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Clin J Sport Med. 2011 Mar;21(2):119-25. doi: 10.1097/JSM.0b013e3182042a9a.

Association between the female athlete triad and endothelial dysfunction in dancers.

Author information

1
Department of Orthopaedic Surgery, Medical College of Wisconsin, 9200 West Wisconsin Ave., Milwaukee, WI 43226, USA. azeni@mcw.edu

Abstract

OBJECTIVE:

To determine the prevalence of the 3 components of the female athlete triad [disordered eating, menstrual dysfunction, low bone mineral density (BMD)] and their relationships with brachial artery flow-mediated dilation in professional dancers.

DESIGN:

Prospective study.

SETTING:

Academic institution in the Midwest.

PARTICIPANTS:

Twenty-two professional ballet dancers volunteered for this study.

INTERVENTIONS:

The prevalence of the female athlete triad and its relationship to endothelial dysfunction.

MAIN OUTCOME MEASURES:

Subjects completed questionnaires to assess disordered eating and menstrual status/history. They also completed a 3-day food record and wore an accelerometer for 3 days to determine energy availability. Serum baseline thyrotropin, prolactin, and hormonal concentrations were obtained. Bone mineral density and body composition were measured with a GE Lunar Prodigy dual-energy X-ray absorptiometry. Endothelial function was determined as flow-mediated vasodilation measured by high-frequency ultrasound in the brachial artery. An increase in brachial diameter <5% to hyperemic flow stimulus was defined a priori as endothelial dysfunction.

RESULTS:

Seventeen dancers (77%) had evidence of low/negative energy availability. Thirty-two percent had disordered eating (EDE-Q score). Thirty-six percent had menstrual dysfunction and 14% were currently using hormone contraception. Twenty-three percent had evidence of low bone density (Z-score < -1.0). Sixty-four percent had abnormal brachial artery flow-mediated dilation (<5%). Flow-mediated dilation values were significantly correlated with serum estrogen and whole-body and lumbar BMD. All the 3 components of the triad plus endothelial dysfunction were present in 14% of the subjects.

CONCLUSIONS:

Endothelial dysfunction was correlated with reduced BMD, menstrual dysfunction, and low serum estrogen. These findings may have profound implications for cardiovascular and bone health in professional women dancers.

PMID:
21358502
PMCID:
PMC3570811
DOI:
10.1097/JSM.0b013e3182042a9a
[Indexed for MEDLINE]
Free PMC Article
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