MD, Section of Human Morphology Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Via Dei Vestini 31, 66013 Chieti, Italy.
J Clin Endocrinol Metab. 2013 Oct;98(10):4187-94. doi: 10.1210/jc.2013-2305. Epub 2013 Aug 21.
Estrogen deficiency, systemic low-grade inflammation, and reduction of adrenal gland function have central roles in noncommunicable chronic disease (NCD) development. With angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism, the deletion variant (DD) is related to higher levels of circulating angiotensin II than I allele carriers (II/ID), which might interact with all of these molecular pathways to increase NCDs risk. On the other hand, physical exercise counteracts the occurrence of NCDs, potentially acting on the same pathways.
The aim of the study was to investigate the effects of walking training on adrenal steroid and cytokine levels and on cardiovascular parameters in postmenopausal women with ACE I/D genotypes.
Thirty-six (DD = 15, II/ID = 21) sedentary postmenopausal women (mean age, 56 ± 4 y) participated in a 13-week program of walking training at moderate intensity. Heart rate, blood pressure, double product, TNF-α, dehydroepiandrosterone sulfate (DHEA-S), and cortisol were evaluated before and after the intervention program.
Before walking training, the ACE DD genotype showed significantly higher TNF-α (P = .007) and lower DHEA-S concentrations (P = .022) than the ACE II/ID individuals. After walking training, both subgroups significantly decreased TNF-α plasma levels and cortisol/DHEA-S ratio (P = .001 and P = .016, respectively) and significantly increased DHEA-S levels (P < .001). Moreover, all the cardiovascular parameters were significantly reduced in the ACE DD participants (P ≤ .05), whereas the ACE I-allele carriers showed a decrease in heart rate (P ≤ .05) and the double product (P ≤ .05).
ACE I/D polymorphism is linked to different adrenal steroid and cytokine levels, and ACE I-allele carriers show a better adrenal activity and systemic inflammatory profile. The introduction of walking training positively influences the menopause immune-neuroendocrine changes, independent of ACE I/D genotype.
雌激素缺乏、全身低度炎症和肾上腺功能减退在非传染性慢性病（NCD）的发展中起核心作用。血管紧张素转换酶（ACE）插入/缺失（I/D）多态性中，缺失变体（DD）与循环血管紧张素 II 水平高于 I 等位基因携带者（II/ID）有关，这可能与所有这些分子途径相互作用，增加 NCD 风险。另一方面，体育锻炼可以对抗 NCD 的发生，可能作用于相同的途径。
本研究旨在研究步行训练对 ACE I/D 基因型绝经后妇女肾上腺类固醇和细胞因子水平以及心血管参数的影响。
36 名（DD=15，II/ID=21）久坐的绝经后妇女（平均年龄 56±4 岁）参加了一项为期 13 周的中等强度步行训练计划。在干预计划前后评估心率、血压、双乘积、TNF-α、硫酸脱氢表雄酮（DHEA-S）和皮质醇。
在步行训练前，ACE DD 基因型的 TNF-α 显著升高（P=0.007），DHEA-S 浓度显著降低（P=0.022）。步行训练后，两组 TNF-α 血浆水平和皮质醇/DHEA-S 比值均显著降低（P=0.001 和 P=0.016），DHEA-S 水平显著升高（P<0.001）。此外，ACE DD 组的所有心血管参数均显著降低（P≤0.05），而 ACE I 等位基因携带者的心率（P≤0.05）和双乘积（P≤0.05）降低。
ACE I/D 多态性与不同的肾上腺类固醇和细胞因子水平相关，ACE I 等位基因携带者显示出更好的肾上腺活性和全身炎症特征。引入步行训练可独立于 ACE I/D 基因型对绝经后免疫神经内分泌变化产生积极影响。
