ENDOCRINE FOLLOW-UP OF ELITE SPORTSMEN : HYPOTALAMO PITUITARY ADRENAL AND SOMATOTROPE AXIS AND BONE REMODELLING
SUIVI ENDOCRINIEN DES SPORTIFS DE HAUT NIVEAU : AXES HYPOTHALAMO-HYPOPHYSO-SURRENALIEN ET SOMATOTROPE ET REMODELAGE OSSEUX
Résumé
ALTHOUGH REGULAR PHYSICAL ACTIVITY LEADS TO NUMEROUS HEALTH BENEFITS, ELITE SPORTSMAN HAS FREQUENTLY BEHAVIORS WHOSE ARE HEALTH RISK. USE OF HORMONAL DRUGS (CORTICOSTEROIDS, GROWYH HORMONE) AND EATING DISORDERSIS SPECIALLY COULD IMPAIR HYPOTHALMO PITUITARY AXIS, SOMATOTROPE AXIS AND BONE REMODELING.
THE AIM OF THIS WORK WAS TO DRAW UP A STATE OF KNWOLEDGE OF THE PHYSIOPATHOLGY OF THESE AXES WITH PLASMATIC MEASURES SINCE THIS HAD BEEN LITTLE STUDIED IN ELITE SPORTSMEN.
SO, LOWER BASAL PLASMA CORTISOL VALUES WERE HIGHLY PREDICTIVE OF ADRENAL INSUFFICIENCY AND MIRRORED A RECENT CORTICOSTEROID USE. MOREOVER, THIS RECORDING WAS STRENGHTENED BY 90% OF ADRENAL INSUFFICIENCY IN SPORTSME WHO UNDERWENT A PERI OR INTRAARTICULAR CORTICOSTEROID INFILTRATION. CONVERSELY, IT IS DIFFICULT TO KNOW IF HIGH PLASMA CORTISOL VALUES ARE THE CONCERN OF PHYSIOLOGICAL ADAPTATIONS TO INTENSIVE SPORT PRATICE OR OF PATHOLOGICAL CONDITIONS (CALORIC DEFICIENCY OR DOPING).
BASAL SOMATOTROPE AXIS ANALYSIS IN DIFFERENT CATEGORY OF SPORTSMEN REVEALED THAT THE MEANS VALUES WERE CLOSED TO THOSE OF NON SPORTSMEN OF THE SAME AGE; THE STUDY WHICH WAS PERFORMED IN ELITE CYCLISTS WOMEN SHOWED THAT THE BONE MINERAL DENSITY WAS ALMOST THE SAME AS THIS WAS EXPECTED IN GENERAL POPULATION.
SO, TESTING BASL HORMONAL FUNCTION IS RELEVANT IN THE MEDICAL FOLLOW UP OF ELITE SPORTSMEN. EACH ABNORMAL VALUE HAS TO BE REGARDED AS A PATHOLOGICAL VALUE, SPECIALLY INDUCED BY DRUGS AND/OR EATING DISORDERS.
THE AIM OF THIS WORK WAS TO DRAW UP A STATE OF KNWOLEDGE OF THE PHYSIOPATHOLGY OF THESE AXES WITH PLASMATIC MEASURES SINCE THIS HAD BEEN LITTLE STUDIED IN ELITE SPORTSMEN.
SO, LOWER BASAL PLASMA CORTISOL VALUES WERE HIGHLY PREDICTIVE OF ADRENAL INSUFFICIENCY AND MIRRORED A RECENT CORTICOSTEROID USE. MOREOVER, THIS RECORDING WAS STRENGHTENED BY 90% OF ADRENAL INSUFFICIENCY IN SPORTSME WHO UNDERWENT A PERI OR INTRAARTICULAR CORTICOSTEROID INFILTRATION. CONVERSELY, IT IS DIFFICULT TO KNOW IF HIGH PLASMA CORTISOL VALUES ARE THE CONCERN OF PHYSIOLOGICAL ADAPTATIONS TO INTENSIVE SPORT PRATICE OR OF PATHOLOGICAL CONDITIONS (CALORIC DEFICIENCY OR DOPING).
BASAL SOMATOTROPE AXIS ANALYSIS IN DIFFERENT CATEGORY OF SPORTSMEN REVEALED THAT THE MEANS VALUES WERE CLOSED TO THOSE OF NON SPORTSMEN OF THE SAME AGE; THE STUDY WHICH WAS PERFORMED IN ELITE CYCLISTS WOMEN SHOWED THAT THE BONE MINERAL DENSITY WAS ALMOST THE SAME AS THIS WAS EXPECTED IN GENERAL POPULATION.
SO, TESTING BASL HORMONAL FUNCTION IS RELEVANT IN THE MEDICAL FOLLOW UP OF ELITE SPORTSMEN. EACH ABNORMAL VALUE HAS TO BE REGARDED AS A PATHOLOGICAL VALUE, SPECIALLY INDUCED BY DRUGS AND/OR EATING DISORDERS.
