Sex-Based Differences in Skeletal Muscle Kinetics and Fiber-Type Composition
Open accessAbstract
Previous studies have identified over 3,000 genes that are differentially expressed in male and female skeletal muscle. Here, we review the sex-based differences in skeletal muscle fiber composition, myosin heavy chain expression, contractile function, and the regulation of these physiological differences by thyroid hormone, estrogen, and testosterone. The findings presented lay the basis for the continued work needed to fully understand the skeletal muscle differences between males and females.
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TL;DR
This review summarizes sex-based differences in skeletal muscle fiber-type composition, myosin heavy chain expression, contractility, fatigue, and hormonal regulation by thyroid hormone, estrogen, and testosterone. It concludes that females generally have a higher prevalence of slower, more oxidative type-I/IIA fibers and greater endurance/recovery, while males tend to have faster contractile kinetics and greater fatigability.
Key findings
- More than 3,000 genes are differentially expressed between male and female skeletal muscle. In human vastus lateralis, female muscle has 35% more MyHC-I/β, 30% less MyHC-IIa, and 15% less MyHC-IIx mRNA than male muscle; type-I fibers account for 44% of biopsy area in women vs. 36% in men, while type-IIA fibers account for 34% in women vs. 41% in men.
- Contractile and fatigue differences are reported: mouse masseter maximal rate of force generation is higher in males (516 vs. 382 g/s), and relaxation is faster in males (41 vs. 48 ms). Endurance is lower in men than women in some studies (11 vs. 18 min; elbow flexor 829 s in males vs. 1,806 s in females), and in adductor pollicis force falls to ∼93% of maximum in women vs. 80% in men after <1 min of exercise.
- Hormonal regulation shows sex-specific effects. T3 treatment in rat soleus produces different fiber-type profiles in males (73% type-I/IIA, 26% type-I/IIAX) vs. females (37% type-I, 49% type-I/IIA, 6% type-I/IIAX). Ovariectomy reduces maximal isometric tetanic force from sham 180 mN to 168 mN, attenuated to 187 mN with estrogen; strong-binding myosin is 0.263 in OVX vs. 0.300 sham and 0.311 with estrogen.
- Testosterone-related morphology: in human vastus lateralis, type-I fibers are 19% larger, type-IIA fibers 59% larger, and type-IIX fibers 66% larger in men than women.
Methods
- Narrative review of sex-based differences in skeletal muscle fiber composition, myosin heavy chain expression, contractile function, and regulation by thyroid hormone, estrogen, and testosterone.
- Evidence is synthesized from cited human and animal studies, including human vastus lateralis biopsies and rodent, rabbit, guinea pig, and canine muscle models; no new primary data are presented.
- Main analysis is literature synthesis, with summary tables for fiber-type expression, baseline contractility, thyroid hormone effects, and ERβ-null mouse data.
Limitations
- The paper states that studies investigating sex-based differences in muscle fiber type are somewhat limited, that experimental models often study only males because sex is thought to confound results, and that further investigations are needed; it also notes that one or two genes cannot explain all sex differences.
- Evident from the text: this is a narrative review without a systematic search or meta-analysis, and findings are heterogeneous across species, muscles, ages, and methods; some cited results are contradictory, such as T3 effects on shortening velocity, and some mechanisms remain uninvestigated, including calcium storage capacity after ovariectomy.
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Claims the paper makes
0 of 103 cited sources checked · 0 supported · 0 flagged
- Premisecitation§ Abstract
All fibers measured in men have significantly larger cross-sectional areas (CSA) compared with women as normalized to biopsy section area.
“Additionally, all of the fibers measured in men have significantly larger cross-sectional areas (CSA) compared with women as normalized to biopsy section area (89).”
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- Premisecitation§ Abstract
Studies on chemically skinned human fibers reveal that MyHC isoform composition is the key determinant of muscle fiber contractile velocity and rate of force development.
“Studies on chemically skinned human fibers reveal that MyHC isoform composition is the key determinant of muscle fiber contractile velocity and rate of force development (11, 72).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Interpretationcitation§ Abstract
There is evidence of sexual dimorphisms with respect to muscle fiber-type composition.
“Although studies investigating sex-based differences in muscle fiber type are somewhat limited, there is also evidence of sexual dimorphisms with respect to muscle fiber-type composition (Table 2).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Table 2
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- Interpretationreasoning§ Abstract
The difference in CSA between men and women seems likely to be due to the overall greater mass in males compared with females since the increase in CSA is nearly proportional to the differences in mass.
“The difference in CSA seems likely to be due to the overall greater mass in males compared with females since the increase in CSA is nearly proportional to the differences in mass.”
Quote in the paperNot a substantial claim - Premisecitation§ Abstract
More than 3,000 genes have been identified as differentially expressed between male and female skeletal muscle.
“Previous studies have identified over 3,000 genes that are differentially expressed in male and female skeletal muscle.”
- Also stated in: § Abstract · plain
“More than 3,000 genes have been identified as being differentially expressed between male and female skeletal muscle (96).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [96] source
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- Also stated in: § Abstract · plain
- Premisecitation§ Abstract
Maximum unloaded shortening velocity is not different between young male and female fibers.
“Although evidence suggests that maximum unloaded shortening velocity is not different between young male and female fibers (25), sex-based differences are seen during fatigue recovery and endurance testing (Table 3).”
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- Premisecitation§ Abstract
Analysis of tetanic force in the mouse masseter shows no significant differences between the sexes on force production.
“Analysis of tetanic force in the mouse masseter shows no significant differences between the sexes on force production (22).”
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- Interpretationnone given§ Abstract
Generally, male muscles are more fatigable than female muscles.
