Correlation between baseline characteristics and clinical outcomes in a large population of diabetes patients treated with liraglutide in a real-world setting in Italy.

PURPOSE: Treatment with liraglutide in randomized controlled trials is associated with significant reductions in glycated hemoglobin (HbA1c) and weight loss in type 2 diabetes patients. The aim of this retrospective observational study was to investigate correlations of glycemic control and weight outcomes with baseline characteristics of patients starting liraglutide in outpatient clinics in Italy. METHODS: Type 2 diabetes patients were followed from baseline to 4, 8, and 12 months. Changes in glycemic parameters, weight, blood pressure, and lipids were assessed. Subanalyses were performed according to baseline characteristics. Multivariate linear and logistic regressions were used to assess correlations between glycemic efficacy, weight reduction, and liraglutide discontinuation after 12 months and baseline characteristics. FINDINGS: Four hundred and eighty-one patients were included. Mean (SD) age at baseline was 57.3 (9.2) years, diabetes duration was 9.5 (6.8) years, weight was 106.7 (20.8) kg, body mass index (BMI; calculated as kg/m(2)) was 37.1 (6.6), HbA1c was 8.7% (1.3%), fasting plasma glucose was 168.5 (45.3) mg/dL; 38.2% were treated previously with insulin and 52.2% were treated with metformin alone. After 12 months, mean (SD) changes were HbA1c -1.2% (1.4%), fasting plasma glucose -28.3 (41.1) mg/dL, weight -3.5 (5.8) kg, BMI -1.3 (2.1), waist circumference -2.6 (6.7) cm (all, P < 0.001). Drop in weight and HbA1c did not differ between baseline BMI classes ≤30 or >30. Weight loss was unchanged among diabetes duration quartiles, and HbA1c reduction was significantly greater in patients with ≤4 years of diabetes duration (P = 0.01). Non-insulin-treated patients reached HbA1c ≤7% significantly more often than treated patients (44.2% vs 21.2%; odds ratio = 2.94; P < 0.001) and had significantly greater weight loss (-4.5 [8.2] kg vs -2.6 [5.4] kg; P = 0.03). Patients on metformin reached HbA1c target more frequently than others (43.1% vs 29.7%; odds ratio = 1.80; 95% CI, 1.05-3.07). Significant positive determinants for HbA1c reduction after 12 months were baseline HbA1c, age, and prior metformin monotherapy, and weight loss at 12 months was positively correlated with baseline weight, and negatively correlated with prior insulin treatment. Overall, 5.0% of patients interrupted liraglutide before the 12th month due to lack of glycemic control; they were less frequently treated with metformin only before liraglutide (29.2% vs 50.2%; P = 0.04). IMPLICATIONS: Treatment with liraglutide in a real-world setting is associated with low therapy failure, good glycemic response, weight loss, and improvement in systolic blood pressure and lipid profile. The HbA1c drop did not differ among baseline BMI classes, indicating that efficacy is maintained in patients with lower BMI. The probability of reaching HbA1c ≤7% was significantly higher in patients previously treated with metformin alone and without any previous insulin. This could reinforce the hypothesis that better results with liraglutide could be achieved in patients after early metformin failure.

Avaliação isocinética da força muscular em atletas profissionais de futebol feminino / Isokinetic assessment of muscle strength in female professional soccer athletes

Força muscular é uma variável comprovadamente importante de ser avaliada não somente para obter bom desempenho na prática de esportes, como também para identificar indivíduos que possam estar em um grupo de risco para lesões musculoesqueléticas. Poucos estudos descrevem valores de força para diferentes articulações em atletas de elite do futebol feminino. O objetivo deste estudo é descrever esses valores. Para isso, 23 atletas da seleção brasileira de futebol feminino, em preparação para as Olimpíadas de 2004, foram avaliadas nos movimentos de flexo-extensão de tronco, rotação interno-externa do quadril e flexo-extensão dos joelhos no dinamômetro isocinético Cybex 6000 (Lumex Inc. Ronkonkoma, NY). Foram encontrados os valores médios de torque máximo, expressos em Nm: rotação interna do quadril: 23,1; rotação externa do quadril: 25,6; flexão de tronco: 213,2; extensão de tronco: 267,7; extensão de joelho: 181,4; flexão de joelho: 102,0. Os valores encontrados devem ser considerados quando o indivíduo testado equivaler ao grupo estudado.

T has been proved that muscle strength is an important variable to be assessed not only to achieve good performance in sports practice, but also to identify deficits which might put the athlete in a group of higher musculoskeletal injury risk. Few studies to date describe strength values of different joints of elite female soccer players. The objective of this study is to describe those values. For that purpose, twenty-three athletes from the Brazilian national female soccer team, in preparation for the Olympic Games of 2004, were evaluated on an isokinetic dynamometer Cybex 6000 for the following movements: trunk flexion and extension, ,internal and external hip rotation, and knee flexion and extension. The following averages for maximum torque in Nm were found: trunk flexion: 213.2; trunk extension: 267.7; internal hip rotation: 23.1; external hip rotation: 25.6; knee flexion:102.0; knee extension: 181.4. There was no significant difference between the dominant and non-dominant sides. The values found should be considered when the tested individual has similarities with the studied group here.