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Polygenic risk scores (PRS) quantify the genetic liability to disease and are calculated using an individual's genotype profile and disease-specific genome-wide association study (GWAS) summary statistics. Type 1 (T1D) and type 2 (T2D) diabetes both are determined in part by genetic loci. Correctly differentiating between types of diabetes is crucial for accurate diagnosis and treatment. PRS have the potential to address possible misclassification of T1D and T2D. Here we evaluated PRS models for T1D and T2D in European genetic ancestry participants from the UK Biobank (UKB) and then in the Michigan Genomics Initiative (MGI). Specifically, we investigated the utility of T1D and T2D PRS to discriminate between T1D, T2D, and controls in unrelated UKB individuals of European ancestry. We derived PRS models using external non-UKB GWAS. The T1D PRS model with the best discrimination between T1D cases and controls (area under the receiver operator curve [AUC] = 0.805) also yielded the best discrimination of T1D from T2D cases in the UKB (AUC = 0.792) and separation in MGI (AUC = 0.686). In contrast, the best T2D model did not discriminate between T1D and T2D cases (AUC = 0.527). Our analysis suggests that a T1D PRS model based on independent single nucleotide polymorphisms may help differentiate between T1D, T2D, and controls in individuals of European genetic ancestry.
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Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 1/genética , Estudo de Associação Genômica Ampla , Predisposição Genética para Doença , Modelos Genéticos , Fatores de Risco , Herança Multifatorial/genéticaRESUMO
OBJECTIVE: To examine the independent contributions of objectively measured sleep duration and fragmentation on cardiometabolic risk accumulation in free-living obese adolescents. STUDY DESIGN: Characteristics of metabolic syndrome (waist circumference, mean arterial pressure, fasting high-density lipoprotein cholesterol, triglycerides, glucose) were measured in obese adolescents and standardized residuals (z-scores) were summed (inverse high-density lipoprotein cholesterol) to create a continuous cardiometabolic risk score (cMetScore), adjusted for age, sex, and race. Sleep and physical activity were objectively measured in habitual, free-living conditions for 7 days (SenseWear Pro3, BodyMedia, Pittsburgh, Pennsylvania; n = 37; 54% female, ages 11-17 years). Associations between sleep duration and cMetScore were assessed via multiple linear regression. RESULTS: Body mass index, total sleep time, and sleep session length were each correlated with cMetScore (P < .05 all). Total sleep time was inversely and independently associated with cMetScore (r = -0.535, P = .001) and was the best independent predictor of metabolic risk. CONCLUSIONS: Sleep duration inversely predicts cardiometabolic risk in obese adolescents, even when we controlled for various measures of physical activity, anthropometry, and adiposity. Further research should investigate the biological mechanism of this relationship and the potential treatment effect of sleep intervention in decreasing cardiometabolic risk in this population.
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Síndrome Metabólica/etiologia , Obesidade Infantil/complicações , Privação do Sono/complicações , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Fatores de RiscoRESUMO
OBJECTIVE: To examine the feasibility and potential benefits of using recumbent cross-training for nonambulatory adults with cerebral palsy (CP). DESIGN: Observational. SETTING: Clinical center for CP treatment and rehabilitation. PARTICIPANTS: Significantly motor-impaired adults with CP (N=11) with a mean age ± SD of 36.3±13.2 years and Gross Motor Function Classification System (GMFCS) levels III and IV. INTERVENTIONS: Participants completed a 40-minute session of aerobic exercise using the NuStep Recumbent Cross Trainer, in which resistance was progressively increased at 5-minute intervals. MAIN OUTCOME MEASURES: Every 5 minutes during the exercise session, heart rate, blood pressure, oxygen consumption (VO(2)), energy expenditure, and respiratory exchange ratios (RERs) were recorded along with rating of perceived exertion. Immediately after, and 24 hours postexercise, participants received a standard survey to assess levels of pain and discomfort. RESULTS: All participants were able to complete the 40-minute exercise protocol. Five of the 11 participants achieved a heart rate of at least 60% maximum throughout the duration, 10 participants had a significant elevation in VO(2) from baseline, and all participants had elevated RER values. Six participants reported pain during exercise, but only 2 reported pain after exercise was over. CONCLUSIONS: The NuStep Recumbent Cross Trainer is a feasible exercise modality for significantly motor-impaired adults with CP, GMFCS III and IV. Moreover, this mode was sufficient to stimulate a significant cardiorespiratory response in all participants, and thus it and similar devices may serve as a viable option for aerobic exercise interventions in this population, to prevent obesity and related cardiometabolic consequences.
