PM & R : the journal of injury, function, and rehabilitation · 2026
Differences in female athlete triad risk factors between Japanese and American female runners: A comparative study.
СтатьяСравнительное исследованиеНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Salamunes Ana Carla C, Koikawa Natsue, Williams Nancy I, Koltun Kristen J, Vijaya Krishnan Maha L, Sakurama Yuko, Matsuda Takao, Suzuki Shihoko, Takazawa Yuji, De Souza Mary Jane
Аннотация
BACKGROUND: Differences in female athlete triad risk factors between runners from Japan and the United States have not been explored.
OBJECTIVE: To compare the prevalence of Triad risk factors and Triad components between female Japanese and American distance runners.
DESIGN: Observational, cross-sectional.
SETTING: Two universities; one in the United States and one in Japan.
PARTICIPANTS: A total of 77 female runners: 36 Japanese middle- and long-distance runners, and 41 American distance runners.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Triad components were energy deficiency, menstrual disturbances, and poor bone health. Triad risk factors were, respectively for each component: body mass index, serum total triiodothyronine, and history of diagnosed eating disorders; delayed menarche, history of menstrual irregularity, and current oligoamenorrhea; and bone mineral density and history of stress fractures. Prevalence was compared with chi-square and Fisher's exact tests. Group differences were assessed with t-tests and Mann-Whitney U tests. Data are mean difference (95% confidence interval [CI]).
RESULTS: Japanese runners had lower body weight (-4.15 [95% CI, -7.03.to -1.27] kg, p = .005) and percentage of body fat (-5.2 [95% CI, -6.9 to -3.5] %, p < .001) than American runners, with no differences in body mass index, serum total triiodothyronine, age of menarche, or menstrual cycle length (p > .05). Japanese runners had significantly lower bone mineral density at the lumbar spine (-0.195 [95% CI, -0.246 to -0.143] g/cm2, p < .001), total hip (-0.115 [95% CI, -0.165 to -0.064] g/cm2, p < .001), and femoral neck (-0.214 [95% CI, -0.260 to -0.167] g/cm2, p < .001), but higher total hip Z-scores than the American runners (0.5 [95% CI, 0.1 to 1.0], p = .022). The prevalence of energy deficiency (56% vs. 32%, p = .035), history of stress fractures (50% vs. 17%, p = .003), and of runners experiencing all three Triad components (42% vs. 16%, p = .014) was higher in Japanese than American runners. No other differences in prevalence were observed.
CONCLUSIONS: Japanese female runners may be at a higher Triad risk than American peers, given their higher prevalence of energy deficiency risk factors, history of stress fractures, and of athletes experiencing all Triad components.
OBJECTIVE: To compare the prevalence of Triad risk factors and Triad components between female Japanese and American distance runners.
DESIGN: Observational, cross-sectional.
SETTING: Two universities; one in the United States and one in Japan.
PARTICIPANTS: A total of 77 female runners: 36 Japanese middle- and long-distance runners, and 41 American distance runners.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Triad components were energy deficiency, menstrual disturbances, and poor bone health. Triad risk factors were, respectively for each component: body mass index, serum total triiodothyronine, and history of diagnosed eating disorders; delayed menarche, history of menstrual irregularity, and current oligoamenorrhea; and bone mineral density and history of stress fractures. Prevalence was compared with chi-square and Fisher's exact tests. Group differences were assessed with t-tests and Mann-Whitney U tests. Data are mean difference (95% confidence interval [CI]).
RESULTS: Japanese runners had lower body weight (-4.15 [95% CI, -7.03.to -1.27] kg, p = .005) and percentage of body fat (-5.2 [95% CI, -6.9 to -3.5] %, p < .001) than American runners, with no differences in body mass index, serum total triiodothyronine, age of menarche, or menstrual cycle length (p > .05). Japanese runners had significantly lower bone mineral density at the lumbar spine (-0.195 [95% CI, -0.246 to -0.143] g/cm2, p < .001), total hip (-0.115 [95% CI, -0.165 to -0.064] g/cm2, p < .001), and femoral neck (-0.214 [95% CI, -0.260 to -0.167] g/cm2, p < .001), but higher total hip Z-scores than the American runners (0.5 [95% CI, 0.1 to 1.0], p = .022). The prevalence of energy deficiency (56% vs. 32%, p = .035), history of stress fractures (50% vs. 17%, p = .003), and of runners experiencing all three Triad components (42% vs. 16%, p = .014) was higher in Japanese than American runners. No other differences in prevalence were observed.
CONCLUSIONS: Japanese female runners may be at a higher Triad risk than American peers, given their higher prevalence of energy deficiency risk factors, history of stress fractures, and of athletes experiencing all Triad components.