: regular menstruation/exercise subjects (n=20), irregular menstruation/exercise subjects (n=20), regular menstruation/sedentary subjects (n=21), and irregular menstruation/sedentary subjects (n=20). We examined dietary behavior and exercise habits, Eating Attitudes Test (EAT-26), body composition, calcaneus broadband ultrasound attenuation (BUA), serum estradiol concentration, BsmI polymorphism at the vitamin D receptor (VDR) gene locus, urinary concentrations of hydroxyproline (HP), 3-methylhistidine (3-MH), and calcium, and urinary pH value. We found that serum estradiol concentration was not affected by exercise training which was supposed to delay the age at menarche in athletes. The desire for being slender in the exercise subjects was significantly stronger than the sedentary subjects (p＜.05). The body dissatisfaction in the exercise subjects was significantly higher than the sedentary subjects (p＜.05). Number of subjects with EAT greater than 20 was found to be more in the exercise groups than in the sedentary groups (15% vs. 4.8%). Although self-perceived food intake was overestimated, the energy intake of the female subjects was below the recommendation. The differences in food intake and body composition among the groups were primarily due to exercise effect (p＜.05). The energy intakes from snack and drinks in the exercise subjects were significantly higher than those in the sedentary subjects (p＜.05), whereas the energy intake from meals was significantly lower (p＜.005). Within the same body weight, the fat-free mass in the exercise subjects tended to be higher than that in the sedentary subjects, whereas the fat mass was lower. The BUA of the exercise subjects was significantly higher than that of the irregular menstruation/sedentary subjects (p＜.05). At a low serum concentration of estradiol, exercise demonstrated a protective role on bone mass and bone quality. Since the genotype distribution found in this study was 4.9% BB; 1.2% Bb; and 93.8% bb, the genetic impact on the bone integrity of our subjects could not be explored statistically. There was no significant difference in the urinary HP, 3-MH, and calcium concentrations among the four groups. The body image of the female subjects affected their eating attitudes, but did not affect their dietary intake. Exercise training influenced the body composition, but not the serum estradiol concentration. Although the food intake was inadequate, along with poor eating attitudes, the ‘Female athlete triad’, however, was not observed in the present study.