Physical and functional evaluations in oncological patients elective to medium and large operations.

PURPOSE: To evaluate the risk of sarcopenia on the length of hospital stay and deaths in preoperative cancer patients as well its relation to physical and functional capacity. METHODS: Preoperative patients admitted to the Cancer Hospital of Mato Grosso comprised the sample. Sociodemographic data, lifestyle data, and a questionnaire for sarcopenia screening were collected. Subsequently, total body mass, height, muscle strength, muscle mass, and physical performance were evaluated. The primary, secondary and tertiary outcomes were sarcopenia, length of stay and death, respectively. The data were tabulated and analyzed using the statistical software SPSS (25.0). The significance level was 5%. RESULTS: We observed 12 (7.4%) patients with low muscle strength, 20 (12.3%) patients with low muscle mass, 11 (6.8%) patients with low physical performance, and 18 (11.1%) patients with scores for possible sarcopenia. When the risk of sarcopenia was observed, 44 (27.2%) patients had at least one risk related to muscle disorder. When analyzing the prevalence and association of sarcopenia with sociodemographic variables, we observed that education level was associated with sarcopenia (p = 0.031). In addition, there was an association between preoperative sarcopenia and postoperative death (p = 0.006). Finally, there were important correlations between muscle strength and physical performance (p < 0.05), between muscle strength and the sarcopenia questionnaire (p < 0.001), and between physical performance and the sarcopenia questionnaire (p < 0.05). CONCLUSION: The results suggest the need for counseling and the need to evaluate patients for risk of sarcopenia, since early intervention, such as dietary supplementation and physical exercise, may favor a better postoperative prognosis, possibly corresponding to shorter hospital stays and longer survival and quality of life for patients, especially those who will undergo surgical procedures.

Combination of resistance and aerobic exercise for six months improves bone mass and physical function in HIV infected individuals: A randomized controlled trial.

To evaluate the effect of combined resistance and aerobic training (RT+AT) on regional bone mineral density (BMD) and physical performance in people living with HIV (PLWH). Forty PLWH (20 men and 20 women) were randomized into RT+AT group (n = 20; age = 38.3 ± 4.9) or non-exercise control group (n = 20; age = 37.9 ± 5.1). The RT+AT group was required to perform a nonlinear periodized resistance training program targeting large muscle groups followed by 20 min aerobic exercise at 65-80% of maximal heart rate. Participants in RT+AT performed three supervised sessions per week for 6-months, whereas participants in the control group were instructed to continue with their current lifestyle habits. The primary outcome was bone mineral density (lumbar spine (L2-L4), femoral neck, and distal 1/3 radius). Secondary outcomes included physical function, anthropometry, inflammatory markers, and growth factors. The RT+AT group demonstrated a significant increase in BMD at follow-up for the Lumbar spine (L2-L4), femoral neck, and 1/3 radius (all, P < .05), and There were no gender differences in the training response between men and women for any of the BMD regions. Similar findings were also observed for lean body mass, IGF1and Adiponectin (P < .001). We observed a decrease in percent body fat, fat mass, IL-6, TNF-α, and myostatin in the RT+AT group (P < .001). Finally, there was a significant increase in handgrip strength and gait speed for both women and men in the RT+AT group (P < .001). A combination of resistance and aerobic training appears to be a feasible and effective means for counteracting bone loss and improving various inflammatory markers, physical function, and growth hormones in PLWH.

Reliability of Trail Walking and Running Tasks Using the Stryd Power Meter.

Footpod monitors are wearable devices attaching to the shoe with the ability to sense oscillations in leg movement; however, few studies provide reliability. The purpose was to provide reliability data for outdoor tasks as measured by the Stryd Power Meter, which is a footpod monitor. Young healthy individuals (N=20, male n=12, female n=8) completed two 5-min self-paced walks along a trail, and two 5-min trail runs. Reliability of the tasks was determined using Coefficient of Variation (CV), Intraclass Correlation (ICC), and 95% confidence intervals (CI). Measures during trail running that returned a CV less than 10%, met the ICC threshold of 0.70, and displayed good to excellent 95% CI included pace, average elapsed power, average elapsed form power, average elapsed leg spring, and vertical oscillation. The only variable during walking to meet these criteria was maximal power (CV=4.02%, ICC=0.968, CI=0.902, 0.989). Running tasks completed on a trail generally return more consistent measures for variables that can be obtained from the Stryd footpod device than walking tasks.

