Sensitivity and Specificity of an Energy Availability Threshold in Differentiating Menstrual Status in Exercising Premenopausal Women

The cardiovascular consequences of hypoestrogenism in premenopausal women are unclear. Accordingly, the influence of menstrual status and endogenous estrogen (E2) exposure on blood pressure (BP), heart rate (HR), and calf blood flow in young (18–35 yr) regularly exercising premenopausal women with exercise-associated menstrual aberrations was investigated. Across consecutive menstrual cycles, daily urinary ovarian steroid levels were analyzed, and the area under the curve was calculated to determine menstrual status and E2exposure. BP, HR, blood flow, vascular conductance, and resistance were measured at baseline and following ischemic calf exercise. Exercising subjects consisted of 14 ovulatory (ExOv), 10 short-term (anovulatory and ≤100 days amenorrhea; ST-E2Def), and 8 long-term (>100 days amenorrhea; LT-E2Def) E2-deficient women. Nine sedentary ovulatory subjects (SedOv) were also studied. All groups were similar in age (24.8 ± 0.7 yr), height (164.8 ± 1.3 cm), weight (57.9 ± 0.9 kg), and body mass index (21.3 ± 0.3 kg/m2). E2-deficient groups had lower ( P < 0.002) E2exposure compared with ovulatory groups. Resting systolic BP, HR, blood flow, and vascular conductance were lower ( P < 0.05) and vascular resistance higher ( P < 0.05) in LT-E2Def compared with both ovulatory groups. Peak ischemic blood flow, vascular conductance, and HR were also lower ( P < 0.05) and vascular resistance higher ( P < 0.05) in LT-E2Def compared with all other groups. Our findings show that exercising women with long-term E2deficiency have impaired regional blood flow and lower systolic BP and HR compared with exercising and sedentary ovulatory women. These cardiovascular alterations represent markers of altered vascular function and autonomic regulation of which the long-term effects remain unknown.

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REMEDY: Menstrual Status and Energy Availability in Active Women

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000402873.26127.51 ◽

2011 ◽

Vol 43 (Suppl 1) ◽

pp. 67

Author(s):

Charlotte P. Guebels ◽

Lynn Cialdella-Kam ◽

Gianni Maddalozzo ◽

Melinda M. Manore

Keyword(s):

Energy Availability ◽

Menstrual Status

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Energy availability discriminates clinical menstrual status in exercising women

Journal of the International Society of Sports Nutrition ◽

10.1186/s12970-015-0072-0 ◽

2015 ◽

Vol 12 (1) ◽

pp. 11 ◽

Cited By ~ 29

Author(s):

Jennifer L Reed ◽

Mary De Souza ◽

Rebecca J Mallinson ◽

Jennifer L Scheid ◽

Nancy I Williams

Keyword(s):

Energy Availability ◽

Menstrual Status ◽

Exercising Women

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Current Energy Availability Is Not Associated With The Menstrual Status Among Japanese Female Athletes

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000536596.81126.17 ◽

2018 ◽

Vol 50 (5S) ◽

pp. 461

Author(s):

Eri TAKAI ◽

Rie ISHIZAWA ◽

Mika GOSHOZONO ◽

Machiko OTAKA ◽

Suguru TORII ◽

...

Keyword(s):

Female Athletes ◽

Energy Availability ◽

Menstrual Status ◽

Japanese Female ◽

Current Energy

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Effect of High Dietary Restraint on Energy Availability and Menstrual Status

Medicine & Science in Sports & Exercise ◽

10.1249/mss.0b013e3182910e11 ◽

2013 ◽

Vol 45 (9) ◽

pp. 1790-1797 ◽

Cited By ~ 19

Author(s):

JENNA C. GIBBS ◽

NANCY I. WILLIAMS ◽

REBECCA J. MALLINSON ◽

JENNIFER L. REED ◽

ASHLEY D. RICKARD ◽

...

Keyword(s):

Dietary Restraint ◽

Energy Availability ◽

Menstrual Status

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Anthropometry, CT, and DXA as predictors of GH deficiency in premenopausal women: ROC curve analysis

Journal of Applied Physiology ◽

10.1152/japplphysiol.90998.2008 ◽

2009 ◽

Vol 106 (2) ◽

pp. 418-422 ◽

Cited By ~ 15

Author(s):

Miriam A. Bredella ◽

Andrea L. Utz ◽

Martin Torriani ◽

Bijoy Thomas ◽

David A. Schoenfeld ◽

...

