Supplementary information for Examining the role of physical activity interventions in modulating androgens and cardiovascular health in postmenopausal females: A narrative review

Supplementary files for article Examining the role of physical activity interventions in modulating androgens and cardiovascular health in postmenopausal females: A narrative review <br> Growing literature has examined the role of physical activity (PA) in modifying the effects of estrogen withdrawal on cardiovascular health in postmenopausal females, yet the impact of PA on androgens is less clear. Changes in androgen concentrations following regular PA may improve cardiovascular health. This narrative review summarized the literature assessing the impact of PA interventions on androgens in postmenopausal females. The association between changes in androgen concentrations and cardiovascular health following PA programs was also examined. Randomized controlled trials were included if they: (i) implemented a PA program of any type and duration in postmenopausal females; and (ii) measured changes in androgen concentrations. Following PA interventions, no changes in androstenedione, conflicting changes in dehydroepiandrosterone/ dehydroepiandrosterone-sulfate, and increases in sex hormone-binding globulin (SHBG) concentrations were found. Total testosterone decreased following aerobic PA but increased after resistance training. Most aerobic PA interventions led to reductions in free testosterone. A combination of caloric restriction and/or fat loss enhanced the influence of PA on most androgens. Evidence exploring the relationship between changes in androgens and cardiovascular health indicators was scarce and inconsistent. PA has shown promise in modifying the concentrations of some androgens (free and total testosterone, SHBG), and remains a well-known beneficial adjuvant option for postmenopausal females to manage their cardiovascular health. Fat loss influences the effect of PA on androgens, however, the synergistic role of PA and androgens on cardiovascular health merits further examination. Many research gaps in the relationship between PA, androgens and cardiovascular disease in postmenopausal females remain.

本文件为论文《探究体力活动干预对绝经后女性雄激素调节与心血管健康的作用：一篇叙述性综述》的补充材料。

越来越多的研究探讨了体力活动（physical activity, PA）在缓解绝经后女性雌激素撤退对心血管健康影响中的作用，但目前体力活动对雄激素（androgens）的影响尚不明朗。规律体力活动后雄激素浓度的变化或可改善心血管健康。本叙述性综述梳理了评估体力活动干预对绝经后女性雄激素水平影响的相关研究，并分析了体力活动干预后雄激素浓度变化与心血管健康之间的关联。

纳入本综述的随机对照试验（randomized controlled trials）需满足以下条件：(i) 针对绝经后女性实施任意类型、任意时长的体力活动干预方案；(ii) 检测雄激素浓度的变化情况。

研究结果显示，经体力活动干预后，雄烯二酮（androstenedione）水平无显著变化，脱氢表雄酮/硫酸脱氢表雄酮（dehydroepiandrosterone/dehydroepiandrosterone-sulfate）的变化结果存在分歧，而性激素结合球蛋白（sex hormone-binding globulin, SHBG）浓度显著升高。总体睾酮水平在有氧运动（aerobic PA）干预后有所下降，但在抗阻训练（resistance training）后则呈上升趋势。多数有氧运动干预方案可降低游离睾酮水平。热量限制（caloric restriction）联合减脂（fat loss）可增强体力活动对多数雄激素的调控作用。目前关于雄激素变化与心血管健康指标间关联的研究证据较为匮乏且结论不一。

研究表明，体力活动可有效调节部分雄激素（游离睾酮、总体睾酮及SHBG）的浓度，仍是绝经后女性管理心血管健康的公认有效辅助手段。不过，减脂会影响体力活动对雄激素的作用效果，而体力活动与雄激素对心血管健康的协同作用仍有待进一步探究。绝经后女性体力活动、雄激素与心血管疾病三者间的关联仍存在诸多研究空白。