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Paralisia Cerebral/reabilitação , Treinamento Resistido , Adulto , Metabolismo Energético/fisiologia , Estudos de Viabilidade , Feminino , Frequência Cardíaca/fisiologia , Humanos , Modelos Logísticos , Masculino , Consumo de Oxigênio/fisiologia , Medição da Dor , Troca Gasosa Pulmonar/fisiologiaRESUMO
PURPOSE: To optimize recovery after radical cystectomy (RC), providers stress the importance of ambulation and adequate rest. However, little is known about the activity and sleep habits of patients undergoing RC. Therefore, we utilized a wearable physical activity monitor (PAM) in the perioperative period to provide the first objective data on physical activity and sleep habits for RC patients. MATERIALS AND METHODS: We prospectively identified patients ≥60 years old with planned RC. Participants completed a 4-week prehabilitation exercise program prior to surgery. They wore a PAM for 7-day intervals: at baseline, after prehabilitation, at postoperative day (POD) 30 and POD90. We tracked physical activity via metabolic equivalents (METs). METs were categorized by intensity: light (MET 1.5-<3), moderate (MET 3-<6), and vigorous (MET ≥6). We calculated daily step totals. We tracked hours slept and number of sleep awakenings. We correlated activity and sleep with self-reported quality of life (QOL). RESULTS: Forty-two patients completed prehabilitation and RC. Moderate intensity exercise decreased at POD30 (61 minutes/d at baseline, 30 minutes/d at POD30, Pâ¯=â¯0.005). Physical activity did not significantly differ for light or vigorous activity at any timepoint. RC did not significantly affect sleep. Sleep and physical activity were associated with mental and physical QOL, respectively. CONCLUSIONS: This is the first study utilizing patient-worn monitors in RC to track physical activity and sleep. This study gives patients and providers a better understanding of postcystectomy recovery expectations. With these results in mind, interventions may be implemented to optimize activity and sleep in the perioperative period.
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Cistectomia , Neoplasias da Bexiga Urinária , Humanos , Pessoa de Meia-Idade , Cistectomia/métodos , Neoplasias da Bexiga Urinária/cirurgia , Qualidade de Vida , Exercício FísicoRESUMO
Systematic and random errors based on self-reported diet may bias estimates of dietary intake. The objective of this pilot study was to describe errors in self-reported dietary intake by comparing 24 h dietary recalls to provided menu items in a controlled feeding study. This feeding study was a parallel randomized block design consisting of a standard diet (STD; 15% protein, 50% carbohydrate, 35% fat) followed by either a high-fat (HF; 15% protein, 25% carbohydrate, 60% fat) or a high-carbohydrate (HC; 15% protein, 75% carbohydrate, 10% fat) diet. During the intervention, participants reported dietary intake in 24 h recalls. Participants included 12 males (seven HC, five HF) and 12 females (six HC, six HF). The Nutrition Data System for Research was utilized to quantify energy, macronutrients, and serving size of food groups. Statistical analyses assessed differences in 24 h dietary recalls vs. provided menu items, considering intervention type (STD vs. HF vs. HC) (Student's t-test). Caloric intake was consistent between self-reported intake and provided meals. Participants in the HF diet underreported energy-adjusted dietary fat and participants in the HC diet underreported energy-adjusted dietary carbohydrates. Energy-adjusted protein intake was overreported in each dietary intervention, specifically overreporting beef and poultry. Classifying misreported dietary components can lead to strategies to mitigate self-report errors for accurate dietary assessment.