“Generally, male muscles are more fatigable than female muscles.”
Quote in the paperNot a substantial claim - Interpretationcitation§ Abstract
Fiber-type composition and contractile function can be altered by the presence or removal of specific hormones.
“Fiber-type composition and contractile function can be altered by the presence or removal of specific hormones.”
Quote in the paperSubstantial claim - Premisecitation§ Abstract
Skeletal muscle is an estrogen-responsive tissue such that estrogen receptor (ER) mRNA and protein levels change with circulating estrogen levels.
“Skeletal muscle is an estrogen-responsive tissue such that estrogen receptor (ER) mRNA and protein levels change with circulating estrogen levels (7).”
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- Premisecitation§ Abstract
Thyroid hormone receptors and estrogen receptors are suggested to interact in a way that modulates estrogen-sensitive gene expression.
“Thyroid hormone receptors and estrogen receptors are suggested to interact in a way that modulates estrogen-sensitive gene expression (26, 102).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation§ Abstract
During a tetanic force protocol, the maximal rate of force generation is significantly higher in males than in females (516 vs. 382 g/s).
“However, the same study reveals that, during a tetanic force protocol, the maximal rate of force generation is significantly higher in males than in females (516 vs. 382 g/s).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [22] source
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- Premisecitation§ Abstract
Hypothyroidism produces a lower type-II fiber percentage in male and female patients compared with healthy patients.
“Hypothyroidism produces a lower type-II fiber percentage in male and female patients compared with healthy patients (63).”
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- Premisecitation§ Abstract
The rate of relaxation is significantly faster in the male masseter during a tetanus compared with the female masseter (41 vs. 48 ms).
“Additionally, the rate of relaxation is significantly faster in the male masseter during a tetanus compared with the female masseter (41 vs. 48 ms) (22).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [22] source
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- Interpretationcitation§ Abstract
Sex-based differences are seen during fatigue recovery and endurance testing.
“Although evidence suggests that maximum unloaded shortening velocity is not different between young male and female fibers (25), sex-based differences are seen during fatigue recovery and endurance testing (Table 3).”
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- Interpretationreasoning§ Abstract
The effects of estrogen on skeletal muscle fiber-type composition may correlate with the previously described findings on the effects of T3 on skeletal muscle.
“Thus the effects of estrogen on skeletal muscle fiber-type composition may correlate with the previously described findings on the effects of T3 on skeletal muscle.”
Quote in the paperNot a substantial claim - Premisecitation§ Abstract
ERα-null mice have decreased tetanic tension of gastrocnemius and TA muscles in females compared with wild-type controls.
“ERα-null mice have decreased tetanic tension of gastrocnemius and TA muscles in females compared with wild-type controls (14).”
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- Interpretationreasoning§ Abstract
The differences in actin-myosin bond strength suggest that estrogen may play a role in increasing force production at the myofilament level.
“The differences in actin-myosin bond strength suggest that estrogen may play a role in increasing force production at the myofilament level.”
Quote in the paperSubstantial claim- Rests on an assumption: A strong actin-myosin bond produces a greater force.
- Premisecitation§ Abstract
Supplementation with estrogen increases the type-IIX percentage composition in the plantaris back to 42%.
“Supplementation with estrogen increases the type-IIX percentage composition in the plantaris back to 42% (70).”
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- Premisecitation§ Abstract
Contraction duration is significantly longer in the female soleus in both wild-type (91 ms) and null (100 ms) compared with male wild-type (57 ms) and null (63 ms) mice.
“Contraction duration is significantly longer in the female soleus in both wild-type (91 ms) and null (100 ms) compared with male wild-type (57 ms) and null (63 ms) mice.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33] source
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- Premisecitation§ Abstract
In a test of physical performance, HRT leads to a significant increase in vertical jumping height in women compared with exercise alone and no treatment.
“In a test of physical performance, HRT leads to a significant increase in vertical jumping height in women compared with exercise alone and no treatment (85).”
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- Premisecitation§ Abstract
In the mouse plantaris muscle, OVX leads to a reduction in the relative amount of type-IIX fibers from 38% in sham animals to 33%.
“However, in the mouse plantaris muscle, OVX does lead to a reduction in the relative amount of type-IIX fibers from 38% in sham animals to 33% (70).”
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- Premisecitation§ Abstract
There is no difference in fiber-type composition of the soleus of OVX mice.
“There is no difference in fiber-type composition of the soleus of OVX mice (67).”
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- Premisecitation§ Abstract
Testosterone replacement is not associated with increased endurance.
“Testosterone is not typically associated with enhanced contractile function in that testosterone replacement is not associated with increased endurance.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [51] source
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- Premisecitation§ Abstract
Hypogonadal and eugonadal men exhibit similar limb muscle strength and endurance during exercise.
“For instance, hypogondal and eugonadal men exhibit similar limb muscle strength and endurance during exercise (51).”
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- Premisecitation§ Abstract
In male hypogonadal mice, IIB fiber-type diameter significantly declines compared with wild-type males.
“However, in other instances, IIB fiber-type diameter in male hypogonadal mice significantly declines compared with wild-type males.”
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- Interpretationcitation§ Abstract
This response may be through a testosterone-induced increase in the number of satellite cells and thus hypertrophy.
“This response may be through a testosterone-induced increase in the number of satellite cells and thus hypertrophy (82, 83).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Premisecitation§ Abstract
Analysis of mRNA reveals an upregulation of genes encoding slow-twitch muscle contractile proteins in AR-null mice.
