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雌激素对骨骼肌的影响:性别很重要。

The influence of estrogen on skeletal muscle: sex matters.

机构信息

Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Waterloo, Ontario, Canada.

出版信息

Sports Med. 2010 Jan 1;40(1):41-58. doi: 10.2165/11319760-000000000-00000.

Abstract

As women enter menopause, the concentration of estrogen and other female hormones declines. This hormonal decrease has been associated with a number of negative outcomes, including a greater incidence of injury as well as a delay in recovery from these injuries. Over the past two decades, our understanding of the protective effects of estrogen against various types of injury and disease states has grown immensely. In skeletal muscle, studies with animals have demonstrated that sex and estrogen may potentially influence muscle contractile properties and attenuate indices of post-exercise muscle damage, including the release of creatine kinase into the bloodstream and activity of the intramuscular lysosomal acid hydrolase, beta-glucuronidase. Furthermore, numerous studies have revealed an estrogen-mediated attenuation of infiltration of inflammatory cells such as neutrophils and macrophages into the skeletal muscles of rats following exercise or injury. Estrogen has also been shown to play a significant role in stimulating muscle repair and regenerative processes, including the activation and proliferation of satellite cells. Although the mechanisms by which estrogen exerts its influence upon indices of skeletal muscle damage, inflammation and repair have not been fully elucidated, it is thought that estrogen may potentially exert its protective effects by: (i) acting as an antioxidant, thus limiting oxidative damage; (ii) acting as a membrane stabilizer by intercalating within membrane phospholipids; and (iii) binding to estrogen receptors, thus governing the regulation of a number of downstream genes and molecular targets. In contrast to animal studies, studies with humans have not as clearly delineated an effect of estrogen on muscle contractile function or on indices of post-exercise muscle damage and inflammation. These inconsistencies have been attributed to a number of factors, including age and fitness level of subjects, the type and intensity of exercise protocols, and a focus on sex differences that typically involve factors and hormones in addition to estrogen. In recent years, hormone replacement therapy (HRT) or estrogen combined with exercise have been proposed as potentially therapeutic agents for postmenopausal women, as these agents may potentially limit muscle damage and inflammation and stimulate repair in this population. While the benefits and potential health risks of long-term HRT use have been widely debated, controlled studies using short-term HRT or other estrogen agonists may provide future new and valuable insights into understanding the effects of estrogen on skeletal muscle, and greatly benefit the aging female population. Recent studies with older females have begun to demonstrate their benefits.

摘要

随着女性进入绝经期,雌激素和其他女性激素的浓度下降。这种激素的减少与许多负面结果有关,包括受伤的发生率增加以及受伤后的恢复时间延长。在过去的二十年中,我们对雌激素对各种类型的损伤和疾病状态的保护作用的理解有了极大的提高。在骨骼肌中,动物研究表明,性别和雌激素可能潜在地影响肌肉收缩特性,并减轻运动后肌肉损伤的指标,包括肌酸激酶释放入血液和肌肉内溶酶体酸性水解酶、β-葡糖苷酸酶的活性。此外,许多研究表明,雌激素可减轻运动或损伤后大鼠骨骼肌中炎症细胞(如中性粒细胞和巨噬细胞)的浸润。雌激素还在刺激肌肉修复和再生过程中发挥重要作用,包括卫星细胞的激活和增殖。尽管雌激素影响骨骼肌损伤、炎症和修复的机制尚未完全阐明,但人们认为雌激素可能通过以下几种方式发挥其保护作用:(i)作为抗氧化剂,从而限制氧化损伤;(ii)通过插入膜磷脂来作为膜稳定剂;和(iii)与雌激素受体结合,从而调节许多下游基因和分子靶标。与动物研究相比,人体研究并没有明确阐述雌激素对肌肉收缩功能或运动后肌肉损伤和炎症的影响。这些不一致归因于许多因素,包括受试者的年龄和健康水平、运动方案的类型和强度,以及关注除雌激素以外的激素和因素的性别差异。近年来,激素替代疗法(HRT)或雌激素联合运动被提议作为绝经后妇女的潜在治疗药物,因为这些药物可能潜在地限制肌肉损伤和炎症,并刺激该人群的修复。虽然长期 HRT 使用的益处和潜在健康风险已广泛争论,但使用短期 HRT 或其他雌激素激动剂的对照研究可能为理解雌激素对骨骼肌的影响提供新的有价值的见解,并使老年女性人口受益匪浅。最近对老年女性的研究已经开始显示出其益处。

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