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Risk of severe disease and death due to COVID-19 is increased in certain patient demographic groups, including those of advanced age, male sex, and obese body mass index. Investigations of the biological variations that contribute to this risk have been hampered by heterogeneous severity, with immunologic features of critical disease potentially obscuring differences between risk groups. To examine immune heterogeneity related to demographic risk factors, we enrolled 38 patients hospitalized with clinically homogeneous COVID-19 pneumonia - defined as oxygen saturation less than 94% on room air without respiratory failure, septic shock, or multiple organ dysfunction - and performed single-cell RNA-Seq of leukocytes collected at admission. Examination of individual risk factors identified strong shifts within neutrophil and monocyte/dendritic cell (Mo/DC) compartments, revealing altered immune cell type-specific responses in higher risk COVID-19 patient subgroups. Specifically, we found transcriptional evidence of altered neutrophil maturation in aged versus young patients and enhanced cytokine responses in Mo/DCs of male versus female patients. Such innate immune cell alterations may contribute to outcome differences linked to these risk factors. They also highlight the importance of diverse patient cohorts in studies of therapies targeting the immune response in COVID-19.
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COVID-19 , Humanos , Feminino , Masculino , Idoso , Índice de Massa Corporal , Citocinas , Hipóxia , Imunidade Inata , DemografiaRESUMO
Leptin, a protein hormone secreted by adipose tissue, plays an important role in regulating energy metabolism and the immune response. Despite similar extremes of adiposity, mutant mouse models, db/db, carrying spontaneous deletion of the active form of the leptin receptor (LEPR-B) intracellular signaling domain, and the s/s, carrying a specific point mutation leading to a dysfunctional LEPR-B-STAT3 signaling pathway, have been shown to have robust differences in glucose homeostasis. This suggests specific effects of leptin, mediated by non-STAT3 LEPR-B pathways. Differences in the LEPR-B signaling pathways in these two LEPR-B mutant mice models are expected to lead to differences in metabolism. In the current study, the hypothesized differences in metabolism were investigated using the metabolomics approach. Proton nuclear magnetic resonance spectroscopy ((1)HNMR) was conducted on 24 h urine samples in deuterium oxide using a 500 MHz instrument at 25°C. Principle Component Analysis showed clear separation of urine NMR spectra between the groups (P < 0.05). The CHENOMX metabolite database was used to identify several metabolites that differed between the two mouse models. Significant differences (P < 0.05) in metabolites associated with the glycine, serine, and homocysteine metabolism were observed. The results demonstrate that the metabolomic profile of db/db and s/s mice are fundamentally different and provide insight into the unique metabolic effects of leptin exerted through non-STAT3 LEPR-B pathways.
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Homeostase/fisiologia , Metaboloma/genética , Receptores Mitogênicos/genética , Fator de Transcrição STAT3/genética , Transdução de Sinais/genética , Urina/química , Análise de Variância , Animais , Glicosúria/urina , Homeostase/genética , Homocisteína/sangue , Técnicas Imunoenzimáticas , Espectroscopia de Ressonância Magnética , Masculino , Metabolômica/métodos , Camundongos , Camundongos Mutantes , Análise de Componente Principal , Receptores Mitogênicos/deficiência , Fator de Transcrição STAT3/deficiência , Gravidade EspecíficaRESUMO
BACKGROUND: The purpose of this study was to determine the sex-specific pattern of pediatric cardiometabolic risk with principal component analysis, using several biological, behavioral and parental variables in a large cohort (n = 2866) of 6th grade students. METHODS: Cardiometabolic risk components included waist circumference, fasting glucose, blood pressure, plasma triglycerides levels and HDL-cholesterol. Principal components analysis was used to determine the pattern of risk clustering and to derive a continuous aggregate score (MetScore). Stratified risk components and MetScore were analyzed for association with age, body mass index (BMI), cardiorespiratory fitness (CRF), physical activity (PA), and parental factors. RESULTS: In both boys and girls, BMI and CRF were associated with multiple risk components, and overall MetScore. Maternal smoking was associated with multiple risk components in girls and boys, as well as MetScore in boys, even after controlling for children's BMI. Paternal family history of early cardiovascular disease (CVD) and parental age were associated with increased blood pressure and MetScore for girls. Children's PA levels, maternal history of early CVD, and paternal BMI were also indicative for various risk components, but not MetScore. CONCLUSIONS: Several biological and behavioral factors were independently associated with children's cardiometabolic disease risk, and thus represent a unique gender-specific risk profile. These data serve to bolster the independent contribution of CRF, PA, and family-oriented healthy lifestyles for improving children's health.