“Analysis of mRNA reveals an upregulation of genes encoding slow-twitch muscle contractile proteins in AR-null mice (2, 59).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation§ Abstract
In female hypogonadal mice, the hypogonadal phenotype leads to an increase in IIB fiber diameter compared with wild-type females.
“Surprisingly, in females, the hypogonadal phenotype leads to an increase in IIB fiber diameter compared with wild-type females (79).”
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- Premisecitation§ Abstract
Testosterone supplementation in postmenopausal women leads to a 50% increase in protein synthesis rate compared with no effect with estrogen treatment.
“Additionally, testosterone supplementation in postmenopausal women leads to a 50% increase in protein synthesis rate compared with no effect with estrogen treatment (87).”
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- Premisecitation§ Abstract
In adult guinea pigs, castration produces atrophy of several muscles, including the latissimus dorsi, sternomastoid, and spinotrapezius.
“In the adult guinea pig, castration produces atrophy of several muscles, including the latissimus dorsi, sternomastoid, and spinotrapezius (48).”
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- Premisecitation§ Abstract
Male AR-null mice have a decrease in muscle mass that is not seen in AR-null females.
“Male AR-null mice have a decrease in muscle mass that is not seen in AR-null females (59).”
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- Interpretationreasoning§ Abstract
The contractile effect in AR-null mice is thought to be mediated by activation of estrogen receptors.
“thus this contractile effect is thought to be mediated by the activation of ERs.”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions
Knockout of ACVR2A causes muscle hypertrophy in female mice.
“Another study reveals that knockout of ACVR2A causes muscle hypertrophy in female mice (55).”
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- Interpretationreasoning§ Conclusions
The prevalence of slower-twitch fibers is a benefit to female performance in that the slower oxidative fibers and higher oxidative capacity allow for increased endurance and recovery.
“The prevalence of the slower-twitch fibers is also a benefit to female performance in that the slower oxidative fibers and higher oxidative capacity allow for increased endurance and recovery, highlighting the sex-based differences in response to fatigue or muscle tetanus.”
Quote in the paperSubstantial claim- Rests on an assumption: In adult mammalian muscle, the four main MyHC isoforms (MyHC-I, -IIa, -IIx, and -IIb) increase in contractile speed in that order.
- Premisecitation§ Conclusions
Previous studies have identified sex as a determinant for the ability of muscle-derived stem cells to regenerate.
“For instance, previous studies have identified sex as a determinant for the ability of muscle-derived stem cells to regenerate.”
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- Premisecitation§ Conclusions
Female muscle-derived stem cells regenerate more efficiently when transplanted into dystrophic mice.
“Specifically, female muscle-derived stem cells regenerate more efficiently when transplanted into dystrophic mice (24).”
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- Interpretationreasoning§ Abstract
The effects of testosterone deficiency are exacerbated in males compared with females.
“Overall, the effects of testosterone deficiency are exacerbated in males compared with females.”
Quote in the paperSubstantial claim - Premisecitation§ Conclusions
Over 3,000 genes are differentially regulated in male and female muscle.
“The identification of over 3,000 genes differentially regulated in male and female muscle highlights the complex differences that occur in skeletal muscle from both sexes (96).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [96] source
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- Premisecitation§ Abstract
Aromatase converts testosterone to estrogen.
“Because aromatase converts testosterone to estrogen (60), testosterone can induce its effects via either ERs or ARs, thus this contractile effect is thought to be mediated by the activation of ERs.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [60] Maggiolini M, 1999, Cancer Res
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- Interpretationreasoning§ Conclusions
One or two genes cannot be responsible for altering all of the factors of fiber-type composition, size, and contractile function.
“In this review, we present changes in fiber-type composition, size, and contractile function in males and females; however, one or two genes cannot be responsible for altering all of these factors.”
Quote in the paperSubstantial claim
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- Classified as probably not a substantial claim. 9
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Findingnone given§ AbstractIn the mouse hindlimb, MyHC-IIa expression is higher in males vs. females in the soleus (58% in males vs. 36% in females) and tibialis anterior (39% in males vs. 25% in females), whereas in the plantaris, IIa expression is higher in females (37%) than in males (16%).
“For example, MyHC-IIa expression is higher in males vs. females in the soleus (58% in males vs. 36% in females) and tibialis anterior (TA) (39% in males vs. 25% in females), whereas in the plantaris, IIa expression is higher in females (37%) than in males (16%).”
Quote in the paperNot a substantial claimMay combine two claims.
Premisecitation§ AbstractThe mouse masseter is composed of high numbers of IIX fibers in both sexes; however, there are threefold fewer IIB fibers and more IIA fibers in females compared with males.
“The mouse masseter is composed of high numbers of IIX fibers in both sexes; however, there are threefold fewer IIB fibers and more IIA fibers in females compared with males (27).”
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Premisecitation§ AbstractAnalysis of mRNA from male and female vastus lateralis biopsies by microarray shows (when normalized to α-actinin) that female muscle has 35% more MyHC-I/β, 30% less MyHC-IIa, and 15% less MyHC-IIx mRNA than corresponding male muscle.
“Analysis of mRNA from both male and female vastus lateralis biopsies by microarray shows (when normalized to α-actinin) that the female muscle has 35% more MyHC-I/β, 30% less MyHC-IIa, and 15% less MyHC-IIx mRNA than the corresponding male muscle (96).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [96] source
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Premisecitation§ AbstractThere are 11 myosin heavy chain (MyHC) genes that encode different myosin isoforms in mammals.
“There are 11 myosin heavy chain (MyHC) genes that encode different myosin isoforms in mammals (77).”
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Premisecitation§ AbstractType-I fibers account for 36% of the total biopsy area in men and 44% in women, whereas type-IIA fibers account for 41% in men and only 34% in women.