Effect of administration of high-protein diet in rats submitted to resistance training.

PURPOSE: Although there is limited evidence regarding the pathophysiological effects of a high-protein diet (HD), it is believed that this type of diet could overload the body and cause damage to the organs directly involved with protein metabolism and excretion. The aim of this study was to verify the effects of HD on biochemical and morphological parameters of rats that completed a resistance training protocol (RT; aquatic jump) for 8 weeks. METHODS: Thirty-two adult male Wistar rats were divided into four groups (n = 8 for each group): sedentary normal protein diet (SN-14%), sedentary high-protein diet (SH-35%), trained normal protein diet (TN-14%), and trained high-protein diet (TH-35%). Biochemical, tissue, and morphological measurements were made. RESULTS: Kidney (1.91 ± 0.34) and liver weights (12.88 ± 1.42) were higher in the SH. Soleus muscle weight was higher in the SH (0.22 ± 0.03) when compared to all groups. Blood glucose (123.2 ± 1.8), triglycerides (128.5 ± 44.0), and HDL cholesterol levels (65.7 ± 20.9) were also higher in the SH compared with the other experimental groups. Exercise reduced urea levels in the trained groups TN and TH (31.0 ± 4.1 and 36.8 ± 6.6), respectively. Creatinine levels were lower in TH and SH groups (0.68 ± 0.12; 0.54 ± 0.19), respectively. HD negatively altered renal morphology in SH, but when associated with RT, the apparent damage was partially reversed. In addition, the aquatic jump protocol reversed the damage to the gastrocnemius muscle caused by the HD. CONCLUSIONS: A high-protein diet promoted negative metabolic and morphological changes, while RT was effective in reversing these deleterious effects.

Digoxin Induces Cardiac Hypertrophy Without Negative Effects on Cardiac Function and Physical Performance in Trained Normotensive Rats.

Cardiotonic drugs and exercise training promote cardiac inotropic effects, which may affect training-induced cardiac adaptations. This study investigated the effects of long-term administration of digoxin on heart structure and function, and physical performance of rats submitted to high-intensity interval training (HIIT). Male Wistar rats, 60 days old, were divided into control (C), digoxin (DIGO), trained (T), and trained with digoxin (TDIGO). Digoxin was administered by gavage (30 µg/kg/day) for 75 days. The HIIT program consisted of treadmill running 60 min/day (8 min at 80% of the maximum speed (MS) and 2 min at 20% of the MS), 5 days per week during 60 days. The main cardiac parameters were evaluated by echocardiograph and cardiomyocyte area was determined by histology. There were no group x time effects of digoxin, HIIT or interactions (digoxin and HIIT) on functional echocardiographic parameters (heart rate; ejection fraction) or in the maximum exercise test. There was a group x time interaction, as evidenced by observed cardiac hypertrophy in the TDIGO group evaluated by ratio of left ventricle weight to body weight (p<0.002) and cardiomyocyte area (p<0.000002). Long-term administration of digoxin promoted cardiac hypertrophy without affecting cardiac function and physical performance in rats submitted to HIIT.

Effects of Resistance Training Volume on MMPs in Circulation, Muscle and Adipose Tissue.

The aim of this study was to investigate the effects of different resistance training (RT) volumes on MMP activity in skeletal muscle, visceral adipose tissue and circulation. 21 Wistar rats were randomly divided into 3 groups (n=7 per group): sedentary control (SC); RT with 4 ladder climbs (RT-4; 50, 75, 90 and 100% of their maximal carrying capacity) and RT with 8 ladder climbs (RT-8 with 2 sets for each load). The 8-week RT consisted of climbing a 1.1-m vertical ladder with weights secured to the animals' tails. MMP-2 and -9 activity were analyzed by zymography. RT-8 displayed higher active MMP-2 activity as compared with SC and RT-4 in skeletal muscle (p<0.05). There was no significant difference between groups for pro and intermediate-MMP-2 activity in visceral adipose tissue, while RT-8 presented lower active MMP-2 activity as compared with SC (p<0.05). Plasma pro and active MMP-2 and MMP-9 activity was lower in RT-8 as compared with RT-4 (p<0.05). These results suggest that higher volume RT up-regulates MMP-2 activity in skeletal muscle, while down-regulating MMP-2 in visceral adipose tissue. Moreover, it induces a decrease of MMP-2, 9 activity in circulation. Different tissue and circulatory MMP responses to RT may result in specific remodeling.

