The prevalence and impact of sarcopenia in older cardiac patients undergoing inpatient cardiac rehabilitation - results from a prospective, observational cohort pre-study.

BACKGROUND: The prevalence of sarcopenia and its impact in older patients undergoing inpatient cardiac rehabilitation (iCR) after cardiac procedure has been insufficiently studied. The main aim of this study was to evaluate the prevalence of sarcopenia and quantify the functional capacity of older sarcopenic and non-sarcopenic patients participating in iCR. METHODS: Prospective, observational cohort study within the framework of the ongoing multicenter prehabilitation study "PRECOVERY". A sample of 122 patients ≥75 years undergoing iCR after cardiac procedure were recruited in four German iCR facilities and followed up 3 months later by telephone. At iCR (baseline), the Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F) questionnaire was used to identify sarcopenic patients. In addition, Katz-Index, Clinical Frailty Scale (CFS), handgrip strength (HGS), Short Physical Performance Battery (SPPB) and 6-minute walk distance (6MWD) measured functional capacity and frailty at baseline. Outcomes were prevalence of sarcopenia and the correlation of sarcopenia to functional capacity and frailty at baseline as well as the SARC-F score at follow-up. The Wilcoxon test was applied for pre-post-test analysis. Correlation between sarcopenia and 6MWD, SPPB score and HGS was tested with the eta coefficient with one-way ANOVA. RESULTS: Complete assessments were collected from 101 patients (79.9 ± 4.0 years; 63% male). At baseline, the mean SARC-F score was 2.7 ± 2.1; 35% with sarcopenia. Other baseline results were Katz-Index 5.7 ± 0.9, CFS 3.2 ± 1.4, HGS 24.9 ± 9.9 kg, SPPB score 7.5 ± 3.3 and 6MWD 288.8 ± 136.5 m. Compared to baseline, fewer patients were sarcopenic (23% versus 35%) at follow-up. In the subgroup of sarcopenic patients at baseline (n = 35), pre-post comparison resulted in a significant SARC-F improvement (p = 0.017). There was a significant correlation between sarcopenia measured by SARC-F and poor results in the assessments of functional capacity (p < 0.001; r > 0.546). CONCLUSIONS: The prevalence of sarcopenia in older patients at iCR after cardiac procedure is high (35%) and remains high at follow-up (23%). Sarcopenia screening is important since the diagnosis of sarcopenia in these patients correlates significantly with poor functional capacity. The results indicate that these patients may benefit from prehabilitation aimed at improving perioperative outcomes, increasing functional capacity and mitigating adverse effects. TRIAL REGISTRATION: German Clinical Trials Register (DRKS; http://www.drks.de ; DRKS00032256). Retrospectively registered on 13 July 2023.

Effects of exercising before breakfast on the health of T2DM patients-A randomized controlled trial.

This is the first study to examine whether training before breakfast in the overnight-fasted state is more effective in improving the health of patients with type 2 diabetes mellitus (T2DM) than after breakfast in the fed state. Thirty T2DM patients (60 ± 8 years, 33.7 ± 4.6 kg/m2 ) were randomly assigned to the F group (training in the overnight-fasted state (n = 15)) and to the C group (training in the fed state (control group, n = 15)). All patients completed an 8-week combined endurance/strength training program. Physical training significantly increased time to physical exhaustion during an endurance test (+10.4%), power output during strength tests (chest presses: +36.7% and seated rows: +37.8%), and fat-free mass (+1.7 kg). Body fat mass (-1.9 kg), glycated hemoglobin (HbA1c) values (absolute change: -0.3%), serum insulin values (-2.5 microU/mL), the homeostatic model assessment for insulin resistance (HOMA-IR) index (-1.1), and circulating triglyceride levels (-31 mg/dL) decreased significantly from pre- to post-training. The training had no effect on body mass index, serum fasting glucose, total cholesterol, low-density lipoprotein/high-density lipoprotein ratio or interleukin (IL)-6, IL-10 and tumor necrosis factor (TNF)α levels. Analyses of variance revealed no time × group interaction for any variable (P > .05). The training was effective in improving the health of T2DM patients. However, the preliminary study's data do not provide any evidence that the nutritional state (overnight-fasted or fed) in regular physical training plays a significant role for training-induced adaptations in T2DM patients. Full trials (using other training protocols as well) should be conducted to gain further knowledge about the relevance of pre-exercise breakfast ingestion.

