IGF-I and IGFBP-1 in Relation to Body Composition and Physical Performance in Female Olympic Athletes.

Introduction: Insulin- like growth factor-I (IGF-I) is an anabolic hormone that may affect athletic performance in female athletes, and insulin-like growth factor binding protein-1 (IGFBP-1) is an important regulator of bioactive IGF-I. There is limited knowledge of the role of endogenous IGF-I and IGFBP-1 for body composition and physical performance in female elite athletes. Purpose: To examine IGF-I, age adjusted IGF-I (IGFSD), IGFBP-1 and insulin in female Olympic athletes compared with controls and different sport categories, and in relation to body composition and physical performance in the athletes. Methods: Female athletes (n=103) and untrained controls (n=113) were included in this cross-sectional study. Body composition was established by dual-energy X-ray absorptiometry. Serum IGF-I and IGFBP-1 were analyzed by radioimmunoassay and IGFSD was calculated. Insulin was analyzed by electrochemiluminescence immunoassay. Athletes were offered to participate in standardized physical fitness tests. Results: The athletes demonstrated significantly higher IGF-I, IGFSD and IGFBP-1 and lower insulin levels than controls (p<0.05, p<0.05, p<0.01, p<0.001 respectively). Power athletes had significantly higher IGFSD compared to both endurance and technical athletes (p<0.05, p<0.01, respectively). In athletes and controls combined, significant positive correlations were found between IGF variables and higher bone mineral density (BMD) and lean mass and lower fat percent. IGF-I was positively correlated with squat jump (rs = 0.28, p<0.05) and IGFBP-1 correlated positively with squats (rs =0.35, p<0.05). Conclusion: We found higher IGF-I, IGFSD and IGFBP-1 in female athletes than controls, and the highest IGFSD in power athletes. IGF-I and IGFBP-1 were related to increased BMD and lean mass and lower fat percent, as well as were positively associated with physical fitness tests. Future studies are needed to elucidate if these results reflect adaptive responses to physical activity or genetic predisposition.

Digit Ratio (2D:4D) and Physical Performance in Female Olympic Athletes.

Background: The second to fourth digit ratio (2D:4D ratio) is suggested to be a negative correlate of prenatal testosterone. Little is known about the role of the 2D:4D ratio in relation to serum and urinary androgens for physical performance in female athletes. We aimed to compare the 2D:4D ratio in female Olympic athletes with sedentary controls, and to investigate the 2D:4D ratio in relation to serum and urinary androgens and physical performance in the athletes. Methods: This cross-sectional study included 104 Swedish female Olympic athletes participating in power, endurance and technical sports and 117 sedentary controls. The 2D:4D ratio was calculated using direct digit measurements. Serum androgens and urinary androgen metabolites were analyzed by liquid chromatography-tandem mass spectrometry. The athletes performed standardized physical performance tests and body composition was established by dual-energy X-ray absorptiometry. Results: The 2D:4D ratio was significantly lower in the athletes compared with controls although serum testosterone levels were comparable between groups and within normal reference values. The 2D:4D ratio correlated negatively with urinary levels of testosterone glucuronide and 5α- and 5ßAdiol-17G, whereas there were no correlations to serum androgen levels. Furthermore, the 2D:4D ratio correlated negatively with strength tests and positively with 3,000-meter running in the athletes. Conclusion: Female Olympic athletes had a lower 2D:4D ratio, possibly reflecting a higher prenatal androgen exposure, than sedentary controls. Furthermore, the 2D:4D ratio was related to urinary levels of androgen metabolites and physical performance in the athletes but not to serum androgen levels. It is suggested that the 2D:4D ratio could reflect androgen metabolism and may be of importance for sporting success in female athletes.

Serum androgen profile and physical performance in women Olympic athletes.

BACKGROUND: The role of endogenous androgens for body composition and physical performance in women athletes is still not elucidated. AIM: To examine the serum androgen profile in relation to body composition and physical performance in women Olympic athletes and to compare endocrine variables and body composition to controls. STUDY DESIGN: Cross-sectional study, conducted between 2011 and 2015 at the Women's Health Research Unit, Karolinska University Hospital, Stockholm. METHODS: Swedish women Olympic athletes (n=106) and age-matched and body mass index-matched sedentary controls (n=117) were included in the study. Blood sampling was performed in a rested, fasting state for the measurement of serum androgens and their metabolites by liquid chromatography-tandem mass spectrometry. Body composition was determined by dual-energy X-ray absorptiometry (controls n=100, athletes n=65). The athletes performed standardised performance tests (n=59) (squat jump (SJ) and countermovement jump (CMJ). RESULTS: The athletes demonstrated significantly higher levels of the precursor androgens dehydroepiandrosterone (DHEA) and 5-androstene-3ß, 17ß-diol (5-DIOL) and the metabolite etiocholanolone glucuronide (Etio-G), significantly lower levels of estrone (p<0.05, respectively), higher bone mineral density (p<0.001) and more lean mass (p<0.001) compared with controls. Serum levels of DHEA, 5-DIOL and Etio-G correlated positively to lean mass variables and physical performance in the athletes. DHEA and lean mass legs explained 66% of the variance in SJ, whereas lean mass explained 52% of the variance in CMJ. CONCLUSIONS: The present data suggest that endogenous androgens are associated with a more anabolic body composition and enhanced performance in women athletes. These results are of importance for the current discussion regarding hyperandrogenism in women athletes.