“Type-I fibers account for 36% of the total biopsy area in men and 44% in women, whereas type-IIA fibers account for 41% in men and only 34% in women (89).”
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Premisecitation§ AbstractMyHC isoform expression directly affects muscle fiber-type contractile velocity via myosin ATPase activity, with relative velocities I < IIA < IIX < IIB.
“Functionally, MyHC isoform expression directly affects muscle fiber-type contractile velocity via myosin ATPase activity (74), with relative velocities of I < IIA < IIX < IIB (73, 74).”
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Premisecitation§ AbstractHuman skeletal muscle does not express MyHC-IIb protein, at least in part due to reduced activity of the human MyHC-IIb promoter region.
“In contrast, human skeletal muscle does not express MyHC-IIb protein, a phenomenon that appears to be, at least in part, due to a reduction in the activity of the human MyHC-IIb promoter region (37).”
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Premisecitation§ AbstractAverage MyHC isoform percentages in the male vastus lateralis are IIx (20%), IIa (46%), and I (34%), whereas female samples are IIx (23%), IIa (36%), and I (41%).
“Overall, in this analysis, the average MyHC isoform percentages in the male vastus lateralis are IIx (20%), IIa (46%), and I (34%), whereas the females samples are IIx (23%), IIa (36%), and I (41%) (89).”
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Interpretationnone given§ AbstractSkeletal muscle fiber-type composition is dependent on species, anatomical location/function, and sex.
“Overall, evidence to date suggests that skeletal muscle fiber-type composition is dependent on species, anatomical location/function, and sex.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ AbstractMale rabbit masseter is comprised of nearly 80% type-IIA fibers, whereas the female masseter contains only ∼50%.
“Male rabbit masseter is comprised of nearly 80% type-IIA fibers, whereas the female masseter contains only ∼50% (28).”
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Premisecitation§ AbstractTreatment of euthyroid animals with T3 induces hyperthyroidism, producing a reversible slow-to-fast MyHC isoform transition from I → IIa → IIx → IIb.
“Treatment of euthyroid animals with T3 induces hyperthyroidism, producing a reversible slow-to-fast MyHC isoform transition from I → IIa → IIx → IIb (for review, see Ref. 78).”
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Interpretationreasoning§ AbstractThese studies suggest a potential role for T3 in skeletal muscle contractility and in sex-based differences that may exist in the response to changing T3 levels but point to the need for further investigations.
“These studies suggest a potential role for T3 in skeletal muscle contractility and in sex-based differences that may exist in the response to changing T3 levels but point to the need for further investigations.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Premisecitation§ AbstractHormonal regulation of skeletal muscle development and contractility are well documented.
“In fact, hormonal regulation of skeletal muscle development and contractility are well documented (29, 70).”
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Premisecitation§ AbstractEndurance is longer in women (15 min) compared with men (8 min), and after reaching exhaustion, recovery occurs faster in women than in men.
“Endurance is longer in women (15 min) compared with men (8 min), and after reaching exhaustion, recovery occurs faster in women than in men (31).”
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Premisecitation§ AbstractT3 treatment in euthyroid animals leads to a conversion from IIA to IIB fibers in the EDL of young and old female rats vs. no transition in males.
“T3 treatment in euthyroid animals leads to a conversion from IIA to IIB fibers in the EDL of young and old female rats vs. no transition in males (52).”
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Premisecitation§ AbstractThyroid hormone (T3) can regulate MyHC gene expression.
“Thyroid hormone (T3) can regulate MyHC gene expression (42).”
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Interpretationreasoning§ AbstractThese studies suggest that force generation and relaxation are faster during fatigue in men compared with women, whereas endurance is higher and recovery is quicker in women than in men.
“These studies suggest that force generation and relaxation are faster during fatigue in men compared with women, whereas endurance is higher and recovery is quicker in women than in men.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ AbstractDuring menopause, the decline in estrogen levels is paralleled with a slight increase in injury risk and a decline in lean body mass.
“During menopause, the decline in estrogen levels is paralleled with a slight increase in injury risk and a decline in lean body mass (9).”
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Premisecitation§ AbstractAfter treatment with T3, male rat soleus muscle expresses 73% type-I/IIA and 26% type-I/IIAX of the total fibers, whereas females express 37% type-I, 49% type-I/IIA, and only 6% type-I/IIAX fibers.
“Specifically, after treatment with T3, male rat soleus muscle expresses 73% type-I/IIA and 26% type-I/IIAX of the total fibers, whereas females express 37% type-I, 49% type-I/IIA, and only 6% type-I/IIAX fibers (101).”
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Premisecitation§ AbstractHypothyroid females appear to have a higher proportion of type-II fibers compared with hypothyroid males; however, type-II fiber atrophy occurs in hypothyroid female patients but not in males.
“Hypothyroid females appear to have a higher proportion of type-II fibers compared with hypothyroid males; however, type-II fiber atrophy occurs in hypothyroid female patients but not in males (63).”
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Premisecitation§ AbstractFour weeks of T3 treatment induces an increase in type-IIA fibers and a downregulation of type-I fibers in male and female rat soleus muscle.
“Four weeks of T3 treatment induces an increase in type-IIA fibers and a downregulation of type-I fibers in male and female rat soleus muscle (57, 101).”
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Premisecitation§ AbstractThe increase in IIX content from the type-I/IIAX fibers is greater in young T3-treated males (21%) than females (10%), and the upregulation of IIA is greater in young females (43%) than in young males (27%).
“Overall, the increase in IIX content from the type-I/IIAX fibers is greater in young T3-treated males (21%) than females (10%), and the upregulation of IIA is greater in young females (43%) than in young males (27%) (101).”