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Comportamentos Relacionados com a Saúde , Estilo de Vida , Síndrome Metabólica/epidemiologia , Fatores Etários , Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Distribuição de Qui-Quadrado , Criança , Análise por Conglomerados , Teste de Esforço , Feminino , Predisposição Genética para Doença , Humanos , Modelos Lineares , Masculino , Comportamento Materno , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/psicologia , Michigan/epidemiologia , Atividade Motora , Análise Multivariada , Comportamento Paterno , Linhagem , Valor Preditivo dos Testes , Análise de Componente Principal , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversos , Fumar/epidemiologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The molecular mechanisms underlying the sex differences in human muscle morphology and function remain to be elucidated. The sex differences in the skeletal muscle transcriptome in both the resting state and following anabolic stimuli, such as resistance exercise (RE), might provide insight to the contributors of sexual dimorphism of muscle phenotypes. We used microarrays to profile the transcriptome of the biceps brachii of young men and women who underwent an acute unilateral RE session following 12 weeks of progressive training. Bilateral muscle biopsies were obtained either at an early (4 h post-exercise) or late recovery (24 h post-exercise) time point. Muscle transcription profiles were compared in the resting state between men (n = 6) and women (n = 8), and in response to acute RE in trained exercised vs. untrained non-exercised control muscle for each sex and time point separately (4 h post-exercise, n = 3 males, n = 4 females; 24 h post-exercise, n = 3 males, n = 4 females). A logistic regression-based method (LRpath), following Bayesian moderated t-statistic (IMBT), was used to test gene functional groups and biological pathways enriched with differentially expressed genes. RESULTS: This investigation identified extensive sex differences present in the muscle transcriptome at baseline and following acute RE. In the resting state, female muscle had a greater transcript abundance of genes involved in fatty acid oxidation and gene transcription/translation processes. After strenuous RE at the same relative intensity, the time course of the transcriptional modulation was sex-dependent. Males experienced prolonged changes while females exhibited a rapid restoration. Most of the biological processes involved in the RE-induced transcriptional regulation were observed in both males and females, but sex specificity was suggested for several signaling pathways including activation of notch signaling and TGF-beta signaling in females. Sex differences in skeletal muscle transcriptional regulation might implicate a mechanism behind disproportional muscle growth in males as compared with female counterparts after RE training at the same relative intensity. CONCLUSIONS: Sex differences exist in skeletal muscle gene transcription both at rest and following acute RE, suggesting that sex is a significant modifier of the transcriptional regulation in skeletal muscle. The findings from the present study provide insight into the molecular mechanisms for sex differences in muscle phenotypes and for muscle transcriptional regulation associated with training adaptations to resistance exercise.