Effects of dietary restriction or swimming on lymphocytes and macrophages functionality from old rats.

Although aging compromises the functionality of macrophages (MΦ) and lymphocytes (LY), and dietary restriction (DR) and exercise partially counterbalance immunosenescence, it is unknown what effects of both strategies have on the functionality of these immune cells. Rats were randomly distributed into adult control (AD), older group (OLD), older submitted to 50% of DR (DR) and older submitted to swimming (EX) (n = 10 in each group). The function of immune cells (proliferative index, phagocytic capacity and H2O2 production), the weight and protein content of lymphoid organs (thymus and spleen), plasma glutamine concentration, interleukins (IL-1, IL-2, IL-6) and, immunoglobulins (IgA and IgG) were analysed. There was an increase of 74% in body weight in aged animals as compared with the AD group, while body weight reduced 19% in the DR as compared with the OLD group. Swimming training stimulated MΦ phagocytosis, while the EX group presented a decrease of the proliferative capacity of LY from the mesenteric lymph nodes (44% and 62%, respectively), when stimulated with ConA and LPS as compared with the old rats. These data demonstrated that DR and exercise affects differentially MΦ and LY function.

Effects of combined exercise training on immunological, physical and biochemical parameters in individuals with HIV/AIDS.

The practice of exercise has shown to be beneficial to quality of life of individuals with HIV/AIDS. Thus, the present study analysed the effects of a combined exercise training in persons living with HIV/AIDS. Ten participants participated in the present study. The following variables were analysed: viral load and cell counts for TCD4+/TCD8; maximal oxygen consumption (VO2max); total mass, absolute fat mass, relative fat mass, absolute lean mass, relative lean mass and body mass index; fasting glycaemia, fasting insulinaemia, homeostatic model assessment (HOMA) index (insulin resistance - homeostatic model assessment (IR-HOMA)); total cholesterol, triglycerides, high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), low-density lipoprotein (LDL); superoxide dismutase, catalase, glutathione peroxidase activities; thiobarbituric acid reactive substances. The combined exercise training consisted of resistance exercises plus aerobic training (60 min · session(-1), three times per week, during 20 weeks). The number of TCD4+ cells, absolute lean mass and relative lean mass, muscle strength for the 45° leg press, seated row and triceps extension, HDL-c levels as well as VO2max increased post-training. The activity of superoxide dismutase, catalase, glutathione peroxidase enzymes and thiobarbituric acid reactive substances levels were diminished post-training. Finally, it can be concluded that combined exercise training is able to change positively several variables related to health of individuals with HIV/AIDS, mainly the immune system as well as antioxidant mechanisms re-establishment.

Resistance exercise leading to failure versus not to failure: effects on cardiovascular control.

BACKGROUND: The aim of the present study was to evaluate the acute effects of resistance exercise (RE) leading to failure and RE that was not to failure on 24 h blood pressure (BP) and heart rate variability (HRV) in sedentary normotensive adult women. METHODS: Ten women (33.2 ± 5.8 years; 159.3 ± 9.4 cm; 58.0 ±6.4 kg; body fat 28.4 ± 2.8%) randomly underwent three experimental sessions: control (40 minutes of seated rest), RE leading to failure with 3 sets of 10 repetitions maximum (10-RM), and RE not to failure at 60% of 10-RM with 3 sets of 10 repetitions. Immediately post session BP and HRV were measured for 24 h. RESULTS: Ratings of perceived exertion and heart rate were higher during the 10-RM session when compared with 60% of 10-RM (6.4 ± 0.5 vs 3.5 ± 0.8 and 123.7 ± 13.9 vs 104.5 ± 7.3 bpm, respectively). The systolic, diastolic and mean BP decreased at 07:00 a.m. after the 10-RM session when compared with the control session (-9.0 ± 7.8 mmHg, -16.0 ± 12.9 mmHg and -14.3 ± 11.2 mmHg, respectively). The root mean square of the squared differences between R-R intervals decreased after both the 60% of 10-RM and 10-RM sessions compared with the control session. CONCLUSIONS: An acute RE session leading to failure induced a higher drop of BP upon awakening, while both RE sessions reduced cardiac parasympathetic modulation. RE may be an interesting training strategy to acutely decrease BP in adult women.

Intermittent fasting compromises the performance of eutrophic rats submitted to resistance training.

