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绝经后时期脱氢表雄酮对代谢和心血管系统的影响。

Dehydroepiandrosterone on metabolism and the cardiovascular system in the postmenopausal period.

机构信息

Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, 105 Alexander Fleming St, Campinas, SP, 13083-881, Brazil.

Department of Physiology and Biophysics, Institute of Biomedical Science, University of Sao Paulo, 1524 Prof. Lineu Prestes Ave., ICB 1, Sao Paulo, SP, 05508-900, Brazil.

出版信息

J Mol Med (Berl). 2020 Jan;98(1):39-57. doi: 10.1007/s00109-019-01842-5. Epub 2019 Nov 12.

Abstract

Dehydroepiandrosterone (DHEA), mostly present as its sulfated ester (DHEA-S), is an anabolic hormone that naturally declines with age. Furthermore, it is the most abundant androgen and estrogen precursor in humans. Low plasma levels of DHEA have been strongly associated with obesity, insulin resistance, dyslipidemia, and high blood pressure, increasing the risk of cardiovascular disease. In this respect, DHEA could be regarded as a promising agent against metabolic syndrome (MetS) in postmenopausal women, since several age-related metabolic diseases are reported during aging. There are plenty of experimental evidences showing beneficial effects after DHEA therapy on carbohydrate and lipid metabolism, as well as cardiovascular health. However, its potential as a therapeutic agent appears to attract controversy, due to the lack of effects on some symptoms related to MetS. In this review, we examine the available literature regarding the impact of DHEA therapy on adiposity, glucose metabolism, and the cardiovascular system in the postmenopausal period. Both clinical studies and in vitro and in vivo experimental models were selected, and where possible, the main cellular mechanisms involved in DHEA therapy were discussed. Schematic representation showing some of the general effects observed after administration DHEA therapy on target tissues of energy metabolism and the cardiovascular system. ↑ represents an increase, ↓ represents a decrease, - represents a worsening and ↔ represents no change after DHEA therapy.

摘要

脱氢表雄酮(DHEA),主要以其硫酸盐酯(DHEA-S)的形式存在,是一种合成代谢激素,随着年龄的增长而自然下降。此外,它是人体中最丰富的雄激素和雌激素前体。血浆中 DHEA 水平低与肥胖、胰岛素抵抗、血脂异常和高血压密切相关,增加了心血管疾病的风险。在这方面,DHEA 可以被视为绝经后妇女代谢综合征(MetS)的一种有前途的治疗药物,因为在衰老过程中会出现几种与年龄相关的代谢疾病。大量的实验证据表明,DHEA 治疗对碳水化合物和脂质代谢以及心血管健康有有益的影响。然而,由于缺乏对一些与 MetS 相关症状的影响,其作为治疗药物的潜力似乎存在争议。在这篇综述中,我们检查了关于 DHEA 治疗对绝经后时期肥胖、葡萄糖代谢和心血管系统影响的现有文献。选择了临床研究以及体外和体内实验模型,并在可能的情况下,讨论了 DHEA 治疗涉及的主要细胞机制。示意性表示在给予 DHEA 治疗后对能量代谢和心血管系统的靶组织观察到的一些一般影响。↑表示增加,↓表示减少,-表示恶化,↔表示 DHEA 治疗后没有变化。

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