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Premisecitation§ AbstractAfter intermittent bouts of isometric contraction (5 s on and 5 s off) in the adductor pollicis muscle, women fatigue more slowly and to a smaller degree than men.
“After intermittent bouts of isometric contraction (5 s on and 5 s off) in the adductor pollicis muscle, women fatigue more slowly and to a smaller degree than men (31).”
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Premisecitation§ AbstractIn another study of euthyroid animals, treatment with T3 induces expression of IIX in the soleus of aged male rats (4-15%), whereas there is no detectable IIX in females at any age.
“In another study of euthyroid animals, treatment with T3 induces expression of IIX in the soleus of aged male rats (4–15%), whereas there is no detectable IIX in females at any age (52).”
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Interpretationreasoning§ AbstractThese studies highlight the differences in fiber-type conversion as it relates to sex and pinpoints the differences in IIx expression in males and females.
“These studies highlight the differences in fiber-type conversion as it relates to sex and pinpoints the differences in IIx expression in males and females.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ AbstractAnimal models of low estrogen levels, which occur after ovariectomy (OVX), reveal an increase in overall body mass and in the mass of individual muscles.
“Animal models of low estrogen levels, which occur after ovariectomy (OVX), reveal an increase in overall body mass and in the mass of individual muscles (68).”
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Premisecitation§ AbstractAlthough forces exerted by both young men and women are not significantly different, endurance is lower for men than for women (11 vs. 18 min).
“Although forces exerted by both young men and women are not significantly different, endurance is lower for men than for women (11 vs. 18 min) (39).”
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Premisecitation§ AbstractOVX leads to an increase in overall body weight and muscle weight, and a 70% increase in ERα mRNA with no change in ERβ mRNA.
“OVX leads to an increase in overall body weight and muscle weight (68), and a 70% increase in ERα mRNA with no change in ERβ mRNA (7).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
Interpretationcitation§ AbstractEstrogen has been shown to influence fiber size, overall muscle weight, muscle regeneration, and contractility, and to induce minimal changes in fiber-type distribution.
“Estrogen has been shown to influence fiber size, overall muscle weight, muscle regeneration, and contractility, and to induce minimal changes in fiber-type distribution.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown data§ AbstractOverall, ERβ deletion increases the contractile time and decreases the speed of contractile kinetics in both males and females.
“Overall, ERβ deletion increases the contractile time and decreases the speed of contractile kinetics in both males and females.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationcitation§ AbstractThis decline in regenerative capacity is thought to be directly related to findings that estrogen is associated with maintenance of muscle strength in pre- and postmenopausal women and suggests a role for ERs in skeletal muscle maintenance.
“This decline in regenerative capacity is thought to be directly related to findings that estrogen is associated with maintenance of muscle strength in pre- and postmenopausal women (69) and suggests a role for ERs in skeletal muscle maintenance (64, 84, 85, 88).”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
Premisecitation§ AbstractThe fraction of strong binding myosin in OVX muscle is 0.263 or ∼15% lower than baseline. Following estrogen treatment, the fraction of strongly bound myosin increases to 0.311, which is indistinguishable from sham levels (0.300).
“The fraction of strong binding myosin in OVX muscle is 0.263 or ∼15% lower than baseline (67, 68). Following estrogen treatment, the fraction of strongly bound myosin increases to 0.311, which is indistinguishable from sham levels (0.300) (67).”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
Premisecitation§ AbstractRelaxation time during a basic contraction in the soleus is significantly shorter in wild-type males (104 ms) than in females (158 ms) and in null males (104 ms) compared with null females (191 ms).
“Relaxation time during a basic contraction in the soleus is significantly shorter in wild-type males (104 ms) than in females (158 ms) and in null males (104 ms) compared with null females (191 ms).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33] source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
Interpretationreasoning§ AbstractBecause of the OVX-induced decrease in tetanic force, which requires rapid replenishment and utilization of calcium stores, and the increase in fiber diameter, which could compensate for a decline in calcium sensitivity, calcium handling and sensitivity may be playing a role in the regulation of contractile differences in samples with and without estrogen.
“Because of the OVX-induced decrease in tetanic force, which requires rapid replenishment and utilization of calcium stores, and the increase in fiber diameter, which could compensate for a decline in calcium sensitivity, calcium handling and sensitivity may be playing a role in the regulation of contractile differences in samples with and without estrogen.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ AbstractRonkainen et al. found that HRT is associated with better mobility, greater muscle power, and favorable body and muscle composition in women ages 54-62.
“Ronkainen et al. (76) found that HRT is associated with better mobility, greater muscle power, and favorable body and muscle composition in women ages 54–62 (76).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [76] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractAnalysis of contractile function in OVX mice reveals a significant decrease in maximal isometric tetanic force from sham levels (180 mN) to 168 mN. This decline is attenuated to 187 mN with estrogen supplementation.
“Analysis of contractile function in OVX mice reveals a significant decrease in maximal isometric tetanic force from sham levels (180 mN) to 168 mN (67, 68). This decline is attenuated to 187 mN with estrogen supplementation (67).”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
Interpretationcitation§ AbstractIn the studies referenced in the previous sections, there is no change in MyHC isoform expression or overall muscle fiber-type composition, but there are estrogen-related changes in fiber-type diameter, muscle size, contractility, and the actin-myosin interaction.
