Huang Xin, Huang Longxiang, Liu Changhua
College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, Sichuan, China.
School of Pharmacy/School of Modern Chinese Medicine Industry, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, Sichuan, China.
Eur J Appl Physiol. 2025 Apr;125(4):989-999. doi: 10.1007/s00421-024-05669-y. Epub 2024 Dec 2.
Muscle injuries, particularly those resulting from irregular bouts of strenuous exercise, have become a significant public health issue, especially among the athletic population. The physiological mechanisms linking intense physical exertion to muscle damage remain incompletely understood, necessitating further investigation to elucidate the causal pathways involved.
The objective of this systematic review is to explore the physiological mechanisms that may underlie the causal relationship between strenuous exercise and the incidence of muscle injury.
A systematic review was conducted to synthesize available evidence on the topic.
We utilized advanced Mendelian randomization techniques with dual cohorts to analyze single-nucleotide polymorphisms (SNPs) significantly associated with strenuous exercise (P < 5 × 10^-8). Data on muscle injuries in the wrist and hand muscle, hips, and thighs were sourced from genome-wide association studies (GWAS) databases. A comprehensive sensitivity analysis was performed, incorporating inverse variance weighting, weighted median, MR-Egger regression, multicollinearity assessment, heterogeneity evaluation, and leave-one-out analyses.
Our findings reveal a significant positive correlation between strenuous exercise and the risk of muscle injury in the hips and thighs (OR = 1.0046062, 95% CI [0.0004911795, 0.008700143], p = 0.028195794). In contrast, no causal link was identified between strenuous exercise and muscle injury in the wrist and hand muscle (OR = 0.9989059, 95% CI [-0.01131070, 0.009121317], p = 0.8336501).
The present systematic review suggests that strenuous exercise is positively associated with an increased risk of muscle injury in the lower limbs. This association appears to be mediated through physiological mechanisms that are more pronounced in the lower extremities compared to the wrist and hand muscle. Further research is warranted to dissect the intricate physiological processes that contribute to this differential susceptibility to injury.
肌肉损伤，尤其是因不定期剧烈运动导致的损伤，已成为一个重大的公共卫生问题，在运动员群体中尤为突出。剧烈体力活动与肌肉损伤之间的生理机制仍未完全明了，需要进一步研究以阐明其中涉及的因果途径。
本系统评价的目的是探索剧烈运动与肌肉损伤发生率之间因果关系背后可能存在的生理机制。
进行了一项系统评价，以综合该主题的现有证据。
我们运用先进的孟德尔随机化技术和双队列分析与剧烈运动显著相关的单核苷酸多态性（SNP，P < 5×10^-8）。手腕和手部肌肉、臀部及大腿肌肉损伤的数据来自全基因组关联研究（GWAS）数据库。进行了全面的敏感性分析，包括逆方差加权、加权中位数、MR-Egger回归、多重共线性评估、异质性评估和留一法分析。
我们的研究结果显示，剧烈运动与臀部和大腿肌肉损伤风险之间存在显著正相关（优势比[OR]=1.0046062，95%置信区间[0.0004911795，0.008700143]，p=0.028195794）。相比之下，未发现剧烈运动与手腕和手部肌肉损伤之间存在因果联系（OR=0.9989059，95%置信区间[-0.01131070，0.009121317]，p=0.8336501）。
本系统评价表明，剧烈运动与下肢肌肉损伤风险增加呈正相关。这种关联似乎是通过生理机制介导的，与手腕和手部肌肉相比，这些生理机制在下肢更为明显。有必要进一步研究剖析导致这种不同损伤易感性的复杂生理过程。
