Uporaba izračunanega prostega in biološko razpoložljivega testosterona v razmerju s kortizolom za oceno sindroma pretreniranosti pri vrhunskih športnikih

Ježek, Barbara (avtor), Jerin, Aleš (mentor), Drole, Kristina (komentor)

Pri športnikih se lahko razvije sindrom pretreniranosti, katerega posledica je zmanjšana športna zmogljivost in povečana možnost za zdravstvene težave (npr. preobremenitvene poškodbe). Diagnostika sindroma je zahtevna in trenutno še ne obstaja dober diagnostični označevalec. Možen označevalec je znižanje razmerja koncentracije testosterona in kortizola (razmerje T/C) glede na bazalno vrednost športnika, vendar metodologija uporabe različnih oblik testosterona v literaturi ni enotna. Namen magistrske naloge je bil preveriti ujemanje v spremembi razmerja T/C in verjetnosti za prisotnosti sindroma pretreniranosti, pri čemer smo za izračun razmerja uporabili različne oblike testosterona. Predvidevali smo, da sta izračunana prosti in biološko razpoložljivi testosteron v razmerju T/C boljša označevalca za povečano verjetnost za sindrom pretreniranosti kot celokupni testosteron. V magistrskem delu smo spremljali 93 vrhunskih športnikov, članov 1. slovenske rokometne lige, pri katerih smo med sezono izvedli odvzeme venske krvi. V serumskih vzorcih smo s pomočjo elektrokemiluminiscentne metode izmerili koncentracijo testosterona, kortizola in SHBG, albumin pa smo določali s kolorimetrično metodo z bromkrezol zelenim. Za izračun prostega in biološko razpoložljivega testosterona smo uporabili enačbo po Vermeulenu. Razmerje T/C smo izračunali s pomočjo izmerjenega celokupnega testosterona in izračunanih oblik. Za bazalno vrednost razmerja T/C smo vzeli rezultate iz vzorčenja, ki se je izvedlo pred pričetkom sezone. V sezoni smo opravili še dve vzorčenji. Med skupinama z manjšo in večjo verjetnostjo za sindrom pretreniranosti smo ugotovili statistično značilne razlike (p=0,03) v spremembi razmerja T/C glede na bazalno vrednost, če za izračun razmerja uporabimo celokupni testosteron. Pri uporabi prostega (p=0,07) ali biološko razpoložljivega testosterona (p=0,052) v izračunu razmerja nismo uspeli dokazati statistično značilnih razlik. Rezultati logistične regresije, so pokazali, da znižanje razmerja T/C ob uporabi celokupnega testosterona povečuje verjetnost za prisotnost sindroma pretreniranosti (p=0,027). Mejno vrednost razmerja T/C smo določili s pomočjo ROC (ang. receiver operating characteristic) krivulje ter se giblje v območju 29–31% znižanja razmerja T/C odvisno od uporabljene oblike testosterona. Rezultati statične analize, so pokazali, da je celokupni testosteron uporabljen v razmerju T/C boljši označevalec verjetnosti za sindrom pretreniranosti kot prosti in biološko razpoložljivi testosteron.

• Jezik: Slovenski jezik
• Ključne besede: sindrom pretreniranosti, razmerje T/C, prosti testosteron, biološko razpoložljivi testosteron, preobremenitvene poškodbe
• Vrsta gradiva: Magistrsko delo/naloga
• Organizacija: FFA - Fakulteta za farmacijo
• Leto izida: 2023
• PID: 20.500.12556/RUL-151601
• Datum objave v RUL: 12.10.2023

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Use of calculated free and bioavailable testosterone to cortisol ratio to assess overtraining syndrome in elite athletes

Izvleček

Athletes are at risk for developing overtraining syndrome, which leads to decrease in athletic performance and increased risk of health problems (for example overuse injuries). Diagnosing the syndrome is complicated, and there is currently no good diagnostic marker. One potential marker is a decrease in the testosterone to cortisol ratio (T/C ratio) compared to the athlete's basal value, but the methodology for using different forms of testosterone is not uniform across the literature. The main objective of this work was to investigate a correlation between the change in the T/C ratio and the probability of the presence of overtraining syndrome, using different forms of testosterone to calculate the ratio. We hypothesised that calculated free and bioavailable testosterone in the T/C ratio would be better markers of increased likelihood of overtraining syndrome than total testosterone. As part of the master's thesis, 93 elite athletes of the 1st Slovenian Handball League were observed and venous blood samples were taken from them during the course of one handball season. In serum samples testosterone, cortisol and SHBG were measured by the electrochemiluminescent method, and albumin was determined by the colorimetric method using bromcresol green. The Vermeulen equation was used to calculate free and bioavailable testosterone. The T/C ratio was calculated using the measured total testosterone and the calculated forms The baseline T/C ratio was based on the results of the sampling performed before the training season. Two additional samplings were carried out during the season. We found statistically significant differences (p=0,03) in the change in T/C ratio from baseline between the groups with lower and higher probability of overtraining syndrome, when total testosterone is used to calculate the ratio. When using free (p=0,07) or bioavailable testosterone (p=0,052) to calculate the ratio, we did not detect statistically significant differences. The results of the logistic regression showed that a decrease in the T/C ratio using total testosterone increases the chance of overtraining syndrome (p=0,027). The T/C ratio threshold was determined using the receiver operating characteristic (ROC) curve and ranges from a 29-31% reduction in the T/C ratio, depending on the form of testosterone used. The results of the statistical analysis indicate that total testosterone used in the T/C ratio is a better marker of probability of overtraining syndrome than free and bioavailable testosterone.

• Ključne besede: overtraining syndrome, T/C ratio, free testosterone, bioavailable testosterone, overuse injuries