Endurance training alters YKL40, PERM1, and HSP70 skeletal muscle protein contents in men with type 2 diabetes mellitus.

BACKGROUND: The fight against type 2 diabetes mellitus (T2DM) is tremendously challenging. This pilot study investigates whether endurance training (3 times per week for 3 months, moderate intensity) can change the skeletal muscle protein contents of chitinase-3-like protein-1 (YKL40), peroxisome proliferator-activated receptor y coactivator-1 and estrogen-related receptor-induced regulator in muscle-1 (PERM1) and heat-shock protein-70 (HSP70), which have been discussed as novel therapeutically relevant targets. METHODS: Muscle biopsies were obtained from overweight/obese men with T2DM (n = 7, years = 63 ± 9) at T1 (6 weeks pre-training), T2 (1 week pre-training) and T3 (3 to 4 days post-training). The protein levels of YKL40, PERM1, and HSP70 were determined by immunohistochemistry. RESULTS: YKL40, PERM1, and HSP70 were significantly upregulated following endurance training (T2-T3: +103%, +61%, +89%, p = 0.012, p = 0.010, p = 0.028). There was a fiber type-specific distribution of HSP70 with increased protein contents in type I fibers. A significant change in the fiber type distribution with an increase in type I fibers and a decrease in type II fibers was observed post-training. There were no significant differences for YKL40, PERM1, HSP70, or the fiber type distribution between T1 and T2. CONCLUSION: The training-induced upregulation of YKL40, PERM1, and HSP70 could help manage the diabetic disease and reduce its complications.

Moderate endurance training (marathon-training) - effects on immunologic and metabolic parameters in HIV-infected patients: the 42 KM cologne project.

BACKGROUND: Improved treatment options of HIV have resulted in regular physical activities of many HIV-infected patients. However, data on effects of sports in HIV-patients are scarce. METHODS: 21 HIV-infected persons were monitored prospectively while preparing for a marathon run. Multiple parameters with regard to immunology, quality of life and metabolism were measured at 4 time points (at baseline 1 year before the marathon run, 3 and 6 months after beginning of training, and immediately before marathon). RESULTS: 13 out of 21 participants completed the marathon (12 male, 1 female; median age 42 years [27-50]; CD4 = 620/µl [146-1268]; 11 were on ART since 3.5 years [1-7]). 8 participants ceased training early. All reasons for stopping (besides one pre-existing metatarsal fracture) were not regarded as training-related (e.g. time limitation n = 3; newly diagnosed anal cancer n = 1; personal reasons/unknown n = 3). We observed a significant increase in absolute CD4-T-cells (620/µl [146-1268] vs. 745 [207-1647]; p = 0.001) with simultaneous decrease of CD4-T-cell apoptosis (53% [47-64] vs. 32% [14-42]); p < 0.01). No effects on viral load independent of ART occurred. Systolic blood pressure and cholesterol improved significantly, although moderate and normal at baseline (cholesterol 185 mg/dl [98-250] vs. 167 [106-222], p = 0.02; RRsys 125 mmHg [100-145] vs. 120 [100-140], p = 0.01). Blood count, liver enzymes, creatinine and CK remained unchanged. CONCLUSIONS: The results of this pilot study indicated improved metabolic and immunologic parameters in HIV-infected patients undergoing moderate endurance training. Although training effects or ART cannot be ultimately separated as underlying mechanisms, we conclude that marathon training is safe for HIV-infected patients and potentially improves general health. TRIAL REGISTRATION: DRKS00011592 (retrospectively registered on February 9th 2017).

Influence of endurance training on skeletal muscle mitophagy regulatory proteins in type 2 diabetic men.