Assuntos
Regulação da Expressão Gênica , Músculo Esquelético/metabolismo , Treinamento Resistido , Caracteres Sexuais , Adulto , Análise por Conglomerados , Regulação para Baixo/genética , Feminino , Perfilação da Expressão Gênica , Redes Reguladoras de Genes/genética , Humanos , Masculino , Especificidade de Órgãos/genética , Reprodutibilidade dos Testes , Descanso/fisiologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transcrição Gênica , Regulação para Cima/genética , Adulto JovemRESUMO
BACKGROUND: In people with obesity, ß-cell function may adapt to insulin resistance. We describe ß-cell function in people with severe obesity and normal fasting glucose (NFG), impaired fasting glucose (IFG), and type 2 diabetes (T2DM), as assessed before, 3 to 6 months after, and 2 years after medical weight loss to describe its effects on insulin sensitivity, insulin secretion, and ß-cell function. METHODS: Fifty-eight participants with body mass index (BMI) ≥ 35 kg/m2 (14 with NFG, 24 with IFG, and 20 with T2DM) and 13 normal weight participants with NFG underwent mixed meal tolerance tests to estimate insulin sensitivity (S[I]), insulin secretion (Φ), and ß-cell function assessed as model-based Φ adjusted for S(I). All 58 obese participants were restudied at 3 to 6 months and 27 were restudied at 2 years. RESULTS: At 3 to 6 months, after a 20-kg weight loss and a decrease in BMI of 6 kg/m2, S(I) improved in all obese participants, Φ decreased in obese participants with NFG and IFG and tended to decrease in obese participants with T2DM, and ß-cell function improved in obese participants with NFG and tended to improve in obese participants with IFG. At 2 years, ß-cell function deteriorated in participants with NFG and T2DM but remained significantly better in participants with IFG compared to baseline. CONCLUSIONS: Short-term weight loss improves ß-cell function in participants with NFG and IFG, but ß-cell function tends to deteriorate over 2 years. In participants with IFG, weight loss improves longer-term ß-cell function relative to baseline and likely relative to no intervention, suggesting that obese people with IFG are a subpopulation whose ß-cell function is most likely to benefit from weight loss.
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Intolerância à Glucose/prevenção & controle , Secreção de Insulina , Células Secretoras de Insulina/fisiologia , Obesidade Mórbida/prevenção & controle , Redução de Peso , Biomarcadores/análise , Estudos de Casos e Controles , Dieta com Restrição de Carboidratos , Feminino , Seguimentos , Intolerância à Glucose/fisiopatologia , Humanos , Células Secretoras de Insulina/citologia , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/fisiopatologia , PrognósticoRESUMO
Local inflammation in obese adipose tissue has been shown to contribute to insulin resistance; however, the role of macrophage infiltration within skeletal muscle is still debatable. This study aimed to evaluate the association of skeletal muscle macrophage gene expression with adiposity levels and insulin sensitivity in obese patients. Twenty-two nondiabetic obese patients and 23 healthy lean controls were included. Obese patients underwent a 3-month weight loss intervention. Macrophage gene expression in skeletal muscle (quantitative real-time polymerase chain reaction), body composition (dual-energy X-ray absorptiometry), and insulin sensitivity (homeostatic model assessment (HOMA) and oral glucose tolerance test) were compared between groups and their associations were analyzed. To validate skeletal muscle findings, we repeated the analyses with macrophage gene expression in adipose tissue. Expression levels of macrophage genes (CD68, CD11b, CD206, CD16, CD40, and CD163) were lower in skeletal muscle tissue of obese versus lean participants. Macrophage gene expression was also found to be inversely associated with adiposity, fasting insulin, and HOMA (r = -0.4 â¼ -0.6, p < 0.05), as well as positively associated with insulin sensitivity (r = 0.4 â¼ 0.8, p < 0.05). On the other hand, adipose tissue macrophage gene expression showed higher levels in obese versus lean participants, presenting a positive association with adiposity levels. Macrophage gene expression, in both skeletal and adipose tissue samples, was only minimally affected by the weight loss intervention. In contrast with the established positive relationship between adiposity and macrophage gene expression, an unexpected inverse correlation between these 2 variables was observed in skeletal muscle tissue. Additionally, muscle macrophage gene expression was inversely correlated with insulin resistance.