ALORS QUE LA PRATIQUE REGULIERE DE L'ACTIVITE PHYSIQUE ENTRAINE DE NOMBREUX BENEFICES, LE SPORTIF DE HAUT NIVEAU DEVELOPPE PLUS FREQUEMMENT DES CONDUITES A RISQUE SUCEPTIBLES DE MENACER SA SANTE. EN PARTICULIER, L'UTILISATION DE PRODUITS HORMONAUX (GLUCOCORTICOIDES, HORMONE DE CROISSANCE) ET LES TROUBLES DU COMPORTEMENT ALIMENTAIRE PEUVENT ALTERER LE FONCTIONNEMENT DES AXES CORTICOTROPES, SOMATOTROPE ET DU REMODELAGE OSSEUX.
LA PHYSIOPATHOLOGIE DE CES AXES AYANT ETE PEU ETUDIEE CHEZ LES SPORTIFS DE HAUT NIVEAU, L'OBJECTIF DE CE TRAVAIL A ETE D'EN REALISER UN ETAT DES LIEUX A L'AIDE DE DOSAGES PLASMATIQUES.
AINSI, LES CORTISOLEMIES BASSES AVAIENT UNE FORTE VALEUR PREDICTIVE D'INSUFFISANCE SURRENALIENNE ET REFLETAIENT LA PRISE RECENTE DE GLUCOCORTICOIDES. LA SURVENUE D'INSUFFISANCE SURRENALIENNE CHEZ 90% DES SPORTIFS QUI AVAIENT EU UNE INFILTRATION LOCALE DE GLUCOCORTICOIDES A CONFIRME CE CONSTAT. EN COMPLEMENT, LES CORTISOLEMIES ELEVEES FONT DISCUTER LES MECANISMES PHYSIOLOGIQUES (ADAPTATIONS PROVOQUEES PAR LA PRATIQUE INTENSIVE DU SPORT) OU PHYSIOPATHOLOGIQUE (DEFICIT CALORIQUE OU DOPAGE HORMONAL).
L'ANALYSE DE LA FONCTION SOMATOTROPE DANS DES DISCIPLINES SPORTIVES DIFFERENTES A REVELE QUE LES VALEURS BASALES ETAIENT COMPARABLES A CELLES DE SUJETS NON SPORTIFS DU MEME AGE. DE MEME, L'ETUDE REALISEE CHEZ DES FEMMES CYLSITES ELITE A MONTRE QUE LA DENSITE MINERALE OSSEUSE ETAIENT COMPARABLES A CELLE DE LA POPULATION GENERALE.
AINSI, L'ETUDE DE LA FONCTION HORMONALE BASALE EST PERTINENTE DANS LE SUIVI DES SPORTIFS DE HAUT NIVEAU. TOUTE VALEUR ANORMALE DOIT ETRE CONSIDEREE COMME PATHOLOGIQUE ET FAIRE SUSPECTER LA PRISE DE PRODUIT DOPANT ET/OU UN DESEQUILIBRE ENERGETIQUE.
LA PHYSIOPATHOLOGIE DE CES AXES AYANT ETE PEU ETUDIEE CHEZ LES SPORTIFS DE HAUT NIVEAU, L'OBJECTIF DE CE TRAVAIL A ETE D'EN REALISER UN ETAT DES LIEUX A L'AIDE DE DOSAGES PLASMATIQUES.
AINSI, LES CORTISOLEMIES BASSES AVAIENT UNE FORTE VALEUR PREDICTIVE D'INSUFFISANCE SURRENALIENNE ET REFLETAIENT LA PRISE RECENTE DE GLUCOCORTICOIDES. LA SURVENUE D'INSUFFISANCE SURRENALIENNE CHEZ 90% DES SPORTIFS QUI AVAIENT EU UNE INFILTRATION LOCALE DE GLUCOCORTICOIDES A CONFIRME CE CONSTAT. EN COMPLEMENT, LES CORTISOLEMIES ELEVEES FONT DISCUTER LES MECANISMES PHYSIOLOGIQUES (ADAPTATIONS PROVOQUEES PAR LA PRATIQUE INTENSIVE DU SPORT) OU PHYSIOPATHOLOGIQUE (DEFICIT CALORIQUE OU DOPAGE HORMONAL).
L'ANALYSE DE LA FONCTION SOMATOTROPE DANS DES DISCIPLINES SPORTIVES DIFFERENTES A REVELE QUE LES VALEURS BASALES ETAIENT COMPARABLES A CELLES DE SUJETS NON SPORTIFS DU MEME AGE. DE MEME, L'ETUDE REALISEE CHEZ DES FEMMES CYLSITES ELITE A MONTRE QUE LA DENSITE MINERALE OSSEUSE ETAIENT COMPARABLES A CELLE DE LA POPULATION GENERALE.
AINSI, L'ETUDE DE LA FONCTION HORMONALE BASALE EST PERTINENTE DANS LE SUIVI DES SPORTIFS DE HAUT NIVEAU. TOUTE VALEUR ANORMALE DOIT ETRE CONSIDEREE COMME PATHOLOGIQUE ET FAIRE SUSPECTER LA PRISE DE PRODUIT DOPANT ET/OU UN DESEQUILIBRE ENERGETIQUE.
Domaines
Physiologie [q-bio.TO]
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