[¼Shermer's neck« is a rare injury in long-distance cycle races. Association with diplopia described for the first time]. / ¼Shermer's neck« sällsynt skada vid långdistans-cykellopp - Association med diplopi beskrivs för första gången.

Shermer's neck was first described in 1983 in an ultra-distance cyclist and it is often associated with neck pain (in our patient diplopia as first symptom) and exhaustion and impaired neck motor function with inability to extend the neck against gravity. The diplopia, for the first time described in connection with Shermer's neck, was accentuated when elevating the eyes and looking at distance, most likely reflecting exhaustion in the elevator muscles of the eye. Shermer's neck usually appears after 800 km of non-stop bike racing. Risk factors include former neck injuries, staying low in aerobars for a long time, and wearing helmet light/cameras. Prevention includes neck strength training, muscle stretching, raising of handle bars and different kinds of chin support. The most important treatment is rest and not riding a bike. In our patient the diplopia was normalized after 4 hours of sleep. It can take 2-14 days to regain full neck motor function. The possibility of developing Shermer's neck and diplopia (¼Berglund's diplopia«) must be taken into account when many untrained individuals participate in popular shorter races over about 300 km.

Body composition and endocrine profile of male Olympic athletes striving for leanness.

OBJECTIVE: To investigate the endocrine profile, body composition, and state of mood in male Olympic athletes participating in sports that do or do not emphasize leanness. DESIGN: Cross-sectional study. SETTING: Research unit at a university hospital. PARTICIPANTS: Forty-four Swedish male Olympic athletes participating in 26 different sport disciplines. MAIN OUTCOME MEASURES: Body composition was determined by dual-energy x-ray absorptiometry, and blood levels of steroid hormones and biomarkers of nutritional status were analyzed. In addition, states of mood were assessed employing the profile of mood states (POMS) test. The athletes were divided into 2 groups on the basis of whether their sporting discipline emphasized leanness or not. RESULTS: In all subjects, body composition, hormone levels, and POMS scores were within normal ranges. However, the leanness athletes (n = 18) displayed significantly lower proportion of body fat (P < 0.01), higher spinal bone mineral density (P < 0.05), lower serum levels of free testosterone and leptin (P < 0.05), and higher serum levels of insulin-like growth factor binding protein 1 (P < 0.05) than nonleanness athletes (n = 26). Leanness athletes also had higher POMS scores for depression and anger, and a higher global POMS score (P < 0.05), the latter being positively correlated to the frequency of illness (r = 0.42, P < 0.01) before the Olympic Games. CONCLUSION: Although there were no indications of energy deficiency or endocrine disturbance in the leanness athletes, their higher POMS scores and frequency of illness may indicate the potential harmfulness of their pursuit of outstanding athletic performance.

Enhanced systolic myocardial function in elite endurance athletes during combined arm-and-leg exercise.

The aim here was to employ color tissue velocity imaging (TVI), to test the hypothesis that highly trained endurance athletes exhibit enhanced systolic function of the left ventricular (LV) myocardium both at rest and during combined arm-and-leg exercise in comparison with untrained subjects. For each of the ten elite male (EG) and ten matched control participants (CG), LV dimensions and systolic function were assessed at rest using echocardiography. Subsequently, these subjects exercised continuously on a combined arm-and-leg cycle ergometer for 3 min each at 50, 60, 70, 80, 90 and 100% of VO(2max). Oxygen uptake, heart rate, systolic blood pressure (SBP) and peak contraction systolic velocities of the LV myocardium (PSV) were recorded in the end of each level. At rest, the trained and untrained groups differed with respect to LV dimensions, but not systolic function. At 60-100% VO(2max), the EG group demonstrated both higher PSV and SBP. The observation that the EG athletes had higher PSV than CG during exercise at 60-100% VO(2max), but not at rest or at 50% of VO(2max), suggested an enhanced systolic capacity. This improvement is likely to be due to an enhanced inotropic contractility, which only becomes apparent during exercise.

Hyperandrogenism may explain reproductive dysfunction in olympic athletes.