“In the studies referenced in the previous sections, there is no change in MyHC isoform expression or overall muscle fiber-type composition, but there are estrogen-related changes in fiber-type diameter, muscle size, contractility, and the actin-myosin interaction.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ AbstractIn rat soleus and EDL muscles, OVX leads to a slight increase in the mean fiber diameter of type-I, -IIA, and -IIB fibers. Estrogen supplementation decreases fiber diameter in all fiber types in both the soleus and EDL significantly from OVX levels to below baseline levels.
“In rat soleus and EDL muscles, OVX leads to a slight increase in the mean fiber diameter of type-I, -IIA, and -IIB fibers. Estrogen supplementation decreases fiber diameter in all fiber types in both the soleus and EDL significantly from OVX levels to below baseline levels (90).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [90] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractIn male and female vastus lateralis muscle, expression of ERα mRNA is 180-fold higher than ERβ, with no significant difference in expression levels between males and females.
“In male and female vastus lateralis muscle, expression of ERα mRNA is 180-fold higher than ERβ, with no significant difference in expression levels between males and females (98).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [98] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractOVX induces a reduction in time to peak tension and increases time to 50% relaxation in rats, whereas estrogen replacement reverses the OVX-induced reduction in peak tension.
“OVX induces a reduction in time to peak tension and increases time to 50% relaxation in rats, whereas estrogen replacement reverses the OVX-induced reduction in peak tension (62).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [62] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractSkeletal muscle expresses two forms of ERs (α and β), and the effects of estrogen are mediated, in part, through these receptors.
“Skeletal muscle expresses two forms of ERs (α and β), and the effects of estrogen are mediated, in part, through these receptors (14, 21, 56, 98).”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
Premisecitation§ AbstractStudies on muscle repair following exercise-induced injury highlight a sex-based difference in which higher levels of muscle creatine kinase (indicative of injury) are observed in male than in female rats following injury. Following OVX, levels of muscle creatine kinase in females are similar to levels in injured males.
“Studies on muscle repair following exercise-induced injury highlight a sex-based difference in which higher levels of muscle creatine kinase (indicative of injury) are observed in male than in female rats following injury. Following OVX, levels of muscle creatine kinase in females are similar to levels in injured males (3, 4, 8).”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
Premisecitation§ AbstractThere is no sexually dimorphic expression in either ERα or ERβ in skeletal muscle.
“As stated previously, there is no sexually dimorphic expression in either ERα or ERβ in skeletal muscle (98).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [98] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractFollowing a fatiguing protocol on soleus and EDL muscle, force decreases less in ERβ−/− males than in wild-type males, whereas the reverse is true for females, suggesting a role for ERβ knockout in enhancing endurance in males and reducing endurance in females.
“Following a fatiguing protocol on soleus and EDL muscle, force decreases less in ERβ−/− males than in wild-type males, whereas the reverse is true for females, suggesting a role for ERβ knockout in enhancing endurance in males and reducing endurance in females (33).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractRecent studies suggest a beneficial role for hormone replacement therapy (HRT), supplementation with estrogen and progesterone, and the induction of pathways by which estrogen can aide in skeletal muscle maintenance and repair.
“Recent studies suggest a beneficial role for hormone replacement therapy (HRT), supplementation with estrogen and progesterone, and the induction of pathways by which estrogen can aide in skeletal muscle maintenance and repair (71).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [71] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractERα-null mice have a decreased muscle regenerative capacity following injury, as evidenced by small myofibers and centrally located nuclei.
“ERα-null mice have a decreased muscle regenerative capacity following injury, as evidenced by small myofibers and centrally located nuclei (50).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] source
Not checked in the free run.
May combine two claims.
Interpretationreasoning§ AbstractTaken together, these findings on estrogen and the ER-mediated regulation of the contractile response and fiber-type distribution suggest a role for estrogen and its receptors in contractile maintenance and function, with a differential effect of estrogen in males vs. females.
“Taken together, these findings on estrogen and the ER-mediated regulation of the contractile response and fiber-type distribution suggest a role for estrogen and its receptors in contractile maintenance and function, with a differential effect of estrogen in males vs. females.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ AbstractIn mice, although overall muscle weight increases, the fiber CSA of the soleus and TA do not significantly change.
“In mice, castration produces a decrease in body weight, which is attenuated with testosterone supplementation, and although overall muscle weight increases, the fiber CSA of the soleus and TA do not significantly change (6).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ AbstractWith advancing age, testosterone levels drop, and testosterone deficiency is associated with early death, primarily from cardiovascular disease, a decrease in muscle mass and/or strength, and sexual dysfunction.
“With advancing age, testosterone levels drop, and testosterone deficiency is associated with early death, primarily from cardiovascular disease, a decrease in muscle mass and/or strength, and sexual dysfunction (46).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [46] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractARs are widely expressed in myoblasts, myofibers, and motoneurons in both males and females, and testosterone injected into the masseter of female guinea pigs leads to an increase in fiber size.
“ARs are widely expressed in myoblasts, myofibers, and motoneurons in both males and females (17, 100), and testosterone injected into the masseter of female guinea pigs leads to an increase in fiber size (35).”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ AbstractTestosterone is a highly studied androgen that is associated with an increase in muscle mass.
“Testosterone is a highly studied androgen that is associated with an increase in muscle mass (66, 83).”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ AbstractTestosterone has been shown to induce its effects through binding to intracellular androgen receptors (ARs), which then regulate gene transcription.
“Testosterone has been shown to induce its effects through binding to intracellular androgen receptors (ARs) (34), which then regulate gene transcription (18, 81).”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
Premisecitation§ AbstractAnalysis of fiber-type distribution in hypogonadal male vs. female mice reveals no significant changes in type-I, -IIA, -IIX, or -IIB fibers in gastrocnemius muscle or in type-I or -IIA fibers in the soleus.
