Horber F F, Scheidegger J R, Grünig B E, Frey F J
J Clin Endocrinol Metab. 1985 Jul;61(1):83-8. doi: 10.1210/jcem-61-1-83.
Treatment with glucocorticoids causes wasting of proximal skeletal muscles. There is evidence that physical training improves muscle mass and strength in glucocorticoid-treated rats. Whether this is also true in humans is not known. The present investigation was designed to establish in what respect moderate physical training may alter muscle mass and function as assessed quantitatively by computed tomography (CT) and an isokinetic dynamometer (Cybex II). Compared with matched normal subjects (n = 12), patients (n = 12) treated with prednisone [12.6 +/- 3.3 (+/- SD) mg/day] had a 20% lower midthigh muscle area and a 36% increase in midthigh fat to muscle ratio. The mean peak torque and the total work output of the thigh muscle were lower by more than 20%. Baseline measurements of total work output or peak torque at all tested velocities increased with midthigh muscle area (r = 0.73; n = 24; P less than 0.001). Fifty days of isokinetic training in 12 patients increased the thigh muscle area, decreased the thigh fat area, and normalized the mean peak torque and total work output. The increase in peak torque was inversely correlated with the daily dose of prednisone (r = 0.60; n = 12; P less than 0.05). Thus, glucocorticoid-induced muscle wasting can be reversed by increasing physical activity in patients taking a low to moderate dose of prednisone.
糖皮质激素治疗会导致近端骨骼肌萎缩。有证据表明，体育锻炼可改善糖皮质激素治疗的大鼠的肌肉质量和力量。但这在人类中是否同样如此尚不清楚。本研究旨在确定适度体育锻炼在哪些方面可能会改变肌肉质量和功能，这些改变通过计算机断层扫描（CT）和等速测力计（Cybex II）进行定量评估。与匹配的正常受试者（n = 12）相比，接受泼尼松[12.6±3.3（±标准差）mg/天]治疗的患者（n = 12）大腿中部肌肉面积低20%，大腿中部脂肪与肌肉的比例增加36%。大腿肌肉的平均峰值扭矩和总功输出降低超过20%。在所有测试速度下，总功输出或峰值扭矩的基线测量值随大腿中部肌肉面积增加（r = 0.73；n = 24；P < 0.001）。12名患者进行50天的等速训练后，大腿肌肉面积增加，大腿脂肪面积减少，平均峰值扭矩和总功输出恢复正常。峰值扭矩的增加与泼尼松的每日剂量呈负相关（r = 0.60；n = 12；P < 0.05）。因此，对于服用低至中等剂量泼尼松的患者，增加身体活动可以逆转糖皮质激素引起的肌肉萎缩。