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Adiposidade , Resistência à Insulina , Macrófagos/metabolismo , Músculo Esquelético/fisiologia , Absorciometria de Fóton , Adulto , Antígenos CD/genética , Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/genética , Antígenos de Diferenciação Mielomonocítica/metabolismo , Composição Corporal , Antígeno CD11b/genética , Antígeno CD11b/metabolismo , Estudos de Casos e Controles , Feminino , Proteínas Ligadas por GPI/genética , Proteínas Ligadas por GPI/metabolismo , Teste de Tolerância a Glucose , Comportamentos Relacionados com a Saúde , Educação em Saúde , Humanos , Insulina , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade/genética , Obesidade/terapia , Receptores de Superfície Celular/genética , Receptores de Superfície Celular/metabolismo , Receptores de IgG/genética , Receptores de IgG/metabolismo , Programas de Redução de PesoRESUMO
In recent years, mass spectrometry-based metabolomics has increasingly been applied to large-scale epidemiological studies of human subjects. However, the successful use of metabolomics in this context is subject to the challenge of detecting biologically significant effects despite substantial intensity drift that often occurs when data are acquired over a long period or in multiple batches. Numerous computational strategies and software tools have been developed to aid in correcting for intensity drift in metabolomics data, but most of these techniques are implemented using command-line driven software and custom scripts which are not accessible to all end users of metabolomics data. Further, it has not yet become routine practice to assess the quantitative accuracy of drift correction against techniques which enable true absolute quantitation such as isotope dilution mass spectrometry. We developed an Excel-based tool, MetaboDrift, to visually evaluate and correct for intensity drift in a multi-batch liquid chromatography - mass spectrometry (LC-MS) metabolomics dataset. The tool enables drift correction based on either quality control (QC) samples analyzed throughout the batches or using QC-sample independent methods. We applied MetaboDrift to an original set of clinical metabolomics data from a mixed-meal tolerance test (MMTT). The performance of the method was evaluated for multiple classes of metabolites by comparison with normalization using isotope-labeled internal standards. QC sample-based intensity drift correction significantly improved correlation with IS-normalized data, and resulted in detection of additional metabolites with significant physiological response to the MMTT. The relative merits of different QC-sample curve fitting strategies are discussed in the context of batch size and drift pattern complexity. Our drift correction tool offers a practical, simplified approach to drift correction and batch combination in large metabolomics studies.
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Metabolômica/métodos , Software , Cromatografia Líquida , Humanos , Espectrometria de Massas , Múltiplas Afecções CrônicasRESUMO
Overweight and obesity are highly prevalent in the population of the United States, affecting roughly 2/3 of Americans. These diseases, along with their associated conditions, are a major burden on the healthcare industry in terms of both dollars spent and effort expended. Volitional weight loss is attempted by many, but weight regain is common. The ability to predict which patients will lose weight and successfully maintain the loss versus those prone to regain weight would help ease this burden by allowing clinicians the ability to skip treatments likely to be ineffective. In this paper we introduce a new windowed approach to the persistent homology signal processing algorithm that, when paired with a modified, semimetric version of the Hausdorff distance, can differentiate the two groups where other commonly used methods fail. The novel approach is tested on accelerometer data gathered from an ongoing study at the University of Michigan. While most standard approaches to signal processing show no difference between the two groups, windowed persistent homology and the modified Hausdorff semimetric show a clear separation. This has significant implications for clinical decision making and patient care.
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Algoritmos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Humanos , Processamento de Sinais Assistido por ComputadorRESUMO
BACKGROUND: Pediatric weight management programs have substantial attrition rates, which have led to recommendations to assess readiness prior to enrollment. Both pretreatment readiness scales and behaviors, such as exercise, have been theorized to predict subsequent program completion. The purpose of this study was to explore the role of self-reported pretreatment exercise in adolescents on completion of a pediatric weight management program and to explore the predictive ability of standard readiness scales. METHODS: A total of 146 obese (BMI≥95(th) percentile) pediatric (ages 11-18) participants joined a 6-month multidisciplinary weight management program between March, 2007, and July, 2010. Completers were compared retrospectively to noncompleters on demographic, readiness, and pretreatment exercise practices from clinic-developed intake questionnaires using univariate analyses. Regression analyses specified the degree to which these variables predicted program completion. RESULTS: The 6-month completion rate was 53%. There was no relationship between self-reported readiness and program completion. Self-reported pretreatment weekly strengthening activity (SA) was significantly associated with program completion, compared to those who performed SA either never [univariate odds ratio (OR) 3.18, 95% confidence interval (CI) 1.51-6.68, p=0.002; multivariate OR 2.43, 95% CI 1.06-5.58, p=0.036] or daily (univariate OR 4.90, 95% CI 1.74-13.77, p=0.002; multivariate OR 4.69, 95% CI 1.45-15.14, p=0.010). No relationship was found between other forms of exercise and program completion. CONCLUSIONS: Self-reported pretreatment weekly SA, but not standard readiness scales, predicted pediatric weight management program completion.