“Analysis of fiber-type distribution in hypogonadal males vs. females reveals no significant changes in type-I, -IIA, -IIX, or -IIB fibers in gastrocnemius muscle or in type-I or -IIA fibers in the soleus (79).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [79] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractIn AR-null males, force production decreases in fast-twitch fibers, whereas fatigue resistance increases in slow-twitch fibers to levels similar to wild-type females.
“Additionally, in AR-null males, force production decreases in fast-twitch fibers, whereas fatigue resistance increases in slow-twitch fibers to levels similar to wild-type females (59).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [59] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractIn mice, castration produces a decrease in body weight that is attenuated with testosterone supplementation.
“In mice, castration produces a decrease in body weight, which is attenuated with testosterone supplementation, and although overall muscle weight increases, the fiber CSA of the soleus and TA do not significantly change (6).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractIn hypogonadal mice, gastrocnemius fiber-type distribution is relatively unchanged from wild-type mice, with relative contribution I < IIX < IIA < IIB in both males and females.
“Additionally fiber-type distribution of the gastrocnemius is relatively unchanged from wild-type mice, with I < IIX < IIA < IIB being the relative contribution of each fiber-type in males and females (79).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [79] source
Not checked in the free run.
May combine two claims.
Premisecitation§ AbstractIn vastus lateralis biopsies, fiber-type cross-sectional area is larger in men than in women; type-I fibers are 19% larger, type-IIA fibers are 59% larger, and type-IIX fibers are 66% larger in men than in women (normalized to total biopsy section analyzed).
“As mentioned earlier, studies of vastus lateralis biopsies show fiber-type CSA to be larger in men than in women. Specifically, type-I fibers are 19% larger, type-IIA fibers are 59% larger, and type-IIX fibers are 66% larger in men than in women (normalized to total biopsy section analyzed) (89).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [89] source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.
Interpretationreasoning§ AbstractThese anabolic effects of testosterone are well characterized and provide the catalysts for further investigation of the response of muscle fiber-type composition to testosterone deficiency and supplementation in males and females.
“These anabolic effects of testosterone are well characterized and provide the catalysts for further investigation of the response of muscle fiber-type composition to testosterone deficiency and supplementation in males and females.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationcitation§ AbstractDuring fatigue, where females typically have greater endurance, ERβ elimination decreases the endurance in the female and enhances endurance in the male.
“During fatigue, where females typically have greater endurance, ERβ elimination decreases the endurance in the female and enhances endurance in the male.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ AbstractTestosterone supplementation leads to an increase in muscle mass and a decrease in fat content in hypogonadal men.
“Testosterone supplementation leads to an increase in muscle mass and a decrease in fat content in hypogonadal men (13).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [13] Brodsky IG, 1996, J Clin Endocrinol Metab
Not checked in the free run.
May combine two claims.
Premisecitation§ ConclusionsGRB10 knockout in male and female mice produces an increase in muscle weight and a decrease in body fat percentage, thus enhancing muscularity.
“GRB10 knockout in male and female mice produces an increase in muscle weight and a decrease in body fat percentage and thus enhances muscularity (86).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [86] source
Not checked in the free run.
May combine two claims.
Interpretationreasoning§ AbstractTestosterone deficiency leads to a decline in body mass, a decrease in fast-twitch fiber diameter, a conversion to slow-twitch fibers, and enhanced fatigue resistance in males but not females.
“Testosterone deficiency leads to a decline in body mass, a decrease in fast-twitch fiber diameter, a conversion to slow-twitch fibers, and enhanced fatigue resistance in males but not females.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ ConclusionsIn the study by Welle et al., two genes upregulated in women compared with men are GRB10 and ACVR2A, which code for proteins in signaling pathways of growth factors known to regulate muscle mass.
“In this study, the authors focus on two particular genes that are upregulated in women compared with men and that are known to code for proteins that are in signaling pathways of growth factors known to regulate muscle mass: growth factor receptor-bound protein 10 (GRB10) and activin receptor type-2A (ACVR2A).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [96] source
Not checked in the free run.
May combine two claims.
Interpretationreasoning§ ConclusionsEstrogen and testosterone are implicated in skeletal muscle growth, fiber size, and minimally in contractile function.
“Although thyroid hormone induces a conversion from slow to fast fibers and increases contractile velocity, sex-specific hormones estrogen and testosterone are implicated in skeletal muscle growth, fiber size, and minimally in contractile function.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationnone given§ ConclusionsSex-based differences in skeletal muscle fiber-type composition and function are apparent in numerous species and are present in specific anatomical locations.
“Sex-based differences in skeletal muscle fiber-type composition and function are apparent in numerous species and are present in specific anatomical locations.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationnone given§ ConclusionsThere is a prevalence of slower type-I and -IIA fibers in females compared with males that parallels the lower contractile velocity in females compared with males.
“There is a prevalence of slower type-I and -IIA fibers in females compared with males that parallels the lower contractile velocity in females compared with males.”
Quote in the paperNot a substantial claim- Rests on an assumption: In adult mammalian muscle, the four main MyHC isoforms (MyHC-I, -IIa, -IIx, and -IIb) increase in contractile speed in that order.
May combine two claims.
Interpretationcitation§ AbstractTestosterone can induce its effects via either estrogen receptors or androgen receptors.
“Because aromatase converts testosterone to estrogen (60), testosterone can induce its effects via either ERs or ARs, thus this contractile effect is thought to be mediated by the activation of ERs.”
Quote in the paperSubstantial claim
The paper relies on this without support.
Sex is often thought to confound results in experimental models, so usually only males are studied.