PURPOSE: Female athletes are known to be at risk for reproductive dysfunction and osteopenia because of energy deficiency. Although endocrine balance and an optimal body composition are essential for top elite performance, these parameters have not yet been explored fully in Olympic sportswomen. The objective of this study, therefore, was to characterize the menstrual status, body composition, and endocrine balance in female Olympic athletes participating in different disciplines. METHODS: Ninety Swedish female Olympic athletes underwent a gynecologic examination that included vaginal examination by ultrasound and determination of body composition. In addition, blood samples were collected for the analysis of reproductive hormones and biomarkers of energy availability. RESULTS: Of all the athletes, 47% were using hormonal contraception (HC). Menstrual dysfunction (MD) was common (27%) among those not using HC and, particularly, in endurance athletes. However, the proportion of body fat and biomarkers of energy availability were within the normal ranges and none exhibited osteopenia. On the contrary, bone mineral density was generally high, particularly in the power athletes. The most common diagnosis associated with MD was polycystic ovary syndrome (PCOS) and not hypothalamic inhibition because of energy deficiency. CONCLUSIONS: Female Olympic athletes participating in different sports were found to have an anabolic body composition and biomarkers of energy availability within the normal ranges. Most cases of menstrual disturbances observed were due to PCOS. These findings challenge the contemporary concept that reproductive dysfunction in sportswomen is typically a consequence of chronic energy deficiency.

Special attention to the weight-control strategies employed by Olympic athletes striving for leanness is required.

BACKGROUND: Optimization of body weight and composition is a key priority for elite athletes striving for a competitive advantage. The present investigation was designed to characterize various parameters related to weight control in Olympic competitors. DESIGN: Cross-sectional study. SETTING: Research unit at a University Hospital. PARTICIPANTS: 223 athletes (125 men and 98 women, with only 1 drop-out), all members of the Swedish teams participating in the Olympic Games of 2002 and 2004. MAIN OUTCOME MEASUREMENTS: Self-reported body weight and height, from which BMI was calculated, variation in weight during the year prior to Olympic competition, and self-reported weight control strategies by questionnaire. The athletes were divided into two groups on the basis of whether their sporting discipline emphasized leanness or not. RESULTS: The athletes participating in disciplines that emphasize leanness demonstrated a lower mean BMI (22.7 +/- 2.7 vs 3.7 +/- 2.3 for nonlean athletes, P < 0.05), greater variation in weight (5.3% vs 4.7%, P < 0.05), more frequent attempts to lose weight (P < 0.001), longer total training time (P < 0.001), a higher training load yet weighed more than they desired at the time of competition. These differences were most evident in male athletes. Furthermore, 9.4% of lean athletes reported previously suffering from an eating disorder, in comparison to 2.7% of the nonlean athletes (P < 0.05). More athletes in disciplines emphasizing leanness also reported being ill during the prior 3 month period (38.5% vs 21.6%, P < 0.05). CONCLUSIONS: This investigation reveals that the weight control practices employed by Olympic athletes participating disciplines that emphasize leanness appear to be suboptimal. Counseling concerning weight control could be used as a tool to prevent illness and enhance performance.

["Unfair" effect of physical activity. Physically inactive individuals must exercise for a longer period to achieve the preventive targets]. / "Orättvis effekt av fysisk aktivitet. Otränade måste träna längre tid för att nå uppsatta mål om prevention.

The capacity to turnover energy during exercise is regulated by the maximal aerobic capacity. Advices regarding physical activity must therefore be modified and individualised based on the maximal aerobic capacity of the patient. Initially, physical training of patients with low capacity to turn over energy will make it more difficult for the patient to achieve goals of disease prevention and weight reduction. In addition, physical inactive subjects are more negative to physical exercise than physically active subjects. However, physically inactive subjects must be informed that they can increase their maximal aerobic capacity by physical training rapidly. In addition, they must be informed that it takes 10-20 weeks of regular physical endurance training to achieve increased vitality and a more positive attitude towards physical activity, and furthermore, that it is necessary with physical endurance training 2-4 times on a weekly basis to maintain positive effects of physical training.

Effect of salbutamol, a beta-2-adrenergic agonist, on erythropoietin concentration in healthy males.

Fifteen healthy males, aged 20-30 years, participated in a double-blind cross-over study on the effect of the beta-2 stimulator salbutamol on erythropoietin concentration and hemoglobin concentration. The treatment period comprised inhalation of salbutamol, 0.8 mg four times daily for 2 weeks. Serum-erythropoietin was essentially unaltered after treatment with salbutamol, 9.5 +/- 4.94 IU. l-1 (mean +/- SD), as compared to both control situation, 9.2 +/- 4.50 IU. l-1(mean +/- SD), and placebo treatment (9.7 +/- 4.07 IU. l-1) (mean+/-SD). The same pattern, no significant changes between control situation and treatment with salbutamol or placebo, also applied to hemoglobin concentration. In conclusion, it is not possible to increase erythropoietin concentration, and thereby erythropoiesis, by inhalation of high doses of the International Olympic Committee (IOC)-approved beta-2 stimulator salbutamol for 2 weeks in healthy young males.