The syndrome of Relative Energy Deficiency in Sport (RED-S) includes wide-ranging effects on physiological and psychological functioning, performance, and general health. However, RED-S is understudied among male athletes at the highest performance levels. This cross-sectional study aimed to investigate surrogate RED-S markers prevalence in Norwegian male Olympic-level athletes. Athletes (n = 44) aged 24.7 ± 3.8 years, body mass 81.3 ± 15.9 kg, body fat 13.7% ± 5.8%, and training volume 76.1 ± 22.9 hr/month were included. Assessed parameters included resting metabolic rate (RMR), body composition, and bone mineral density by dual-energy X-ray absorptiometry and venous blood variables (testosterone, free triiodothyronine, cortisol, and lipids). Seven athletes (16%) grouped by the presence of low RMR (RMR_ratio < 0.90) (0.81 ± 0.07 vs. 1.04 ± 0.09, p < .001, effect size 2.6), also showed lower testosterone (12.9 ± 5.3 vs. 19.0 ± 5.3 nmol/L, p = .020) than in normal RMR group. In low RMR_ratio individuals, prevalence of other RED-S markers (—subclinical—low testosterone, low free triiodothyronine, high cortisol, and elevated low-density lipoprotein) was (N/number of markers): 2/0, 2/1, 2/2, 1/3. Low bone mineral density (z-score < −1) was found in 16% of the athletes, all with normal RMR. Subclinical low testosterone and free triiodothyronine levels were found in nine (25%) and two (5%) athletes, respectively. Subclinical high cortisol was found in 23% of athletes while 34% had elevated low-density lipoprotein cholesterol levels. Seven of 12 athletes with two or more RED-S markers had normal RMR. In conclusion, this study found that multiple RED-S markers also exist in male Olympic-level athletes. This highlights the importance of regular screening of male elite athletes, to ensure early detection and treatment of RED-S.

运动中相对能量缺乏综合征 (RED-S) 包括对生理和心理功能、表现和整体健康的广泛影响。然而，RED-S 在最高表现水平的男性运动员中的研究不足。这项横断面研究旨在调查挪威男性奥林匹克水平运动员中替代性 RED-S 标记的流行率。运动员 (n = 44) 年龄 24.7 ± 3.8 岁，体重 81.3 ± 15.9 kg，体脂 13.7% ± 5.8%，训练量 76.1 ± 22.9 小时/月。评估的参数包括静息代谢率 (RMR)、身体成分和双能 X 射线吸收法测定的骨矿物质密度和静脉血变量（睾酮、游离三碘甲状腺原氨酸、皮质醇和脂质）。七名运动员 (16%) 按 RMR 低（RMR_{比率）分组}< 0.90) (0.81 ± 0.07 vs. 1.04 ± 0.09, p < .001, 影响大小 2.6)，也显示出 比正常 RMR 组 更低的睾酮 (12.9 ± 5.3 vs. 19.0 ± 5.3 nmol/L, p = .020) . 在低 RMR_比率的个体中，其他 RED-S 标志物（-亚临床-低睾酮、低游离三碘甲状腺原氨酸、高皮质醇和升高的低密度脂蛋白）的患病率是（N/标志物数量）：2/0、2/1 , 2/2, 1/3。低骨密度（z-score < -1) 在 16% 的运动员中发现，所有 RMR 均正常。分别在九名 (25%) 和两名 (5%) 运动员中发现了亚临床低睾酮和游离三碘甲状腺原氨酸水平。23% 的运动员发现亚临床高皮质醇，而 34% 的运动员低密度脂蛋白胆固醇水平升高。12 名具有两个或更多 RED-S 标记的运动员中有 7 名 RMR 正常。总之，这项研究发现，男性奥林匹克水平运动员中也存在多种 RED-S 标记。这凸显了男性精英运动员定期筛查的重要性，以确保早期发现和治疗 RED-S。