OBJECTIVES: The aim of this study was to analyze the effects of intermittent fasting (IF) on the performance of rats subjected to resistance training ladder climbs (RTLCs). METHODS: Thirty-two Wistar rats (80-d-old) were placed into one of the following four groups (n = 8/group): control (C), which were fed a standard diet with no exercise; intermittent fasting (IF) rats underwent IF for 16 h/d, fed a standard diet for a period of 8 h/d with no exercise; trained control (TC) were fed a standard diet and submitted to RTLC; and trained intermittent fasting (TIF) underwent IF for 16 h/d, fed a standard diet for a period of 8 h/d, and submitted to RTLC. Training groups completed 6-wk of RTLC (3 × /wk). The maximal load test (MLT) was applied on two occasions: before the first RTLC session and at the end of week 6 of physical training. Its purpose was to compare changes in performance over time. Both blood collection and total extraction of the organs were performed at the end of the experimental period. RESULTS: Food intake was higher in the TC group than in either the IF or TIF groups. TC supported a higher load (g) during the final MLT compared with the C, IF, and TIF groups, respectively. TC (initial MLT: 371.4 ± 31.1; final MLT: 593.9 ± 33.5) and TIF (initial MLT: 402.3 ± 31.8; final MLT: 495.4 ± 83.3) presented higher values when the pre- and post-RTLC moments were compared. The relative weight of the stomach was higher in TIF than in C and TC rats. There was no difference in aspartate transaminase and alanine transaminase enzyme activities or in creatinine and total cholesterol levels. CONCLUSIONS: IF negatively affected RTLC performance. IF plus RTLC increased the relative weight of the stomach as well as reduced food intake, without an increase in body weight, suggesting this combination may have promoted dilation of this organ, due, hypothetically, to the scarcity of food for several hours and the energy expenditure generated by physical training.

Advancements and critical steps for statistical analyses in blood pressure response to resistance training in hypertensive older women: a methodological approach.

BACKGROUND: Repeated measures analysis of covariance and three-way analysis of variance with repeated measures are common statistical methods. For a valid interpretation of blood pressure (BP) response to exercise, a variety of additional statistical methods must be implemented. Four additional statistical methods are presented: technical error of measurement (SEM), smallest real difference (SRD), magnitude-based inference and mixed effect modeling technique (MEM). The aim of this perspective article is to demonstrate how to apply already known statistical analyses regarding BP responsiveness in order to improve interpretation and achieve higher reliability for future studies in exercise science. METHODS: A total of 27 hypertensive older women (aged 68.37 ± 5.55 years) participated in the present study. A whole-body resistance training (RT) program was performed on two nonconsecutive days per week for 10 weeks. BP was monitored during the 10-week RT intervention and after 15 weeks of detraining. First, individuals were classified as high and low responders, then statistical methods to analyze data included the use of SEM, SRD, magnitude-based inference and MEM. RESULTS: When magnitude-based inference was used to classify responsiveness, most participants displayed a trivial response. Decrements in SBP between 1 and 10 mmHg were not clinically meaningful but fell within the measurement error of the SBP measurements. Baseline SBP and time of training predicted post-SBP response. CONCLUSION: Changes over time and declines in SBP might not be a SRD and fell in the SEM. Moreover, SBP responsiveness was the result of inappropriate control of covariates such as period of training.

High-fat diet and fructose drink introduced after weaning rats, induces a better human obesity model than very high-fat diet.

In the present study, we associated a high-fat diet (HF group: 45% kcal from lipids) or very high-fat (VHF group: 60% kcal from lipids) diet with a fructose drink (10% fructose) for hydration. Normal rat chow that received the control diet (content 16.3% kcal from lipid-AIN93G) and water. The treatments were introduced soon after weaning and were administered for 70 days. We aimed to compare HF and VHF groups and find which acts as a better model mimicking human obesity. Body mass gain, final body weight, adipocyte area in inguinal depots, visceral and subcutaneous adipose depots, serum triacylglycerol, and VLDL-c were all higher in the HF group, followed by the VHF group, compared to the C group. Only the HF group showed hyperinsulinemia and hyperleptinemia and higher total caloric intake, Lee index, HOMA2-IR, and total cholesterol. Serum TNF-α and IL-6 levels were lower in the HF and VHF groups than in the C group at the end for 70 days. In Summary, the HF (45%) diet administered with fructose induced a higher similarity of metabolic and hormonal alterations associated with human obesity. PRACTICAL APPLICATIONS: High intake of lipids with sugary drinks has been associated with obesity and its comorbidities. Although a diet with 45% or 60% of lipids is considered hyperlipidic, they are different in their effects on eating behavior and also probably from a metabolic point of view. Common sense is that the reduction in intake of lipids is favorable to health. Our study shows that this is not wholly true, and this information contributes to the guidelines for the treatment of obesity. In addition, the scientific literature on the subject has shown the most diverse results and also the use of experimental models with few similarities with human obesity. Our findings can contribute as a good model of obesity initiated during childhood to investigate possible using nutritional strategies, or the adoption of ergogenic nutritional resources in future studies, for example.

