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Is There an Association between Athletic Amenorrhea and Endothelial Cell Dysfunction?

ZENI HOCH, ANNE1; DEMPSEY, RANIA L.2; CARRERA, GUILLERMO F.3; WILSON, CHARLES R.3; CHEN, ELLEN H.4; BARNABEI, VANESSA M.5; SANDFORD, PAUL R.6; RYAN, TRACEY A.8; GUTTERMAN, DAVID D.7

Medicine & Science in Sports & Exercise: March 2003 - Volume 35 - Issue 3 - p 377-383
doi: 10.1249/01.MSS.0000053661.27992.75
CLINICAL SCIENCES: Clinical Investigations

HOCH, A. Z., R. L. DEMPSEY, G. F. CARRERA, C. R. WILSON, E. H. CHEN, V. M. BARNABEI, P. R. SANDFORD, T. A. RYAN, and D. D. GUTTERMAN. Is There an Association between Athletic Amenorrhea and Endothelial Cell Dysfunction? Med. Sci. Sports Exerc., Vol. 35, No. 3, pp. 377–383, 2003.

Purpose To test the hypothesis that young females with athletic amenorrhea and oligomenorrhea show signs of early cardiovascular disease manifested by decreased endothelium-dependent dilation of the brachial artery.

Methods Ten women with athletic amenorrhea (mean ± SE, age 21.9 ± 1.2 yr), 11 with oligomenorrhea (age 20.8 ± 1.1 yr), and 11 age-matched controls (age 20.2 ± 1.1 yr) were studied. Study subjects were amenorrheic an average of 2.3 (range 0.6–5) yr and oligomenorrheic an average of 6.2 yr. All ran a minimum of 25 miles·wk−1. They were nonpregnant and free of metabolic disease. Brachial artery flow-mediated dilation (endothelium-dependent) was measured with a noninvasive ultrasound technique in each group.

Results Endothelium-dependent brachial artery dilation was reduced in the amenorrheic group (1.08 ± 0.91%) compared with oligomenorrheic (6.44 ± 1.3%;P < 0.05) and eumenorrheic (6.38 ± 1.4%;P < 0.05) groups.

Conclusion Athletic amenorrhea is associated with reduced endothelium-dependent dilation of the brachial artery. This may predispose to accelerated development of cardiovascular disease.

1Sports Medicine Center, Departments of Orthopaedic Surgery/Cardiovascular Center;

2Family & Community Medicine;

3Radiology;

4Cardiovascular Medicine;

5Patrick & Margaret McMahon Obstetrics & Gynecology;

6Physical Medicine and Rehabilitation; and

7Cardiovascular Center, Zablocki Veterans Administration Medical Center, Medical College of Wisconsin, Milwaukee, WI; and

8Froedtert Memorial Lutheran Hospital, Milwaukee, WI

Address for correspondence: Anne Zeni Hoch, D.O., Sports Medicine Center, Women’s Sports Medicine Program, Departments of Orthopaedic Surgery/Cardiovascular Center, 9200 West Wisconsin Avenue, Medical College of Wisconsin, Milwaukee, WI 53226; E-mail: azeni@mcw.edu.

Submitted for publication March 2002.

Accepted for publication November 2002.

©2003The American College of Sports Medicine