有氧运动对中年女性心肺功能和血管内皮功能的影响及其与雌激素的关系

目的:明确有氧运动对中年女性心肺功能的提高是否与血管内皮功能的改善有关,以及心肺功能的提高程度是否受女性雌激素水平的影响。方法:前瞻性募集51名45~55岁健康女性,随机分为运动组(31名,其中15名已绝经)和对照组(20名),运动组进行12周中等强度有氧运动,对照组不进行运动干预。运动心肺功能测试以PVO2反映心肺功能,ELISA测量血浆ADMA和NOS水平评价内皮功能,同时观察血浆雌二醇水平等。结果:运动12周后,运动组PVO2及NOS均较运动前及对照组有显著提高(P0.05),ADMA较运动前及对照组明显下降(P0.05),而E2、体重指数在运动前后及对照组比较均差异无统计学意义;对照组运动干预前后各项指标比较差异无统计学意义。有氧运动组中绝经者与未绝经者上述指标测值均无明显差异。Pearson相关分析显示运动前后PVO2的提高程度与血管内皮功能的改善程度有显著相关性(r=0.339,P=0.023),与ADMA显著负相关(r=0.333,P=0.025),而PVO2和内皮功能的程度均与基线雌激素水平无相关性。结论:有氧运动训练可以显著提高健康中年女性的心肺功能和改善其血管内皮功能,推测心肺功能的提高可能与内皮功能的改善有关;而内皮功能的改善并不依赖于受试者的基础雌激素水平,提示绝经前及绝经后女性均能从运动中得到相同的获益。

Effects of aerobic exercise on cardiorespiratory fitness and endothelial function in middle aged women

Objective: To evaluate the effects of aerobic exercise on cardiorespiratory fitness and endothelial function in middle aged women and whether these effects are related to the estrogen levels. Methods: In this test, a total of 45 healthy women aged 45-55 years were divided into exercise group (n=31, including 15 postmenopausal women) and control group (20 subjects). The exercise group conducted a 12-weeks aerobic exercise, while the control group had no exercise intervention. Each subject had taken cardiopulmonary exercise testing before and after 12 week with PVO2 reflecting the cardiorespiratory fitness. Plasma ADMA and NOS levels were measured to estimate endothelial function, and changes in plasma estrogen levels were also detected. Results: After 12 weeks, PVO2 and plasma NOS levels were increased, and plasma ADMA levels were decreased in exercise group as compared with the control group (P<0.05). However, there were no significant differences between premenopausal and postmenopausal women (P>0.05). Pearson correlation analysis showed the degrees of improvement in PVO2 was positively correlated with NOS (r=0.339, P=0.023), and negatively with ADMA (r=0.333, P=0.025). Both PVO2 and NOS had no correlation to baseline estrogen levels. Conclusion: The aerobic exercise training can significantly improve cardiorespiratory fitness in healthy middle-aged women and improve endothelial function as well. The increases in the cardiorespiratory fitness may be related to the improvement of endothelial function. The improvement of endothelial function is not dependent on the basic estrogen level, suggesting that premenopausal and postmenopausal women get the same benefit from exercise.