Bioenergetic and Metabolic Consequences of the Loss of Ovarian Function in Women

性腺老化在调节某些归因于衰老的生物学变化方面起着明显的作用。 进程。这方面的一个例子是绝经时卵巢衰竭导致的加速骨质流失， 雌激素的恢复可以有效地缓解这种症状，直到其他非性腺衰老因子触发 一种衰落。因为很难将性腺老化的后果与时间上的衰老分开，所以它不是 明确性腺功能丧失在多大程度上会增加患其他年龄相关疾病的风险 骨质疏松。有令人信服的证据表明，对雌性和雄性动物的研究表明，性腺的丧失 机能导致自发性体力活动急剧下降30%至80%。在女性身上，但不是 男性，这会导致体重加速增加，腹部脂肪显著增加，并导致代谢障碍。 一项对绝经期妇女的前瞻性研究表明，体力活动 而维持能量平衡也受人类性腺功能的调节。在这方面， UCAMC SCOR临床项目的主要目标是使用受控干预方法来 确定接近更年期的女性卵巢功能抑制是否会导致 体力活动明显减少。其他目标是评估其他能源成分的变化 决定能量平衡的破坏是否与生物标记物的变化有关 疾病风险，并确定程序化运动是否可以防止这些变化。要实现这些目标 AIMS，66名年龄在45岁至50岁之间、月经周期功能正常的女性将随机接受6 安慰剂、促性腺激素释放激素激动剂(GnRHAc)或GnRHAG+运动干预。 主要结果将是体力活动能量消耗(PAEE)，从每天的总能量计算 通过调整食物和休息EE的热效应来加速(T形三通；双标记水) (Ree；间接量热法)。全球假说是GnRHAG对卵巢功能的抑制 在女性中，由于PAEE的降低以及可能的REE的降低，会导致TEE的下降。 相关性(请参阅说明)： 继发于性腺功能丧失的PAEE下降可能会对健康产生各种不利影响 因为低体力活动与全因死亡率、冠心病、中风、2型有关 糖尿病、某些癌症、抑郁症等。此外，这可能会有更大的不良影响 对女性的影响大于对男性的影响，因为性腺功能丧失发生在女性年龄较早的时候。

Gonadal aging plays a distinct role in mediating some of the biological changes ascribed to the aging process. An example of this is the accelerated bone loss due to ovarian failure at the time of the menopause, which can be effectively mitigated with restoration of estrogens until other non-gonadal aging factors trigger a decline. Because it is difficult to isolate the consequences of gonadal aging from chronologic aging, it is not clear to what extent the loss of gonadal function increases risk for age-related diseases other than osteoporosis. There is compelling evidence from studies of female and male animals that the loss of gonadal function causes a dramatic decline of 30% to 80% in spontaneous physical activity. In females, but not males, this leads to accelerated weight gain, a marked increase in abdominal fat, and metabolic dysfunction. One prospective study of women followed through the menopausal transition suggests that physical activity and the maintenance of energy balance are also regulated by gonadal function in humans. In this context, the primary goal of the UCAMC SCOR clinical project is to use a controlled intervention approach to determine whether the suppression of ovarian function in women approaching the menopause causes a marked decline in physical activity. Additional goals are to assess changes in other components of energy expenditure, determine whether the disruption of energy balance is associated with changes in biomarkers of disease risk, and determine whether programmed exercise can prevent these changes. To achieve these aims, 66 women aged 45 to 50 years with normal menstrual cycle function will be randomized to receive 6 months of placebo, gonadotropin releasing hormone agonist (GnRHAc), or GnRHAG+exercise intervention. The primary outcome will be physical activity energy expenditure (PAEE), calculated from total daily energy expediture (TEE; by doubly-labeled water) with adjustment for the thermic effect of food and resting EE (REE; by indirect calorimetry). The global hypothesis is that the suppression of ovarian function with GnRHAG in women will cause a decrease in TEE due to decreased PAEE and, possibly, a decrease in REE. RELEVANCE (See instructions): A decline in PAEE secondary to the loss of gonadal function could have diverse adverse effects on health because low physical activity is associated with all-cause mortality, coronary heart disease, stroke, type 2 diabetes, certain cancers, depression, etc. Moreover, this would be expected to have a greater adverse effect in women than in men, because the loss of gonadal function occurs at an earlier age in women.