Robust arm and leg muscle adaptation to training despite ACE inhibition: a randomized placebo-controlled trial.

PURPOSE: Angiotensin-converting enzyme (ACE) inhibitor treatment is widely applied, but the fact that plasma ACE activity is a potential determinant of training-induced local muscular adaptability is often neglected. Thus, we investigated the hypothesis that ACE inhibition modulates the response to systematic aerobic exercise training on leg and arm muscular adaptations. METHODS: Healthy, untrained, middle-aged participants (40 ± 7 yrs) completed a randomized, double-blinded, placebo-controlled trial. Participants were randomized to placebo (PLA: CaCO3) or ACE inhibitor (ACEi: enalapril) for 8 weeks and completed a supervised, high-intensity exercise training program. Muscular characteristics in the leg and arm were extensively evaluated pre and post-intervention. RESULTS: Forty-eight participants (nACEi = 23, nPLA = 25) completed the trial. Exercise training compliance was above 99%. After training, citrate synthase, 3-hydroxyacyl-CoA dehydrogenase and phosphofructokinase maximal activity were increased in m. vastus lateralis in both groups (all P < 0.05) without statistical differences between them (all time × treatment P > 0.05). In m. deltoideus, citrate synthase maximal activity was upregulated to a greater extent (time × treatment P < 0.05) in PLA (51 [33;69] %) than in ACEi (28 [13;43] %), but the change in 3-hydroxyacyl-CoA dehydrogenase and phosphofructokinase maximal activity was similar between groups. Finally, the training-induced changes in the platelet endothelial cell adhesion molecule-1 protein abundance, a marker of capillary density, were similar in both groups in m. vastus lateralis and m. deltoideus. CONCLUSION: Eight weeks of high-intensity whole-body exercise training improves markers of skeletal muscle mitochondrial oxidative capacity, glycolytic capacity and angiogenesis, with no overall effect of pharmacological ACE inhibition in healthy adults.

[Effect of treatment with levothyroxine in the lipid profile of the patients with subclinical hypothyroidism]. / Influencia del tratamiento con levotiroxina en el perfil lipídico de los pacientes con hipotiroidismo subclínico.

OBJECTIVE: Controversy surrounds the issue of whether levothyroxine treatment improves lipid profile in patients with subclinical hypothyroidism (SHT). The objective was to detect substantial differences -> or = 20% in total cholesterol (TC) and > or = 15 mg/dl in low-density lipoprotein cholesterol (LDL-c)- in the lipid profiles of patients with subclinical hypothyroidism (SHT) after initiating levothyroxine replacement therapy (T4). PATIENTS AND METHOD: Observational retrospective cohort study with paired data. LOCATION: Primary care center in Manresa (Barcelona). PARTICIPANTS: 100 patients with SHT treated with levothyroxine. MAIN MEASURES: Demographic and clinical variables from the clinical history, as well as temporal data -SHT diagnosis, beginning of T4 treatment and thyroid-stimulating hormone (TSH) normalization, and the quantity of T4 administered to treat SHT-were gathered. Data for TSH, lipid profile and body mass index were recorded at specific moments (beginning of treatment, after 6-18 months on T4, at the euthyroidism stage, and the last value registered in the previous 12 months). RESULTS: The mean age was 61+/-15 [95% confidence interval (CI), 46-76] years and 95% of the patients were women. Obesity was found in 40%, high blood pressure in 39%, dyslipidemia in 37%, diabetes mellitus in 10%, smoking in 7%, and cardiovascular disease in 6% of the patients. No significant differences were detected in TC or in LDL-c after treatment with levothyroxine. Nonsignificant reductions were found in TC (-4 mg/dl; p=0.77) and LDL-c (-10 mg/dl; p=0.31) when euthyroidism was achieved, as well as in TC (-10mg/dl; p=0.58) after 5+/-3 years of treatment. CONCLUSIONS: Levothyroxine treatment in patients with SHT does not lead to substantial reductions in TC or LDL-c, independently of TSH concentrations prior to treatment.