BACKGROUND: Mitophagy is a form of autophagy for the elimination of mitochondria. Mitochondrial content and function are reduced in the skeletal muscle of patients with type 2 diabetes mellitus (T2DM). Physical training has been shown to restore mitochondrial capacity in T2DM patients, but the role of mitophagy has not been examined in this context. This study analyzes the impact of a 3-month endurance training on important skeletal muscle mitophagy regulatory proteins and oxidative phosphorylation (OXPHOS) complexes in T2DM patients. METHODS: Muscle biopsies were obtained from eight overweight/obese T2DM men (61±10 years) at T1 (6 weeks pre-training), T2 (1 week pre-training), and T3 (3 to 4 days post-training). Protein contents were determined by Western blotting. RESULTS: The training increased mitochondrial complex II significantly (T2-T3: +29%, p = 0.037). The protein contents of mitophagy regulatory proteins (phosphorylated form of forkhead box O3A (pFOXO3A), mitochondrial E3 ubiquitin protein ligase-1 (MUL1), Bcl-2/adenovirus E1B 19-kD interacting protein-3 (BNIP3), microtubule-associated protein 1 light chain-3B (the ratio LC3B-II/LC3B-I was determined)) did not differ significantly between T1, T2, and T3. CONCLUSIONS: The results imply that training-induced changes in OXPHOS subunits (significant increase in complex II) are not accompanied by changes in mitophagy regulatory proteins in T2DM men. Future studies should elucidate whether acute exercise might affect mitophagic processes in T2DM patients (and whether a transient regulation of mitophagy regulatory proteins is evident) to fully clarify the role of physical activity and mitophagy for mitochondrial health in this particular patient group.

Hypoxia and Hyperoxia Affect Serum Angiogenic Regulators in T2DM Men during Cycling.

Exercise-induced transient increases in pro-angiogenic regulators can promote angiogenesis.This pilot study aims to analyze the potential of exercise to positively affect angiogenic regulators in patients with type 2 diabetes mellitus (T2DM), who often exhibit abnormal angiogenesis, under different environmental conditions. 9 overweight/obese men with uncomplicated T2DM (8 took anti-diabetic drugs) performed submaximal cycling for 40 min in normoxia (≈21 vol%O2), hypoxia (≈14 vol%O2) and during alternating hypoxia/hyperoxia (≈14 vol%O2/≈30 vol%O2, 5-min intervals) (3×3 crossover design). Serum pro-angiogenic vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP)-2, MMP-9 and anti-angiogenic endostatin were quantified using enzyme-linked immunosorbent assay (ELISA) kits. Non-parametric statistical tests (Wilcoxon, Friedman analysis of variance) were applied. VEGF increased significantly from pre- to post-exercise with hypoxia and hypoxia/hyperoxia. MMP-2 increased significantly in all experimental runs, while MMP-9 only increased significantly with hypoxia and hypoxia/hyperoxia. Endostatin increased significantly with normoxia and hypoxia. However, the magnitude of changes did not differ significantly between conditions. Capillary blood lactate was significantly lower following cycling with hypoxia/hyperoxia than with hypoxia alone. Although differences in subjective ratings of perceived exertion failed significance, 7 subjects were less exerted with hypoxia/hyperoxia than with hypoxia. Submaximal cycling with hypoxia or alternating hypoxia/hyperoxia may induce a more reliable up-regulation of pro-angiogenic regulators compared with normoxia, while hypoxia/hyperoxia may be better tolerated than hypoxia alone.

[Oxidative stress in Masters swimmers following high-intensity (interval) training (HI(I)T)]. / Oxidativer Stress bei Mastersschwimmern nach hochintensivem (Intervall-) Training (HI(I)T).

Increased oxidative stress (OS) can promote diseases in the long term, but it can also trigger cellular adaptations in the short term. The present study aims to analyze whether a 3-month high-intensity (interval) training (HI(I)T) affects OS in 24 Masters swimmers (22-67 years) before (= basal) and after an all-out performance (swimming step-test). Data were analyzed for the entire group and differentiated according to sex and age (under 50 years (U50) and over 50 years (O50)). Prior to the HI(I)T intervention, a significant increase in OS from the basal to the all-out value was observed among the entire group and in the O50-subjects (subgroup analysis). Furthermore, significant increases in basal OS were evident for the entire group post-HI(I)T, but OS was only significantly increased in men in the subgroup analysis. No significant results were observed for women and U50-subjects. The response by Masters swimmers to HI(I)T depends on age and sex.

Endurance training alters basal erythrocyte MCT-1 contents and affects the lactate distribution between plasma and red blood cells in T2DM men following maximal exercise.

