Mastorakos George, Pavlatou Maria, Diamanti-Kandarakis Evanthia, Chrousos George P
Endocrine Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Athens, Greece.
Hormones (Athens). 2005 Apr-Jun;4(2):73-89.
Exercise represents a physical stress that challenges homeostasis. In response to this stressor, autonomic nervous system and the hypothalamic-pituitary-adrenal axis are known to react and to participate in the maintenance of homeostasis. This includes elevation of cortisol and cathecholamines in plasma. However, sustained physical conditioning in highly trained athletes is associated with a decreased hypothalamic-pituitary-adrenal response to exercise. On the other hand, highly trained athletes exhibit a chronic mild hypercortisolism at baseline that may be an adaptive change to chronic exercise. In addition the proinflammatory cytokine IL-6 is also activated. Moreover, exercise stimulates the secretion of GH and prolactin, and may influence the type of immunity by stimulating TH2 response profile. Besides, the stress of exercise inhibits the gonadal function, through the production of glucocorticoids and cathecholamines, as well as through activation of the CRH neurons. Nowadays, apart from the beneficial effects of exercise, there is increasing incidence of exercise-related short- and long- term consequences, especially concerning the female athlete that many authors describe as the so-called "exercise-related female reproductive dysfunction". These consequences include amenorrhea, infertility, eating disorders, osteoporosis, coronary heart disease and euthyroid "sick" syndrome. The mechanisms involved in the pathogenesis of the above disorders are discussed in this review.
运动是一种挑战内稳态的身体应激。已知自主神经系统和下丘脑 - 垂体 - 肾上腺轴会对这种应激源做出反应，并参与内稳态的维持。这包括血浆中皮质醇和儿茶酚胺水平的升高。然而，高水平训练运动员的持续身体训练与下丘脑 - 垂体 - 肾上腺对运动的反应降低有关。另一方面，高水平训练运动员在基线时表现出慢性轻度皮质醇增多症，这可能是对慢性运动的一种适应性变化。此外，促炎细胞因子白细胞介素 - 6 也被激活。而且，运动刺激生长激素和催乳素的分泌，并可能通过刺激 TH2 反应模式来影响免疫类型。此外，运动应激通过糖皮质激素和儿茶酚胺的产生以及促肾上腺皮质激素释放激素神经元的激活来抑制性腺功能。如今，除了运动的有益影响外，与运动相关的短期和长期后果的发生率正在增加，尤其是在女性运动员中，许多作者将其描述为所谓的“运动相关女性生殖功能障碍”。这些后果包括闭经、不孕、饮食失调、骨质疏松症、冠心病和正常甲状腺病态综合征。本综述讨论了上述疾病发病机制中涉及的机制。