Blood Flow Restriction Training Blunts Chronic Kidney Disease Progression in Humans.

PURPOSE: This study aimed to verify the effect of 6 months of periodized resistance training (RT) with and without blood flow restriction (BFR) in patients with stage 2 chronic kidney disease (CKD) on glomerular filtration rate (GFR), uremic parameters, cytokines, and klotho-fibroblast growth factor 23 (FGF23) axis. METHODS: A total of 105 subjects were randomized in three groups of 35 each: control (CTL), RT, and RT + BFR. A first visit was required for an anamnesis to evaluate the number of medications and anthropometric measurements (body weight, height, and body mass index). Muscle strength (one-repetition maximum) was assessed. Venous blood samples were collected at baseline and after 6 months of training in all patients for the analysis of markers of renal function and integrity, as well as for the determination of the inflammatory profile. Statistical significances were adopted with P < 0.05. RESULTS: Both training therapies attenuated the decline of GFR (P < 0.05). The majority of CTL patients declined to stage 3 CKD (88.5%), whereas fewer incidents were noted with RT (25.7%) and RT + BFR (17.1%). Improved uremic parameters as well as inflammation (IL-6, IL-10, IL-15, IL-17a, IL-18, and TNF-α) and klotho-FGF23 axis in RT and RT + BFR (P < 0.05) were observed. Monocyte chemoattractant protein 1 was not changed (P > 0.05) but presented a large effect size (Cohen's d), demonstrating a propensity for improvement. CONCLUSION: Six months of periodized RT with and without BFR in patients with stage 2 CKD attenuated the progression of the disease by maintaining GFR, improving uremic parameters, cytokine profile regulation, and klotho-FGF23 axis.

High-Protein Diet Associated with Resistance Training Improves Performance and Decreases Adipose Index in Rats.

The study tested the hypothesis that a high protein diet based on isolated whey protein (IWP) associated with strength training improves performance and reduces body fat without promoting health damage. Male Wistar rats, 45 days old, were divided into four groups (n = 8/group): normoprotein sedentary (IWP 14%; NS); hyperprotein sedentary (IWP 35%; HS); normoprotein trained (IWP 14%; NT) and hyperprotein trained (IWP 35%; HT). All groups performed the maximum load test at the beginning and after the vertical ladder training protocol for 6 weeks (3x/week). The performance improved in HT when compared to other groups. There was no difference in the plasma levels of testosterone, IGF-1 and the hematological parameters remained normal. The relative weights of the kidneys were higher in the groups fed with high protein; the liver was higher in HT compared to NS and NT, and the heart was higher in HS compared to NS and NT. Concerning relative muscle weight, quadriceps, and gastrocnemius, HT showed higher value compared to NT. Diet containing 35% isolate whey protein associated with resistance training improved performance as well as increased muscles and organs weight of the animals, without damaging the tissues related to protein metabolism (confirmed by unchanged hematological parameters), which may minimize the risk of developing cardiometabolic disorders.

Relation Between Relative Handgrip Strength, Chronological Age and Physiological Age with Lower Functional Capacity in Older Women.

PURPOSE: Relative handgrip strength (RHGS), Aged Based on Exercise Stress Testing (A-BEST), and chronological age were evaluated as predictors of impaired mobility in older women. METHODS: Participants included 88 older women (mean age 68.13±6.02 years) referred for exercise stress testing. Estimated physiological age was computed based on exercise capacity, chronotropic reserve index, heart rate recovery, and medication that could affect heart rate. RHGS was measured using a validated handgrip hydraulic dynamometer and mobility was evaluated by timed up and go test (TUG-test). A hierarchical multiple regression predicted TUG-test performance from A-BEST, chronological age and RHGS. RESULTS: After adjustment for diabetes, RHGS was the only variable to add significantly to the prediction model (p=0.001). An increase in RHGS of 1 kg/body mass index was associated with a decrease in TUG-test of 0.7 seconds. CONCLUSION: Relative handgrip strength test was a better predictor of impaired mobility when compared with chronological and physiological age in older women. Moreover, RHGS represents an inexpensive, simple, portable, noninvasive measurement for a clinician when compared with an exercise stress testing.

