运动中的相对能量缺乏症(REDs):内分泌表现、病理生理学和治疗方法。

IF 22 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Angeliki M Angelidi, Konstantinos Stefanakis, Sharon H Chou, Laura Valenzuela-Vallejo, Konstantina Dipla, Chrysoula Boutari, Konstantinos Ntoskas, Panagiotis Tokmakidis, Alexander Kokkinos, Dimitrios G Goulis, Helen A Papadaki, Christos S Mantzoros
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引用次数: 0

摘要

对瘦弱、能量缺乏的运动员和军人群体的研究,将女性运动员三联征的概念扩展为运动中相对能量缺乏(REDs)综合征。REDs 代表了低能量可用性(LEA)诱发的一系列异常现象,是 REDs 概念中描述的所有症状的根本原因,影响着任何生理性别的运动人群。短期和长期的 LEA 与其他调节因素相结合,可产生多种不适应变化,损害各种生理系统,并对健康、福祉和运动表现产生不利影响。因此,REDs 的综合定义涵盖了与 LEA 相关的一系列生理后遗症和不良临床结果,如神经内分泌、骨骼、免疫和血液学影响,最终导致健康和运动表现受损。在本综述中,我们将讨论 REDs 及其相关疾病的病理生理学。我们简要研究了目前针对 REDs 的治疗建议,主要侧重于针对其根本原因--能量不足--的非药物、行为和生活方式的调整。我们还讨论了旨在控制月经功能障碍和骨应力损伤等症状的治疗方法,并探讨了针对潜在生理机制的潜在新型疗法,强调了瘦素和激活素-花粉抑制素轴在 REDs 病理生理学和治疗中的作用,这些作用仍有待全面阐明。在不久的将来,利用我们对能量可用性或缺乏能量可用性的分子和生理轴的新认识,新型疗法可能会恢复与 LEA 相关的异常,从而预防和/或治疗与 REDs 相关的健康并发症,如应力性骨折,并改善运动表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relative Energy Deficiency in Sport (REDs): Endocrine Manifestations, Pathophysiology and Treatments.

Research on lean, energy-deficient athletic and military cohorts has broadened the concept of the Female Athlete Triad into the Relative Energy Deficiency in Sport (REDs) syndrome. REDs represents a spectrum of abnormalities induced by low energy availability (LEA), which serves as the underlying cause of all symptoms described within the REDs concept, affecting exercising populations of either biological sex. Both short- and long-term LEA, in conjunction with other moderating factors, may produce a multitude of maladaptive changes that impair various physiological systems and adversely affect health, well-being, and sport performance. Consequently, the comprehensive definition of REDs encompasses a broad spectrum of physiological sequelae and adverse clinical outcomes related to LEA, such as neuroendocrine, bone, immune, and hematological effects, ultimately resulting in compromised health and performance. In this review, we discuss the pathophysiology of REDs and associated disorders. We briefly examine current treatment recommendations for REDs, primarily focusing on nonpharmacological, behavioral, and lifestyle modifications that target its underlying cause-energy deficit. We also discuss treatment approaches aimed at managing symptoms, such as menstrual dysfunction and bone stress injuries, and explore potential novel treatments that target the underlying physiology, emphasizing the roles of leptin and the activin-follistatin-inhibin axis, the roles of which remain to be fully elucidated, in the pathophysiology and management of REDs. In the near future, novel therapies leveraging our emerging understanding of molecules and physiological axes underlying energy availability or lack thereof may restore LEA-related abnormalities, thus preventing and/or treating REDs-related health complications, such as stress fractures, and improving performance.

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来源期刊
Endocrine reviews
Endocrine reviews 医学-内分泌学与代谢
CiteScore
42.00
自引率
1.00%
发文量
29
期刊介绍: Endocrine Reviews, published bimonthly, features concise timely reviews updating key mechanistic and clinical concepts, alongside comprehensive, authoritative articles covering both experimental and clinical endocrinology themes. The journal considers topics informing clinical practice based on emerging and established evidence from clinical research. It also reviews advances in endocrine science stemming from studies in cell biology, immunology, pharmacology, genetics, molecular biology, neuroscience, reproductive medicine, and pediatric endocrinology.
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