Chronic elevated lactate levels are associated with insulin resistance in patients with type 2 diabetes mellitus (T2DM). Furthermore, lactacidosis plays a role in limiting physical performance. Erythrocytes, which take up lactate via monocarboxylate transporter (MCT) proteins, may help transport lactate within the blood from lactate-producing to lactate-consuming organs. This study investigates whether cycling endurance training (3 times/week for 3 months) alters the basal erythrocyte content of MCT-1, and whether it affects lactate distribution kinetics in the blood of T2DM men (n = 10, years = 61 ± 9, body mass index = 31 ± 3 kg/m(2)) following maximal exercise (WHO step-incremental cycle ergometer test). Immunohistochemical staining indicated that basal erythrocyte contents of MCT-1 protein were up-regulated (+90%, P = 0.011) post-training. Erythrocyte and plasma lactate increased from before acute exercise (= resting values) to physical exhaustion pre- as well as post-training (pre-training: +309%, P = 0.004; +360%, P < 0.001; post-training: +318%, P = 0.008; +300%, P < 0.001), and did not significantly decrease during 5 min recovery. The lactate ratio (erythrocytes:plasma) remained unchanged after acute exercise pre-training, but was significantly increased after 5 min recovery post-training (compared with the resting value) (+22%, P = 0.022). The results suggest an increased time-delayed influx of lactate into erythrocytes following an acute bout of exercise in endurance-trained diabetic men.

Skeletal muscle nitric oxide (NO) synthases and NO-signaling in "diabesity"--what about the relevance of exercise training interventions?

Type 2 diabetes mellitus associated with obesity, or "diabesity", coincides with an altered nitric oxide (NO) metabolism in skeletal muscle. Three isoforms of nitric oxide synthase (NOS) exist in human skeletal muscle tissue. Both neuronal nitric oxide synthase (nNOS) and endothelial nitric oxide synthase (eNOS) are constitutively expressed under physiological conditions, producing low levels of NO, while the inducible nitric oxide synthase (iNOS) is strongly up-regulated only under pathophysiological conditions, excessively increasing NO concentrations. Due to chronic inflammation, overweight/obese type 2 diabetic patients exhibit up-regulated protein contents of iNOS and concomitant elevated amounts of NO in skeletal muscle. Low muscular NO levels are important for attaining an adequate cellular redox state--thereby maintaining metabolic integrity--while high NO levels are believed to destroy cellular components and to disturb metabolic processes, e.g., through strongly augmented posttranslational protein S-nitrosylation. Physical training with submaximal intensity has been shown to attenuate inflammatory profiles and iNOS protein contents in the long term. The present review summarizes signaling pathways which induce iNOS up-regulation under pathophysiological conditions and describes molecular mechanisms by which high NO concentrations are likely to contribute to triggering skeletal muscle insulin resistance and to reducing mitochondrial capacity during the development and progression of type 2 diabetes. Based on this information, it discusses the beneficial effects of regular physical exercise on the altered NO metabolism in the skeletal muscle of overweight/obese type 2 diabetic subjects, thus unearthing new perspectives on training strategies for this particular patient group.

Strength training alters MCT1-protein expression and exercise-induced translocation in erythrocytes of men with non-insulin-dependent type-2 diabetes.

We investigated the cellular distribution of lactate transporter (MCT1) and its chaperone CD147 (using immunohistochemistry and fluorescence-activated cell sorting) in the erythrocytes of men with non-insulin-dependent type-2 diabetes (NIDDM, n = 11, 61 ± 8 years of age) under acute exercise (ergometer cycling test, World Health Organisation scheme) performed before and after a 3-month strength training program. Cytosolic MCT1 distribution and membraneous CD147 density did not change after acute exercise (ergometer). After the 3-month strength training, MCT1-density was increased and the reaction of MCT1 (but not that of CD147) towards acute exercise (ergometer) was altered. MCT1 localisation was shifted from the centre to the cellular membrane. This resulted in a decrease in the immunohistochemically measured cytosolic MCT1-density. We conclude that strength training alters the acute exercise reaction of MCT1 but not that of CD147 in erythrocytes in patients with NIDDM. This reaction may contribute to long-term normalisation and stabilisation of the regulation of lactate plasma concentration in NIDDM.

Influence of a moderate physical activity intervention on red cell deformability in patients suffering from chronic obstructive pulmonary disease (COPD).

The present study investigates whether a moderate physical activity intervention may alter red cell deformability (RCD) of patients suffering from chronic obstructive pulmonary disease (COPD). Subjects (n = 10; age: 62 ± 4; body-mass index (BMI): 25.8 ± 7.5) performed a training regimen for 10 weeks. In the beginning of the study and after the training period, COPD patients underwent a WHO cycle ergometry test. Venous blood samples were taken before (T0), immediately after (T1) and 30 min after (T2) the intervention. RCD was measured with the laser-assisted optical rotational cell analyzer (LORCA). Significant improvements of the RCD were detected. The semi-maximal shear stress increased significantly. Acute exhaustion had no effect on RCD. Thus, the training period of 10 weeks influenced RCD.