Effect of a Short-term Lifestyle Modification Program on Quality of Life, Anthropometric Characteristics and CD4+T Cell Count of HIV Infected Patients in Tehran/Iran: A Randomized Controlled Trial.

CONTEXT: Increasing physical activity and promoting healthy behaviors may play a key role in reducing the adverse effects of antiretroviral therapy and HIV. OBJECTIVE: This study investigated the effects of an 8-week lifestyle modification program (LMP) on quality of life, anthropometric characteristics and CD4+T cell count of people living with HIV (PLWH). METHODS: Thirty PLWH taking ART were randomly assigned to a lifestyle modification program (LMP) (n = 15) or standard care control (CON) group (n = 15). All volunteers underwent body composition, CD4+T cell count measurement and quality of life assessments at the beginning and end of a two-month experimental period. RESULTS: At follow-up, we observed a significant increase in CD4+T cell count (117.52 cells/mm3; 95% CI, 36.59-198.45) and all subscales and total quality of life score (Short-Form 36 (SF-36) in the LMP group. While we did not observe a significant change in body composition for the LMP group, we did observe a significant increase in body fat (1.75%; 95% CI, 0.15, 2.33) and a reduction in lean body mass (-1.26; 95% CI, -1.26, -2.39) for the CON group. CONCLUSION: A LMP can be safely used as an effective intervention for improving quality of life and immune competence of PLWH who lack time to participate in a structured exercise regimen. TRIAL REGISTRATION: IRCT 201604034076N18. Registered: 2016-05-05 .web address of TRIAL: en.search.irct.ir/trial/4262.

Effects of high-protein diet containing isolated whey protein in rats submitted to resistance training of aquatic jumps.

OBJECTIVES: Isolated whey protein (IWP) can decrease body fat compared with other protein sources. The present study verified the effects of high protein diet (HD) containing IWP on several parameters of rats subjected to resistance training (RT). METHODS: Thirty-two male Wistar rats (60 days of age) were separated into four groups (n = 8/group): sedentary normoproteic (IWP 14%; SN); sedentary hyperproteic (IWP 35%; SH); trained normoproteic (IWP 14%; TN), and trained hyperproteic (WPI 35%; TH). RESULTS: Relative tissue/organ weight (g): perirenal and retroperitoneal adipose tissues were lower in SH and TH compared with SN (no difference to TN); omental and subcutaneous adipose tissues were higher in SN compared with SH. Epididymal adipose tissue was higher in SN compared with other groups. Heart weight was higher in TH compared with TN and SN, but not SH; kidney and liver higher in TH and SH compared with SN and TN; gastrocnemius lower in SN compared with other groups; soleus higher in SH in relation to other groups. The triglycerides levels (mg/dL) was reduced in the TH groups compared with SH, TN, and SN. There were no changes both in the concentrations of adiponectin and leptin and in the protein expression of GLUT-4 and p70s6k. CONCLUSION: HD containing WPI improved body composition, increased the weight of the heart, kidneys, liver and gastrocnemius and soleus muscles; however, this diet maintained the normal histomorphology of muscle and liver and, when associated with RT, reduced the serum levels of triglycerides.

Endurance exercise training decreased serum levels of surfactant protein D and improved aerobic fitness of obese women with type-2 diabetes.