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Exercício Físico , Obesidade/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Redução de Peso , Programas de Redução de Peso , Adolescente , Criança , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Razão de Chances , Valor Preditivo dos Testes , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Estados Unidos/epidemiologiaRESUMO
We assessed the influence of serum 25-hydroxyvitamin D (25[OH]D) and parathyroid hormone (PTH) concentrations on oral glucose tolerance, body composition, and muscle strength in older, nondiabetic adults who performed resistance exercise training (RT) while consuming diets with either 0.9 or 1.2 g protein kg(-1) d(-1). We hypothesized that individuals with insufficient 25(OH)D and/or high PTH would have less improvement in glucose tolerance after 12 weeks of RT compared with individuals with sufficient 25(OH)D and lower PTH. Sixteen men and 19 women (aged 61 ± 8 years; range, 50-80 years; body mass index, 26.3 ± 3.6 kg/m(2)) performed RT 3 times/wk for 12 weeks, with oral glucose tolerance tests done at baseline and postintervention. Protein intake did not influence the responses described below. Plasma glucose area under the curve (P = .02) and 2-hour plasma glucose concentration (P = .03) were higher for vitamin D-insufficient subjects (25[OH]D <50 nmol/L, n = 7) vs vitamin D-sufficient subjects (25[OH]D ≥50 nmol/L, n = 28). These differences remained significant after adjustment for age and body mass index. Resistance exercise training reduced fat mass (mean ± SD, -6% ± 7%; P < .001) and increased lean body mass (2% ± 3%, P < .001) and whole-body muscle strength (32% ± 17%, P < .001) in these weight-stable subjects but did not affect 25(OH)D or PTH concentrations. Oral glucose tolerance improved after RT (-10% ± 16% in glucose area under the curve and -21% ± 40% in 2-hour glucose, P = .001), but baseline 25(OH)D and PTH did not influence these RT-induced changes. These findings indicate that vitamin D status and RT independently affect glucose tolerance, and a training-induced improvement in glucose tolerance does not offset the negative effect of insufficient vitamin D status in older, nondiabetic adults.
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Teste de Tolerância a Glucose , Treinamento Resistido , Vitamina D/sangue , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Composição Corporal/efeitos dos fármacos , Índice de Massa Corporal , Estudos Transversais , Dieta , Feminino , Humanos , Indiana , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Proteínas Musculares , Força Muscular/efeitos dos fármacos , Hormônio Paratireóideo/sangue , Estudos Retrospectivos , Vitamina D/administração & dosagemRESUMO
To develop a global view of muscle transcriptional differences between older men and women and sex-specific aging, we obtained muscle biopsies from the biceps brachii of young and older men and women and profiled the whole-genome gene expression using microarray. A logistic regression-based method in combination with an intensity-based Bayesian moderated t test was used to identify significant sex- and aging-related gene functional groups. Our analysis revealed extensive sex differences in the muscle transcriptome of older individuals and different patterns of transcriptional changes with aging in men and women. In older women, we observed a coordinated transcriptional upregulation of immune activation, extracellular matrix remodeling, and lipids storage; and a downregulation of mitochondrial biogenesis and function and muscle regeneration. The effect of aging results in sexual dimorphic alterations in the skeletal muscle transcriptome, which may modify the risk for developing musculoskeletal and metabolic diseases in men and women.