Development of a Core Set of Quality Criteria for Virtual Reality Applications Designed for Older Adults: Multistep Qualitative Study.

BACKGROUND: Virtual reality (VR) applications are gaining growing significance, particularly among older adults. These applications can provide valuable support to older adults by offering immersive VR content that positively influences various aspects of their daily lives, including activities of daily living. Furthermore, VR applications can contribute to the enhancement of cognitive and motor skills, ultimately leading to an improved quality of life for older individuals. Nevertheless, to ensure a positive impact, it is crucial to develop VR experiences that are tailored to the needs and preferences of the users. OBJECTIVE: This study aims to develop a core set of quality criteria and guidelines for the development of user-centered VR applications specifically designed for older adults (target group). METHODS: The multistep qualitative study design comprised several key stages, beginning with a systematic literature search. This was followed by a framework analysis aimed at identifying a core set of criteria. Subsequently, these criteria underwent validation through expert workshops. The outcomes achieved through this iterative process were organized and categorized into criteria, accompanied by explanations detailing the underlying categories or codes. RESULTS: The quality criteria core set for older adults-friendly VR applications has been developed through an iterative process. It is divided into 2 distinct parts, each containing criteria categorized into specific areas. The first part includes the following categories: (1) quality assurance of medical/health content, (2) data protection provisions, (3) quality requirements, (4) consumer protection, and (5) interoperability. The second part includes the following categories: (1) graphic/quality, (2) 3D character/avatar, (3) providing in-game instructions and prompts, (4) interaction, (5) navigation, and (6) promotion of user motivation and loyalty to use. The results imply a differentiated scope as well as a differentiated granularity of the criteria. CONCLUSIONS: Considering the ongoing advancement of VR technology and the diverse needs within the older adult demographic, it is essential to assess the quality criteria core set results on an individual basis.

The ESA Parastronaut Feasibility Project: Investigating the Need and Contents of Physical Performance Tests for an Inclusive European Astronaut Corps.

INTRODUCTION: In 2022, the European Space Agency (ESA) held the first astronaut selection since the beginning of space flight that allowed physically impaired astronaut candidates to be selected in an inclusive European astronaut corp. The main objective of the 'parastronaut feasibility project' is to investigate if physical performance tests (PPTs) should be part of future astronaut recruitments for an inclusive ESA astronaut corps to test their flight readiness. The objectives of this study are (1) to assess if future (para-)astronaut recruitment campaigns should include PPTs to ensure flight readiness, safety, and mission success; (2) if so, which areas of physical performance should be tested to mimic nominal and off-nominal crew activities during all phases of a space mission; and (3) to assess whether PPTs are compatible with the ethical principles of equal opportunity for an inclusive pool of astronaut candidates. METHODS: 58 subject matter experts with specialisations in space physiology, operational human space flight, space medicine, medical ethics or parasports were interviewed in two rounds using the Delphi method. Both qualitative and quantitative data were obtained, analysed, categorised, and visualised using the qualitative research tool NVivo and Excel. RESULTS: Two thirds of the experts were in favour of adding PPTs to future astronaut selections and recommended to implement them for both physically unimpaired and physically impaired astronaut candidates. The main physical skills that should be examined are space-related, mission-specific coordination skills of the upper extremities, followed by endurance performance and stamina, dexterity of the upper extremities, motor learning ability and mobility. CONCLUSION: Based on this study, it is clear that PPTs should be part of future astronaut selection campaigns. However, the content of these PPTs must be carefully evaluated and validated using existing data on crew activities before, during, and after space flight, while considering equal opportunities in the context of human space flight. Historical considerations have influenced current astronaut requirements, but this study's findings indicate a need to reassess these requirements for future inclusive selection campaigns, as their validity and necessity remain uncertain.

Plasticizers excreted in urine: indication of autologous blood transfusion in sports.