“This is often the case in experimental models where sex is thought to confound results and therefore usually only males are studied.”
The paper relies on this without support.
A strong actin-myosin bond produces a greater force.
“Since a strong actin-myosin bond will produce a greater force, this has been measured in muscles with and without estrogen manipulation.”
The paper relies on this without support.
In adult mammalian muscle, the four main MyHC isoforms (MyHC-I, -IIa, -IIx, and -IIb) increase in contractile speed in that order.
“There are four main MyHC isoforms present in adult mammalian muscle (MyHC-I, -IIa, -IIx, and -IIb), which increase in contractile speed in the presented order.”
The paper relies on this without support.
Thyroid hormone induces a conversion from slow to fast fibers and increases contractile velocity.
“Although thyroid hormone induces a conversion from slow to fast fibers and increases contractile velocity, sex-specific hormones estrogen and testosterone are implicated in skeletal muscle growth, fiber size, and minimally in contractile function.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Many physiological factors differ significantly between biological males and females as a result of genetic differences and androgen-directed development of secondary sex characteristics.
“Many of these physiological factors differ significantly between biological males and females as a result of genetic differences and androgen-directed development of secondary sex characteristics [3, 4].”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [3]
The Abstract reports sex differences in skeletal-muscle physiology and gene expression, and the Conclusions implicate testosterone in muscle growth and fiber size (page numbers unavailable). The paper does not establish that broad physiological differences result from genetic differences or androgen-directed development of secondary sex characteristics; its discussion is focused on skeletal muscle. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMales have superior cardiovascular and respiratory function compared with females, with larger blood and heart volumes, higher hemoglobin concentration, greater cross-sectional area of the trachea and lower oxygen cost of respiration.
“superior cardiovascular and respiratory function, with larger blood and heart volumes, higher hemoglobin concentration, greater cross-sectional area of the trachea and lower oxygen cost of respiration [3, 4, 39, 40].”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [3]
The Abstract mentions sex-based differences in cardiovascular health and disease, but does not describe males as having superior cardiovascular or respiratory function. Searches for blood and heart volume, hemoglobin, tracheal area, and the oxygen cost of respiration found no passage in our copy addressing those comparisons. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Hypothyroidism table reverses the stated type-II fiber change
MinorThe prose says hypothyroidism lowers the type-II fiber percentage in both sexes relative to healthy patients, while Table 4 marks type-II fibers as increasing in both sexes.
“Hypothyroidism produces a lower type-II fiber percentage in male and female patients compared with healthy patients (63).”
“Hypothyroidism in humans ↑ Type-II ↑↑ Type-II 64”
Wild-type male soleus relaxation time differs from Table 5
MinorThe prose gives wild-type males a soleus relaxation time of 104 ms, whereas Table 5 reports 100.4 ms. The prose's 104 ms matches the table's null-male value instead.
“Relaxation time during a basic contraction in the soleus is significantly shorter in wild-type males (104 ms) than in females (158 ms) and in null males (104 ms) compared with null females (191 ms).”
“Relaxation time (soleus) 100.4 ms 158.2 ms 104.0 ms 191.4 ms”
Claim of no fiber-type composition change conflicts with plantaris results
MinorThe later summary says the referenced studies found no change in overall fiber-type composition, but the preceding plantaris results report type-IIX composition changing after ovariectomy and estrogen supplementation.
“In the studies referenced in the previous sections, there is no change in MyHC isoform expression or overall muscle fiber-type composition”
“However, in the mouse plantaris muscle, OVX does lead to a reduction in the relative amount of type-IIX fibers from 38% in sham animals to 33% (70). Supplementation with estrogen increases the type-IIX percentage composition in the plantaris back to 42% (70).”
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Relative strength explains the differences in multi-joint rapid force production between sexes
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Sex differences in semitendinosus muscle fiber‐type composition
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Cerebral and muscle tissue oxygenation during exercise in healthy adults: A systematic review
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miR-206 enforces a slow muscle phenotype
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Sex Differences in Athletic Performance: Perspectives on Transgender Athletes
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Risk Factors for Muscle Loss in Hemodialysis Patients with High Comorbidity
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Protective Role of Testicular Hormone INSL3 From Atrophy and Weakness in Skeletal Muscle
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- Authors
- Haizlip, K. M., Harrison, B. C., & Leinwand, L. A.
- Affiliations
- University of Colorado Boulder (US)
- Corresponding author
- Leinwand, L. A.
- Venue
- Physiology
- Publisher
- American Physiological Society
- Published
- 2015-01
- Volume
- 30
- Issue
- 1
- Pages
- 30-39
- ISSN
- 0886-1714 (ISSN-L)
- 1548-9213
- 1548-9221
- PMC
- PMC4285578
- OpenAlex
- W2097561994
- Semantic Scholar
- b290b0c3482c23b4612ebb91c3677997d764978e
- Cited by
- 521
- References
- 157
- Citations by year
- 2026: 52 · 2025: 79 · 2024: 89 · 2023: 65 · 2022: 69 · 2021: 49 · 2020: 37 · 2019: 41 · 2018: 20 · 2017: 8 · 2016: 7 · 2015: 4
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Physiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007822)
- National Institute of General Medical Sciences (GM-029090-30A1S1, GM-29090-31, R01GM029090)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (K01AR055676)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- sex differences, skeletal muscle, muscle fiber composition, myosin heavy chain, muscle contractility, thyroid hormones, estrogen, testosterone, gene expression
- MeSH terms
- Animals, Female, Humans, Kinetics, Male, Muscle Contraction, Sex Characteristics, Thyroid Hormones, Muscle Fibers, Skeletal, Myosin Heavy Chains
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.
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