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Envelhecimento/genética , Músculo Esquelético/metabolismo , Adulto , Braço , Teorema de Bayes , Feminino , Perfilação da Expressão Gênica , Humanos , Masculino , Doenças Metabólicas/etiologia , Doenças Metabólicas/genética , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/genética , Análise de Sequência com Séries de Oligonucleotídeos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fatores de Risco , Caracteres Sexuais , Transcriptoma , Adulto JovemRESUMO
OBJECTIVE: To explore whether reasons for enrollment in a pediatric multidisciplinary weight management program (PMWMP) are associated with subsequent weight loss. METHOD: A retrospective analysis of obese adolescents (12-18 years old, body mass index [BMI] > 95th percentile) who enrolled in a PMWMP from April 2007 to March 2009, and had BMI measurements at weeks 1 and 12. Reasons for enrollment were obtained from parents' responses to an enrollment questionnaire (which allowed selection of more than one reason). The most common reasons for enrollment were computed. Linear regression was used to explore associations between mean change in BMI and reasons for enrollment, controlling for demographic and anthropometric factors. RESULTS: Most of the 90 adolescents who met the inclusion criteria were female (70%) and white (57%). Mean age was 14.5 years and mean initial BMI was 42 kg/m(2). The most common reasons for enrolling in the PMWMP were due to concerns about adolescents' physical health (96%), concerns about adolescents' mental health (76%), and because of a physician recommendation (73%). The mean 12-week change in BMI showed a greater decrease for those who enrolled due to a physicians' recommendation versus those who did not (-1.5 vs -0.5 kg/m(2): P < .05). This finding remained significant even when controlling for the covariates of interest. CONCLUSIONS: A physician's recommendation to join a PMWMP appears to be associated with greater weight loss among obese adolescents than other reasons for enrollment. Further research should explore how physician involvement affects long-term weight loss.
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Inhibitory signaling through Tyr985 of the leptin receptor contributes to the attenuation of anorectic leptin action in obese animals. Leptin receptor (LEPR-B) Tyr985Leu homozygote mutant mice (termed l/l) were previously generated to study Tyr985's contributions to inhibition of LEPR-B signaling; young female l/l mice display a lean, leptin-sensitive phenotype, while young male l/l are not significantly different from wild-type. We report here that testosterone (but not estrogen) determines the sex-specificity of the l/l phenotype. This provides additional insight into the cellular mechanism by which gonadal hormones determine central sensitivity to leptin, and may help elucidate the long-noted sex differences in leptin sensitivity. Additionally, we observed that Tyr985 signaling protects against a diet-dependent switch that exacerbates obesity with high fat feeding, such that the enhanced leptin sensitivity of l/l mice on a normal diet leads to increased adiposity in the face of chronic high-fat diet.
Assuntos
Obesidade/metabolismo , Receptores para Leptina/metabolismo , Testosterona/metabolismo , Tirosina/metabolismo , Animais , Dieta Hiperlipídica/efeitos adversos , Estradiol/metabolismo , Estradiol/farmacologia , Retroalimentação Fisiológica , Feminino , Hipotálamo/metabolismo , Estudos Longitudinais , Masculino , Camundongos , Camundongos Knockout , Obesidade/etiologia , Orquiectomia , Ovariectomia , Receptores Androgênicos/metabolismo , Receptores para Leptina/genética , Testosterona/farmacologiaRESUMO
The primary aim of this investigation was to evaluate the effect of training on the immune activation in skeletal muscle in response to an acute bout of resistance exercise (RE). Seven young healthy men and women underwent a 12-wk supervised progressive unilateral arm RE training program. One week after the last training session, subjects performed an acute bout of bilateral RE in which the trained and the untrained arm exercised at the same relative intensity. Muscle biopsies were obtained 4 h postexercise from the biceps brachii of both arms and assessed for global transcriptom using Affymetrix U133 plus 2.0 microarrays. Significantly regulated biological processes and gene groups were analyzed using a logistic regression-based method following differential (trained vs. untrained) gene expression testing via an intensity-based Bayesian moderated t-test. The results from the present study suggest that training blunts the transcriptional upregulation of immune activation by minimizing expression of genes involved in monocyte recruitment and enhancing gene expression involved in macrophage anti-inflammatory polarization. Additionally, our data suggest that training blunts the transcriptional upregulation of the stress response and the downregulation of glucose metabolism, mitochondrial structure, and oxidative phosphorylation, and it enhances the transcriptional upregulation of the extracellular matrix and cytoskeleton development and organization and the downregulation of gene transcription and muscle contraction. This study provides novel insight into the molecular processes involved in the adaptive response of skeletal muscle following RE training and the cellular and molecular events implicating the protective role of training on muscle stress and damage inflicted by acute mechanical loading.