BACKGROUND: Misuse of autologous blood transfusions in sports remains undetectable. The metabolites of the plasticizer di-(2-ethylhexyl)phthalate (DEHP) were recently proposed as markers of blood transfusion, based on high urinary concentrations of these compounds observed in patients subjected to blood transfusion. This study evaluates DEHP metabolites in urine for detecting autologous blood transfusion. STUDY DESIGN AND METHODS: One blood bag was drawn from moderately trained subjects and the red blood cells (RBCs) were reinfused after different storage periods. Group 1 (12 subjects) was reinfused after 14 days, and Group 2 (13 subjects), after 28 days of storage. Urine samples were collected before and after reinfusion for determination of the concentrations of three DEHP metabolites, mono-(2-ethylhexyl)phthalate, mono-(2-ethyl-5-hydroxyhexyl)phthalate, and mono-(2-ethyl-5-oxohexyl)phthalate. RESULTS: Concentrations of DEHP metabolites on the days before reinfusion were in agreement with those described after common environmental exposure. A few hours after the reinfusion a significant increase was observed for all metabolites in all volunteers. Concentrations 1 day later were still higher (p < 0.05) than before reinfusion. Variations in urine dilution supported normalization by specific gravity. Concentrations of DEHP metabolites tended to be higher after longer storage times of RBCs. CONCLUSION: Autologous transfusion with RBCs stored in plastic bags provokes an acute increase in the urinary concentrations of DEHP metabolites, allowing the detection of this doping malpractice. The window of detection is approximately 2 days. The method might be applied to urine samples submitted for antidoping testing.

Influence of intermittent hypoxia interval training on exercise-dependent erythrocyte NOS activation and blood pressure in diabetic patients.

NOS-activation in erythrocytes (eryNOS) is impaired in patients suffering from type 2 diabetes. We investigated the effect of physical exercise on eryNOS activation and whether 6 week hypoxia interval training may alter this process. Male patients with diabetes mellitus type 2 (NIDDM, n = 12; age, 61.3 ± 8.4 years; BMI, 29.8 ± 3.7 kg/m(2)) underwent physical exercise training before and after 6 week hypoxia interval training. Training was conducted 4 times per week for 90 min at 15.4-12.7 Vol% of inspired oxygen. Vital parameters were recorded. Before hypoxia intervention, eryNOS phosphorylation at serine(1177) decreased significantly during exercise (basal 17.4 ± 12.0 compared with exercise 8.4 ± 9.2 arbitrary grey values (arGV); P < 0.05). After 6 weeks of hypoxia intervention, eryNOS-pSer(1177) (2.2 ± 2.5 arGV) was significantly lower at baseline. Ergometry showed an increase (7.6 ± 3.0 arGV; P < 0.05) followed by a decrease to almost baseline levels after 30 min (3.8 ± 1.5 arGV). Maximal exercise capacity and O(2)-uptake ([Formula: see text] max) increased significantly. The effects were independent from exercise-induced elevation of blood pressure. Exercise-dependent eryNOS phosphorylation at serine(1177) was increased similar to that described for the endothelium in diabetic patients. EryNOS dysregulation was partially restored after intermittent hypoxia training.

Training-induced alterations of skeletal muscle mitochondrial biogenesis proteins in non-insulin-dependent type 2 diabetic men.

This study investigates whether regular physical activity (moderate endurance or resistance training twice a week for 3 months) influences the key regulatory molecules of mitochondrial biogenesis (peroxisome proliferator-activated receptor gamma coactivator-1α (PGC1α), nuclear respiratory factor-1 (NRF1), and mitochondrial transcription factor A (TFAM)) in patients suffering from non-insulin-dependent type 2 diabetes mellitus (T2DM) (n = 16, years = 62 ± 7, body mass index (BMI) = 30 ± 4 kg/m(2)). Seven T2DM men took part in endurance training, and 9 men participated in resistance training. BMI-matched non-diabetic male control subjects (CON) (n = 7, years = 53 ± 6, BMI = 30 ± 4 kg/m(2)) were studied for comparison. The protein contents of PGC1α, NRF1, and TFAM were determined using immunohistochemical staining methods on biopsies taken from the musculus vastus lateralis. At baseline, no differences were observed in NRF1-density between the T2DM men and the CON, while the contents of PGC1α and TFAM were decreased in the T2DM men. PGC1α and TFAM contents were not changed in the T2DM patients after the training period, but NRF1 was decreased. The down-regulation of mitochondrial signaling molecules might explain the patho-physiological reduction in mitochondrial biogenesis found in T2DM. Physical training, as performed in our study, did not reverse the down-regulation of mitochondrial signaling molecules--at least not after 3 months. [corrected].

Lipid-peroxidation and peroxiredoxin-overoxidation in the erythrocytes of non-insulin-dependent type 2 diabetic men during acute exercise.

