Novel Actions of Metformin to Augment Resistance Training Adaptations in Older Ad

描述（由申请人提供）：随着年龄的增长，骨骼肌质量和力量的损失降低了生活质量，是限制老年人独立生活的主要因素。渐进式抗阻运动训练（PRT）是最有效的干预措施，以增加肌肉力量和对抗衰老的肌肉萎缩;然而，总体而言，肌肉对PRT的反应是迟钝的，在老年人中变化很大。我们的研究小组已经确定，肌肉中大量的抗炎、替代性激活的M2巨噬细胞预测了老年人对PRT的反应;在训练开始前，M2巨噬细胞数量最多、炎症基因表达最低的人获得了最多的质量。此外，对胰岛素抵抗研究中获得的肌肉活检的重新检查表明，二甲双胍治疗增加了M2巨噬细胞丰度，并降低了炎性细胞因子基因表达。这些激动人心的发现使我们得出了我们的中心假设，即二甲双胍辅助治疗可能通过改变肌肉组织炎症环境来改善老年人对PRT的反应，从而增强驱动PRT诱导的肌纤维肥大的机制。在目标1中，我们将确定二甲双胍治疗是否能增加老年功能受限成人的骨骼肌大小和力量。将招募受试者并随机接受安慰剂或二甲双胍治疗2周，随后进行14周PRT计划，继续药物/安慰剂治疗。肌肉大小和力量的增加将被量化。在目标2中，我们将确定肌肉中对二甲双胍的细胞和分子反应，这些反应与对PRT的反应改善相关。将在肌肉活检中检查肌肉巨噬细胞、炎症基因表达以及合成代谢和炎症信号通路。最后，二甲双胍影响肌肉对训练反应的潜在机制，将在目标3中使用人体肌肉细胞培养系统建模运动和肌肉微环境进行探索。前瞻性地识别可能对常规锻炼计划难治的个体，并确定 二甲双胍在改善对PRT的肌肉生长反应方面的有效性，可能有助于开发一种负担得起的、个性化的方法来维持或恢复骨骼肌质量和强度，从而促进更长的健康寿命。

DESCRIPTION (provided by applicant): The loss of skeletal muscle mass and strength with advancing age reduces quality of life and is a major factor limiting an elderly person's chance of living independently. Progressive resistance exercise training (PRT) is the most effective intervention identified to increase muscular strength and combat muscle atrophy of aging; however, overall the muscle response to PRT is blunted and highly variable in the elderly. Our research team has determined that the abundance of anti-inflammatory, alternatively activated M2 macrophages in muscle predicts response to PRT in the elderly; those with the highest number of M2 macrophages and lowest inflammatory gene expression prior to the start of training gained the most mass. Further, reexamination of muscle biopsies obtained in a study on insulin resistance showed that metformin treatment increased M2 macrophage abundance, and decreased inflammatory cytokine gene expression. These provocative findings have led us to our central hypothesis that adjuvant metformin may improve the responses to PRT in the elderly by altering the muscle tissue inflammatory environment, thereby enhancing mechanisms that drive PRT-induced myofiber hypertrophy. In Aim 1, we will determine if metformin treatment augments skeletal muscle size and strength gains in conjunction with PRT in older, functionally limited adults. Participants will be recruited and randomized to receive either placebo or metformin for 2 weeks followed by a 14 week PRT program with continued drug/placebo treatment. Gains in muscle size and strength will be quantified. In Aim 2, we will identify cellula and molecular responses in muscle to metformin which are associated with improved response to PRT. Muscle macrophages, inflammatory gene expression and anabolic and inflammatory signaling pathways will be examined in muscle biopsies. Finally, mechanisms underlying metformin effects on muscle response to training, using a human muscle cell culture system modeling exercise and the muscle microenvironment, will be explored in Aim 3. Prospective identification of individuals likely to be refractory to routine exercise programs, and determining the effectiveness of metformin in improving muscle growth response to PRT, may contribute to the development of an affordable, personalized approach to maintain or restore skeletal muscle mass and strength, thereby promoting longer healthspan.