Sex as a biological variable in exercise prescription: a critical consideration in developing a road map for sex-related differences in cardiovascular research.
Sex as a biological variable in exercise prescription: a critical consideration in developing a road map for sex-related differences in cardiovascular research.
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性别作为运动处方中的生物变量：制定心血管研究中性别相关差异路线图的关键考虑因素。
DOI：
10.1152/ajpheart.00707.2022
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Richardson,RussellS
中科院分区：
文献类型：
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作者：
Bunsawat,Kanokwan;Richardson,RussellS
30 长期以来，定期参加耐力和阻力训练一直被建议作为旨在促进心血管疾病和 32 种代谢疾病的预防和治疗的生活方式的基石。 31然而，人们越来越认识到运动处方并不是“一刀切”的方案 33。事实上，有新的证据表明运动的生理反应存在潜在的性别相关差异 34 (1)。因此，有必要对运动 35 训练引起的男性和女性心血管健康生物标志物的变化进行进一步研究 36，因为对这方面生理学的更好理解可能代表着优化个人定制运动处方的关键步骤 37，从而为两性带来更好的健康 38 结果。最近，Thomas 等人 (2) 在《华尔街日报》上试图阐明 39 名男性和女性在进行 12-40 周的耐力和抗阻训练后传统心血管危险因素是否表现出类似的变化，以及男性和女性在每种训练方式后的反应程度和反应频率是否存在差异。 42 为了解决这些有趣且重要的研究问题，Thomas 等人 (2) 采用了 43 项随机交叉研究设计，其中 68 名参与者参与了以中心为基础的 44 项监督运动干预措施，为期 12 周，每种训练方式之间有 12 周的淘汰期。除了这种严格的研究设计之外，Thomas 等人 (2) 的研究的一个非常新颖的方面是，仅招募同卵双胞胎和同性异卵双胞胎的参与者 47，这有助于减少可能由于遗传性相关问题而导致的研究结果的变异性 48。从研究设计的角度来看，49 作者应该受到赞扬，因为他们在进行一项高水平研究方面做出了出色的努力，该研究在临床上具有重要意义、及时性，并且通过将性别视为生物学变量，为最近提高心血管研究的严谨性、可重复性和包容性做出了贡献 (3)。 5253 Thomas 等人的研究 (2) 记录了男女在进行耐力训练后运动能力的改善，评估为 54 峰值摄氧量 (VO2peak)，但阻力训练没有改善。 55 当 VO2peak 以绝对单位 57 (L/min)(p= 0.051) 表示时，56 名男性志愿者的改善程度（即相对于基线的变化）似乎比女性志愿者更高，但当以相对体重 (mL/min/kg) 表示时则不然(2)。力量，58 确定为卧推和腿举期间 1 次重复的最大值，男女也都有所增加，59
30 Regular engagement in endurance and resistance training has long been recommended as the 31 cornerstone of a lifestyle intended to foster the prevention and treatment of cardiovascular and 32 metabolic diseases. However, there is an increasing recognition that exercise prescription is not a 33 “one size fits all” regime. Indeed, there is emerging evidence of potential sex-related differences 34 in the physiological responses to exercise (1). Therefore, additional investigation into exercise 35 training-induced changes in biomarkers of cardiovascular health in males and females is 36 warranted, as an improved understanding of this aspect of physiology may represent a critical 37 step towards optimizing personally tailored exercise prescription that would lead to better health 38 outcomes for both sexes. Recently in The Journal, Thomas et al.(2) sought to elucidate whether 39 males and females exhibit similar changes in traditional cardiovascular risk factors following 12 40 weeks of endurance and resistance training and whether the degree of responses as well as the 41 frequency of responders following each training modality differed between males and females. 42 To address these interesting and important research questions, Thomas et al.(2) employed a 43 randomized cross-over study design, whereby sixty-eight participants engaged in center-based, 44 supervised exercise interventions for 12 weeks, separated by a 12 week-washout period between 45 each training modality. In addition to this rigorous study design, an exceptionally novel aspect of 46 the study by Thomas et al.(2) was the recruitment of only participants who were monozygotic 47 and same-sex dizygotic twin pairs, which serves to help reduce variability in findings that may 48 be due to heritability-related issues. From the study design standpoint, the authors should be 49 commended for their excellent effort in conducting a high-caliber investigation that is clinically 50 significant, timely, and contributes to the recent effort to enhance rigor, reproducibility, and 51 inclusivity in cardiovascular research by considering sex as a biological variable (3). 5253 The study by Thomas et al.(2) documented an improvement in exercise capacity, assessed as 54 peak oxygen uptake (VO2peak), following endurance, but not resistance training in both sexes. 55 The degree of improvement (ie a change from baseline) appeared to be numerically higher in 56 male volunteers compared to female volunteers when VO2peak was expressed in an absolute units 57 (L/min)(p= 0.051), but not when expressed relative to body weight (mL/min/kg)(2). Strength, 58 determined as 1-repetition maximum during bench and leg press, also increased in both sexes, 59