低体脂影响女性月经的机制及康复策略研究进展

Research progress of the mechanisms of low body fat influencing female menstruation and rehabilitative therapeutic strategies

能量摄入不足和(或)消耗过多的能量供应缺乏状态可逆性抑制下丘脑-垂体轴内分泌活动和功能,引起低促性腺型性腺功能减低。而低体脂和生殖轴抑制落后于能量代谢的变化,是长期能量失衡状态的适应性结果。早期体脂/体质量临界假说认为一定水平的体脂率是青春期启动和正常月经周期维持的必要条件,后期研究认为二者并不存在绝对相关性。但仍不可否认体脂与女性生殖激素、月经和排卵功能存在一定联系,其可能是通过脂肪组织和脂肪因子(瘦素、脂联素)与生殖轴和激素之间的相互作用来影响生殖功能。本文对低体脂影响月经初潮和正常月经周期的机制、脂肪组织和脂肪因子的作用及康复策略的研究进展进行综述。

The status of energy availability deficiency caused by deficient energy intake and(or)excessive energy expend,would irreversibly inhibit the hypothalamic-pituitary axis’s endocrine activity and function,resulting in hypogonadotropic hypogonadism.The drop of body fat and the inhibition of reproductive axis fall behind the change of energy metabolism,but the adaptive adjustment under negative energy imbalance for long term.The early“critical fat hypothesis”considered a threshold of body fat or weight is necessary for puberty initiation and menstrual cycle maintenance while later researches held that body fat and reproduction have no critical correlation.However,it should not deny that there be certain relationship between body fat and female reproductive hormone,menstruation and ovulation function,and the former could impact reproductive function by playing key role in interaction between adipose tissue,adipokines(leptin,adiponectin)and reproductive axis and hormones.This review will focus on the mechanism that low body fat influencing menarche and normal menstruation,and the function of adipose tissue and adipokines,and the rehabilitative therapeutic strategies.