Hypoestrogenism in Amenorrheic Athletes Modulates Cardiovascular Function
Bibliographic record
Abstract
0218 The most severe menstrual dysfunction associated with the Female Athlete Triad (FAT) is amenorrhea, which is characterized by chronic hypoestrogenism. The FAT identifies that amenorrheic athletes may also present with impaired bone health and disordered eating, and more recently, endothelial cell dysfunction. One of the earliest indicators of cardiovascular disease is in fact alterations in endothelial function. PURPOSE: To examine the Influence of chronic hypoestrogenism on markers of cardiovascular function, including peripheral blood flow, an index of endothelial function, in amenorrheic (AM) and eumenorrheic (EU) athletes. METHODS: On days 2–6 in AM (of two 30-day intervals) and during the early follicular phase (days 2–6 of two menstrual cycles) in EU subjects, flow-mediated endothelial-dependent vasodilation at rest and following peak ischemic blood flow was assessed by strain-gauge plethysmography, and blood samples were drawn. Estradiol, nitric oxide (NO), and endothelin-1 (ET-1) were assessed as the mean of the two samples collected. Estradiol levels during test conditions were similar (p = 0.186) between the groups, assuring results attributable to chronic differences in estradiol exposure. RESULTS: The EU (n = 14) and AM (n = 8) groups were similar (p>0.05) with respect to age (25.7±0.9 yrs), height (164.0±0.1 cm) weight (56.3±1.0 kg), age at menarche (12.4±0.2 yrs) and VO2max (44.0±1.1 ml/kg/min). AM athletes had lower resting (2.2±0.1 vs 4.8±0.4, p<0.001) and peak ischemic (42.8±2.1 vs 52.9±2.0; p = 0.004) blood flow responses (ml/100ml/min). AM also had lower resting supine heart rate (50.5±4.8 vs 58.8±1.9; p = 0.07), and supine resting systolic blood pressure (BP) (90.4±5.7 vs 106.8±2.0mmHg; p = 0.004), compared to their EU counterparts. No difference in AM athletes was observed for resting diastolic BP (p = 0.334), resting mean arterial pressure (p = 0.51), serum nitrates (p = 0.117), and ET-1 (p = 0.469) levels, when compared to EU athletes. CONCLUSIONS: In light of the known link between estrogen and vascular function, the observed attenuated blood flow response is likely a consequence of the chronic hypoestrogenism in the AM athletes. These findings confirm altered flowmediated endothelial-dependent vasodilation. Lower resting heart rate and systolic BP may be indicative of altered autonomic regulation, similar to that seen in anorexia nervosa patients. These findings represent an additional health paradigm associated with the FAT and suggests that hypoestrogenism in amenorrheic athletes may lead to deleterious cardiovascular outcomes. Funded by Arthur Thornton Cardiopulmonary Fund.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".