BACKGROUND: Surfactant protein D (SP-D) is a member of the collectin family and is an important component of the pulmonary innate host defense. To find the relationship between exercise training and SP-D in diabetes, we examined the possible effects of a 10-week endurance exercise-training program on serum levels of SP-D, leptin, lipid profile and insulin resistance in obese women with type-2 diabetes mellitus (T2DM). METHODS: Twenty-two obese women with T2DM were randomly assigned to either exercise training (ET) or control (C) group. A subject dropped from ET group due to personal reasons and 1 subject dropped from C group due to commitment to experiments conditions. A total of twenty obese women with T2DM were randomly assigned into endurance exercise training (ET = 10) and control (C = 10) groups. The training group underwent a progressive endurance-training program for 10 weeks (running on a treadmill for 30-55 min/day at 50-75% heart rate reserve) and the control group did not participate in any exercise program. Venous blood samples were collected from both groups before and 72 h after the last session of exercise training for analysis of serum SP-D, leptin, lipid profile, glucose and insulin. Data were analyzed using 2 (group: control, endurance training) × 2 (time: pre, post) ANOVA with repeated measures on the second factor. Absolute changes from rest (∆ baseline) values were calculated according to the following formula: ((measure-baseline)·baseline-1)·100. Percent change between groups was analyzed using independent t-tests (p < 0.05). All analyses were completed using SPSS 19. RESULTS: The serum SP-D levels were decreased after exercise training in ET (∆ = - 78.78 ± 17.14%, p = 0.001) when compare to C (∆ = 9.41 ± 4.75%). Obese diabetic women in the ET group showed significantly lower serum leptin levels (8053.27 ± 878.7 pg/ml, ∆ = - 26.97 ± 16.41%) when compared with women in the control group (9885.5 ± 696 pg/ml, ∆ = 7.02 ± 3.46%, p = 0.003). Fasting glucose was favorably and significantly affected by the intervention (ET ∆ = - 17.01 ± 12.74%, Control ∆ = 15.47 ± 7.32%, p = 0.011). VO2max as an index of aerobic fitness was significantly increased after 10-weeks of endurance exercise training (ET ∆ = 19.29 ± 6.18%). CONCLUSIONS: Endurance exercise training with improvement in aerobic fitness induced a significant reduction of serum SP-D levels in obese women with T2DM.

Acute eccentric resistance exercise decreases matrix metalloproteinase activity in obese elderly women.

The association of ageing with obesity commits elderly women and has been correlated with multiple degenerative processes, which could be occasioned by an enhancing in levels of matrix metalloproteinase-2 and metalloproteinase-9 (MMPs) as well by an cytokine unbalance that included an enhancing on interleukin-6 (IL-6). Furthermore, other factors could be also related to degenerative process, as they could be reduced by eccentric resistance exercise (ERE), which seems particularly important to initiate resistance training in obese older adults. In this view, this study aims to determinate the effects of an acute ERE session on serum MMP-2, MMP-9 and IL-6 in elderly obese women. Ten elderly obese women participated in this study and completed a 10 repetitions maximum test (10 RM) utilizing leg extension exercise. Subjects then completed an acute ERE session consisting of seven sets of 10 repetitions at 110% of 10 RM with a rest of 3 min between sets. Blood samples were collected before, immediately after, 3, 24 and 48 h following the ERE session. Zymograms were utilized to measure the MMP-2 and MMP-9 enzymes from all individuals. Moreover, IL-6 concentration was also determinated. After ERE session, MMP-2 and MMP-9 decreased, remaining significantly below baseline values after 48 h (P<0·05). Although not statistically significant, there was a tendency for IL-6 to decrease 48 h after the ERE when compared with 3 h (P = 0·06). An acute ERE session decreases MMP-9, MMP-2 and IL-6 in elderly obese women, possibly indicating a transient protection against the low grade inflammation present in this specific population.

Elevated glycated hemoglobin levels impair blood pressure in children and adolescents with type 1 diabetes mellitus.

BACKGROUND: Deregulation of glycemic and glycated hemoglobin (HbA1) levels accelerate the progression of cardiovascular complications in type 1 diabetes mellitus (T1DM). The aim of this study was to investigate the association between HbA1 and changes in blood pressure of children and adolescents with T1DM. METHODS: A total of 60 children and adolescents were recruited and allocated into two groups (prehypertension and control group). Blood pressure and HbA1 were measured by the oscillometric method and high-performance liquid chromatography, respectively. RESULTS: The prehypertensive group had (P < 0.05) higher disease duration, body weight, Z score for body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP) and a higher HbA1 when compared with the control children and adolescents. Multiple regression to predict alterations in DBP from HbA1 adjusted for age, disease duration, and body mass index demonstrated a positive relationship with DBP (P < 0.05). A 1 % increase in HbA1 was associated with 1.73 mmHg increase in DBP. CONCLUSIONS: High levels of HbA1 may be associated with increased blood pressure in T1DM. A tight control of HbA1 levels may provide long-term cardiovascular protection in children and adolescents with T1DM.