Estrogen and progesterone exposure is reduced in response to energy deficiency in women aged 25-40 years.
Estrogen and progesterone exposure is reduced in response to energy deficiency in women aged 25-40 years.
复制标题
25-40 岁女性因能量缺乏而减少雌激素和孕激素的暴露。
DOI：
10.1093/humrep/deq172
复制
发表时间：
2010
期刊：
影响因子：
--
通讯作者：
DeSouza,MJ
中科院分区：
文献类型：
--
作者：
Williams,NI;Reed,JL;Leidy,HJ;Legro,RS;DeSouza,MJ
背景：循环类固醇的改变被认为是饮食和运动对乳腺癌风险和骨密度变化影响的重要媒介。本研究旨在验证适度运动训练结合热量限制会对绝经前妇女产生明显的月经紊乱和卵巢类固醇改变的假设。方法将久坐不动的绝经前妇女（25-40岁，体重指数：23.6±0.6 kg/m2）分为光调节组（LC,n= 9）或运动加热量限制组（EX + CR,n= 24），进行一次筛查、一次基线和四个相当于受试者月经周期长度的干预期研究。运动包括有监督的训练课程，即每周2次LC或4次EX + CR， 30-60分钟，中等强度。EX + CR组的饮食热量限制比基线能量需求低20-35%，而LC组保持热量。卵巢类固醇暴露通过每日尿雌激素-1和妊娠二醇葡萄糖醛酸盐（分别为E1G和PdG）和中期尿LH测量来确定。反复评估健康、体成分、血清性激素结合球蛋白（SHBG）和血清雌二醇（E2）。结果干预显著增加了VO2max，降低了体重（- 3.7±0.5 kg，范围从- 8.8到+1.8 kg）和体脂率（- 4.5±0.7%，范围从- 12到+0.3%），这主要归因于EX + CR受试者的变化（时间×组，P< 0.05）。干预期间，EX + CR组血清E2、尿E1G、PdG浓度显著下降（时间，P< 0.05）， SHBG短暂升高（时间，P< 0.05）， LC组无显著变化。曲线下E1G面积的减小与每日能量赤字显著相关（R=0.61；P= 0.003），而与体重减轻量无关。在两组中，干预对月经周期或月经紊乱的发生率均无显著影响。结论：在25-40岁的绝经前妇女中，适度有氧运动训练计划结合适度减肥可显著减少卵巢类固醇暴露而不破坏月经周期。每日能量不足比体重下降更能预示雌激素水平的下降。
BACKGROUNDAlterations in circulating steroids are believed to be important mediators of the impact that diet and exercise have on breast cancer risk and changes in bone density. This study aimed to test the hypothesis that moderate exercise training combined with caloric restriction would produce significant menstrual disturbances and alterations in ovarian steroids in premenopausal women.METHODSSedentary premenopausal women (25–40 years; body mass index: 23.6 ± 0.6 kg/m2) assigned to either a light conditioning (LC,n= 9) or an exercise combined with caloric restriction group (EX + CR,n= 24) were studied for one screening, one baseline and four intervention periods equivalent to the length of subjects’ menstrual cycles. Exercise consisted of supervised training sessions, i.e. two LC or four EX + CR times per week, 30–60 min at a moderate intensity. The EX + CR group was prescribed a diet representing a caloric restriction of 20–35% below baseline energy requirements, whereas the LC group remained eucaloric. Ovarian steroid exposure was determined with daily urinary estrone-1- and pregnanediol glucuronides (E1G and PdG, respectively) and mid-cycle urinary LH measures. Fitness, body composition, and serum sex hormone binding globulin (SHBG) and serum estradiol (E2) were assessed repeatedly.RESULTSThe intervention produced significant increases in VO2max and decreases in both body weight (−3.7 ± 0.5 kg; ranged from −8.8 to +1.8 kg) and percent body fat (−4.5 ± 0.7%; ranged from −12 to +0.3%), which were attributable primarily to changes in the EX + CR subjects (time × group;P< 0.05). Serum E2 and urinary E1G and PdG concentrations declined significantly across the intervention period (time;P< 0.05), whereas SHBG increased transiently (time;P< 0.05) in the EX + CR subjects, with no significant changes observed in the LC group. The decrease in E1G area under the curve was significantly related to the daily energy deficit (R=0.61;P= 0.003), not the amount of weight lost. There was no significant impact of the intervention on menstrual cyclicity or the incidence of menstrual disturbances in either group.CONCLUSIONSA moderate aerobic exercise training program combined with modest weight loss in accordance with recommended guidelines produces significant reductions in ovarian steroid exposure without disrupting menstrual cyclicity in premenopausal women aged 25–40 years. Exposure to a daily energy deficit is a stronger predictor of the decline in estrogen exposure than decreases in body weight.