Iglesias Pedro
Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Calle Joaquín Rodrigo, 1, Majadahonda, 28222 Madrid, Spain.
Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, 28222 Madrid, Spain.
J Clin Med. 2025 Jun 25;14(13):4490. doi: 10.3390/jcm14134490.
Skeletal muscle, traditionally recognized for its motor function, has emerged as a key endocrine organ involved in metabolic regulation and interorgan communication. This narrative review addresses the dual role of muscle as a target tissue for classical hormones-such as growth hormone (GH), insulin-like growth factor type 1 (IGF-1), thyroid hormones, and sex steroids-and as a source of myokines, bioactive peptides released in response to muscle contraction that exert autocrine, paracrine, and endocrine effects. Several relevant myokines are discussed, such as irisin and Metrnl-like myokines (Metrnl), which mediate exercise-associated metabolic benefits, including improved insulin sensitivity, induction of thermogenesis in adipose tissue, and immunometabolic modulations. It also examines how muscle endocrine dysfunction, caused by chronic inflammation, hormone resistance, or sedentary lifestyle, contributes to the development and progression of metabolic diseases such as obesity, type 2 diabetes, and sarcopenia, highlighting the importance of muscle mass in the prognosis of these pathologies. Finally, the therapeutic potential of interventions aimed at preserving or enhancing muscle function-through physical exercise, hormone therapy and anabolic agents-is highlighted, together with the growing research on myokines as biomarkers and pharmacological targets. This review expands the understanding of muscle in endocrinology, proposing an integrative approach that recognizes its central role in metabolic health and its potential to innovate the clinical management of endocrine-metabolic diseases.
骨骼肌传统上因其运动功能而被认知，如今已成为参与代谢调节和器官间通讯的关键内分泌器官。本叙述性综述探讨了肌肉作为经典激素（如生长激素（GH）、胰岛素样生长因子1型（IGF-1）、甲状腺激素和性类固醇）的靶组织以及作为肌动蛋白的来源的双重作用，肌动蛋白是肌肉收缩时释放的生物活性肽，具有自分泌、旁分泌和内分泌作用。文中讨论了几种相关的肌动蛋白，如鸢尾素和类Metrnl肌动蛋白（Metrnl），它们介导与运动相关的代谢益处，包括改善胰岛素敏感性、诱导脂肪组织产热以及免疫代谢调节。文章还研究了由慢性炎症、激素抵抗或久坐不动的生活方式引起的肌肉内分泌功能障碍如何导致肥胖、2型糖尿病和肌肉减少症等代谢性疾病的发生和发展，强调了肌肉量在这些疾病预后中的重要性。最后，强调了通过体育锻炼、激素治疗和合成代谢药物等干预措施来维持或增强肌肉功能的治疗潜力，以及对肌动蛋白作为生物标志物和药理学靶点的研究不断增加。这篇综述扩展了对肌肉在内分泌学中的理解，提出了一种综合方法，认识到其在代谢健康中的核心作用以及在创新内分泌代谢疾病临床管理方面的潜力。