Single bouts of exercise induce an acute state of oxidative stress. It is largely unknown what this means in the context of diseases which are associated with increased oxidative stress, e.g., type 2 diabetes mellitus (T2DM). Free radicals can destroy the structure of erythrocytes and reduce their deformability. Antioxidative peroxiredoxins are highly abundant in erythrocytes. Therefore, we immunohistochemically examined whether the free radical-induced erythrocyte lipid-peroxidation measured by 8-iso-prostaglandin-F2α (8-Iso-PGF) as well as the erythrocyte contents of overoxidized peroxiredoxins (PRDX-SO(2-3)) differ between overweight/obese T2DM men (n = 15, years = 59 ± 10 (mean ± SD)) and overweight/obese non-diabetic control subjects (n = 12, years = 53 ± 4) during acute exercise (WHO-step test). We further studied whether physical training affects the oxidative stress response to acute exercise. Seven men belonging to the diabetic group took part in a moderate intensity cycling endurance training. Erythrocyte 8-Iso-PGF significantly increased during acute exercise and decreased in the 30-min recovery phase in untrained diabetic and non-diabetic men (P ≤ 0.05). Increases/decreases in 8-Iso-PGF in relation to exercise/recovery time were similar in both groups. A significant exercise-induced increase in the contents of erythrocyte PRDX-SO(2-3) was only observed in T2DM men (P ≤ 0.05). PRDX-SO(2-3) contents were not reduced during recovery. Following physical training, the magnitude of exercise-induced increases in 8-Iso-PGF (relative to exercise time) was significantly lower in the erythrocytes of T2DM men (P ≤ 0.05), whereas increases in PRDX-SO(2-3) were significantly higher (P ≤ 0.05). Exercise-induced erythrocyte lipid-peroxidation is similar in untrained overweight/obese T2DM patients and overweight/obese control subjects, while antioxidative mechanisms differ. Physical training might improve oxidative stress in T2DM men's erythrocytes during acute exercise.

#fitspiration: a comparison of the sport-related social media usage and its impact on body image in young adults.

BACKGROUND: Following and posting sport-related content on social media is wide-spread among young people. To date, little is known about the interdependence between sport-related social media use and the thereby perceived personal body image. METHODS: We conducted an online survey (N = 285) to examine how social media influences the sport-related body image. RESULTS: In general, social media are frequently used for sport (n = 136, 47.7%). Resistance training correlated significantly with several motives of sport-related use of social media, and thus, represents the strong online presence of athletic sports. Less correlations could be found in team or other sports. Regarding the perception of body image, it was found that the group of rejecting (negative) body image significantly correlated with the emulation of social media mediated sport-related beauty and body ideals (r = 0.63, p = 0.001), as well as with increased body dissatisfaction when viewing sport-related posts on social media (r = 0.590, p = 0.001). Perceived social pressure and comparison were found to be mediators of the prevailing influence of social media usage. CONCLUSIONS: These results reveal the importance of taking a closer look at socially shaped beauty and body ideals, especially in sport-related contents, striving for more educational campaigns such as Body Positivity and, above all, filtering information. Finally, future research is needed to gain deeper insight into young persons' usage behavior of social media and its impact on the individual's body image. Trial Registration The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University of the Federal Armed Forces Munich, Germany (01/24/2022).

Effects of a Combined Endurance/Strength Training Program on Circulating Irisin Levels in Overweight/Obese Men and Women with Type 2 Diabetes Mellitus.

Irisin is a promising therapeutic target in patients with type 2 diabetes mellitus (T2DM), as studies have demonstrated that irisin can induce "browning" of adipocytes and mitigate pro-inflammatory conditions. Sex-specific changes in irisin levels have been reported in a study involving healthy men and women following physical training. The present study aims to analyze the effects of an 8-week training intervention on circulating irisin levels in patients with T2DM and to find out whether the training responses differ between T2DM men and women. Twenty-nine overweight/obese T2DM patients (19 men, 10 women; age: 46-74 years; body mass index >25 kg/m2) participated in a combined moderate-intensity endurance/strength training program (3 times a week). The irisin levels of men and women did not differ significantly. The post-training irisin levels did not differ significantly from the pre-training values, and there was no interaction effect of sex. This study shows no training-induced (sex-specific) changes in circulating irisin levels in T2DM patients. Large-scale studies using other forms of training are needed to fully clarify whether basal irisin levels can be changed in T2DM men and/or women to counteract T2DM.