Keyword(s):

Waist Circumference ◽

Body Mass ◽

Sensitivity And Specificity ◽

Roc Curve ◽

Gh Deficiency ◽

Premenopausal Women ◽

High Sensitivity ◽

Curve Analysis ◽

Visceral Adiposity ◽

Roc Curve Analysis

Visceral adiposity is a strong determinant of growth hormone (GH) secretion, and states of GH deficiency are associated with increased visceral adiposity and decreased lean body mass. The purpose of our study was to determine the sensitivity and specificity of different methods of assessing body composition [anthropometry, dual-energy X-ray absorptiometry (DXA), and computed tomography (CT)] to predict GH deficiency in premenopausal women and threshold values for each technique to predict GH deficiency, using receiver operator characteristic (ROC) curve analysis. We studied a group of 45 healthy lean, overweight, and obese premenopausal women who underwent anthropometric measurements (body mass index, waist and hip circumferences, skin fold thickness), DXA, CT, and a GH-releasing hormone-arginine stimulation test. ROC curve analysis was used to determine cutoff values for each method to identify GH deficiency. Visceral adiposity measured by CT showed the highest sensitivity and specificity for identifying subjects with GH deficiency with a cutoff of >9,962 mm2 [area under the curve (AUC), 0.95; sensitivity, 100%; specificity, 77.8%; P = 0.0001]. Largest waist circumference showed high sensitivity and specificity with a cutoff of >101.7 cm (AUC, 0.89; sensitivity, 88.9%; specificity, 75%; P = 0.0001). When the ROC curves of visceral fat measured by CT and largest waist circumference were compared, the difference between the two methods was not statistically significant ( P = 0.36). Our study showed that the largest waist circumference predicts the presence of GH deficiency in healthy premenopausal women with high sensitivity and specificity and nearly as well as CT measurement of visceral adiposity. It can be used to identify women in whom GH deficiency is likely and therefore in whom formal GH stimulation testing might be indicated.

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Body Composition, Energy Availability, Training, and Menstrual Status in Female Runners

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2020-0276 ◽

2020 ◽

pp. 1-6

Author(s):

Johanna K. Ihalainen ◽

Oona Kettunen ◽

Kerry McGawley ◽

Guro Strøm Solli ◽

Anthony C. Hackney ◽

...

Keyword(s):

Body Composition ◽

Body Mass ◽

International Association ◽

Secondary Analysis ◽

Low Energy ◽

Energy Availability ◽

Endurance Running ◽

Fat Percentage ◽

Menstrual Status ◽

Low Energy Availability

Purpose: To determine body composition, energy availability, training load, and menstrual status in young elite endurance running athletes (ATH) over 1 year, and in a secondary analysis, to investigate how these factors differ between nonrunning controls (CON), and amenorrheic (AME) and eumenorrheic (EUM) ATH. Correlations to injury, illness, and performance were also examined. Methods: Altogether 13 ATH and 8 CON completed the Low Energy Availability in Females Questionnaire. Anthropometric, energy intake, and peak oxygen uptake assessments were made at 4 time points throughout the year: at baseline post competition season, post general preparation, post specific preparation, and post competition season the following year. Logs of physical activity, menstrual cycle, illness, and injury were kept by all participants. Performance was defined using the highest International Association of Athletics Federations points prior to and after the study. Results: ATH had significantly lower body mass (P < .008), fat percentage (P < .001), and body mass index (P < .027) compared with CON, while energy availability did not differ between ATH and CON. The Low Energy Availability in Females Questionnaire score was higher in ATH than in CON (P < .028), and 8 ATH (vs zero CON) were AME. The AME had significantly more injury days (P < .041) and ran less (P < .046) than EUM, while total annual running distance was positively related to changes in performance in ATH (r < .62, P < .043, n < 11). Conclusions: More than half of this group of runners was AME, and they were injured more and ran less than their EUM counterparts. Furthermore, only the EUM runners increased their performance over the course of the year.

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Autophagy and ageing: implications for age-related neurodegenerative diseases

Essays in Biochemistry ◽

10.1042/bse0550119 ◽

2013 ◽

Vol 55 ◽

pp. 119-131 ◽

Cited By ~ 37

Author(s):

Bernadette Carroll ◽

Graeme Hewitt ◽

Viktor I. Korolchuk

Keyword(s):

Neurodegenerative Diseases ◽

Energy Availability ◽

Future Studies ◽

Intracellular Degradation ◽

Age Related ◽

Autophagy Induction ◽

Social Importance ◽

Cellular Dysfunction ◽

Autophagy Activity ◽

Intense Research

Autophagy is a process of lysosome-dependent intracellular degradation that participates in the liberation of resources including amino acids and energy to maintain homoeostasis. Autophagy is particularly important in stress conditions such as nutrient starvation and any perturbation in the ability of the cell to activate or regulate autophagy can lead to cellular dysfunction and disease. An area of intense research interest is the role and indeed the fate of autophagy during cellular and organismal ageing. Age-related disorders are associated with increased cellular stress and assault including DNA damage, reduced energy availability, protein aggregation and accumulation of damaged organelles. A reduction in autophagy activity has been observed in a number of ageing models and its up-regulation via pharmacological and genetic methods can alleviate age-related pathologies. In particular, autophagy induction can enhance clearance of toxic intracellular waste associated with neurodegenerative diseases and has been comprehensively demonstrated to improve lifespan in yeast, worms, flies, rodents and primates. The situation, however, has been complicated by the identification that autophagy up-regulation can also occur during ageing. Indeed, in certain situations, reduced autophagosome induction may actually provide benefits to ageing cells. Future studies will undoubtedly improve our understanding of exactly how the multiple signals that are integrated to control appropriate autophagy activity change during ageing, what affect this has on autophagy and to what extent autophagy contributes to age-associated pathologies. Identification of mechanisms that influence a healthy lifespan is of economic, medical and social importance in our ‘ageing’ world.

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