RESUMO
Aim: To evaluate the effects of resistance exercise training (RET) and/or glutamine supplementation (GS) on signaling protein synthesis in adult rat skeletal muscles. Methods: The following groups were studied: (1) control, no exercise (C); (2) exercise, hypertrophy resistance exercise training protocol (T); (3) no exercise, supplemented with glutamine (G); and (4) exercise and supplemented with glutamine (GT). The rats performed hypertrophic training, climbing a vertical ladder with a height of 1.1 m at an 80° incline relative to the horizontal with extra weights tied to their tails. The RET was performed three days a week for five weeks. Each training session consisted of six ladder climbs. The extra weight load was progressively increased for each animal during each training session. The G groups received daily L-glutamine by gavage (one g per kilogram of body weight per day) for five weeks. The C group received the same volume of water during the same period. The rats were euthanized, and the extensor digitorum longus (EDL) muscles from both hind limbs were removed and immediately weighed. Glutamine and glutamate concentrations were measured, and histological, signaling protein contents, and mRNA expression analyses were performed. Results: Supplementation with free L-glutamine increased the glutamine concentration in the EDL muscle in the C group. The glutamate concentration was augmented in the EDL muscles from T rats. The EDL muscle mass did not change, but a significant rise was reported in the cross-sectional area (CSA) of the fibers in the three experimental groups. The levels of the phosphorylated proteins (pAkt/Akt, pp70S6K/p70S6K, p4E-BP1/4E-BP1, and pS6/S6 ratios) were significantly increased in EDL muscles of G rats, and the activation of p4E-BP1 was present in T rats. The fiber CSAs of the EDL muscles in T, G, and GT rats were increased compared to the C group. These changes were accompanied by a reduction in the 26 proteasome activity of EDL muscles from T rats. Conclusion: Five weeks of GS and/or RET induced muscle hypertrophy, as indicated by the increased CSAs of the EDL muscle fibers. The increase in CSA was mediated via the upregulated phosphorylation of Akt, 4E-BP1, p70S6k, and S6 in G animals and 4E-BP1 in T animals. In the EDL muscles from T animals, a decrease in proteasome activity, favoring a further increase in the CSA of the muscle fibers, was reported.
RESUMO
El propósito de este estudio fue valorar el estado funcional de adultos mayores con dependencia moderada y severa pertenecientes a un Centro de Salud Familiar, aplicando escalas que evalúan actividades de la vida diaria, nivel cognitivo, nivel educacional y carga del cuidador. Se evaluó a 55 sujetos categorizados con dependencia moderada y severa. Se utilizó el Índice Katz para determinar el nivel de dependencia; Medida de Independencia Funcional (FIM) para la funcionalidad y asistencia dada por una tercera persona; Índice de Barthel para valorar la independencia; Minimental abreviado (MMSE) para el estado cognitivo y la carga del cuidador mediante la Escala de Zarit. La edad media fue de 84,4±7,8 años (74,5% género femenino y 25,5% género masculino). El 45% fue clasificado con dependencia severa total según el Índice de Barthel. Los hombres obtuvieron mayores puntajes en el Índice de Barthel y FIM. El 75% presentó deterioro cognitivo según el MMSE con una media de 7,2±5,3 puntos. El 85% de los cuidadores eran del género femenino y el 49% de éstos presentaban sobrecarga intensa. Se obtuvo una correlación significativa entre FIM motor e Índice de Barthel (r=0,9710), FIM cognitivo y MMSE (r=0,8148), MMSE y nivel educacional (r=0,6537). No se encontró correlación entre edad y cognición e independencia funcional. Según los datos obtenidos, la mayoría de los adultos mayores con dependencia moderada y severa presentan alteraciones motoras y cognitivas, estando correlacionadas al nivel educacional del sujeto.
Este estudo tem como objetivo avaliar, por meio de escalas que investigam atividades cotidianas e os níveis cognitivo, educacional e também a sobrecarga do cuidador, o estado funcional de idosos com dependência moderada e severa pertencentes ao Centro de Saúde Familiar, da cidade de Talca, Chile. Cinquenta e cinco indivíduos foram avaliados categorizados com dependência moderada e severa. Para isso, o estudo utilizou os seguintes métodos: Índice de Katz para determinar o nível de dependência; Medida de Independência Funcional (FIM) para determinar a funcionalidade e assistência fornecida por uma terceira pessoa; o Índice de Barthel para analisar a independência; e o Miniexame do Estado Mental abreviado (MMSE) para avaliar o estado cognitivo e a sobrecarga do cuidador por meio da Escala de Zarit. A média de idade era de 84,4±7,8 anos (74,5% pertencente ao gênero feminino e 25,5% ao masculino). Tendo como base o Índice de Barthel 45% foram classificados com dependência severa total. Os homens obtiveram pontuações maiores no Índice de Barthel e no FIM. 75% apresentaram déficit cognitivo de acordo com o MMSE sendo a média de 7,2±5,3 pontos. Dos cuidadores, 85% eram do gênero feminino e, destes, 49% apresentavam sobrecarga intensa. A correlação significativa obtida foi de r=0,9710 entre FIM motor e Índice de Barthel; r=0,8148 entre FIM cognitivo e MMSE; e r=0,6537 entre MMSE e nível educacional. Não foram encontradas correlações entre idade e cognição e independência funcional. De acordo com os dados obtidos, a maioria dos idosos com dependência moderada e severa apresenta alterações motoras e cognitivas, relacionadas ao nível educacional do indivíduo.
The purpose of this study was to assess the functional status of older adults with moderate and severe dependence from a family health center, applying scales to evaluate activities of daily living, cognitive level, educational level and caregiver burden. We evaluated 55 older adults with moderate and severe dependence. The Katz Index was used to determine the level of dependence, the Functional Independence Measure (FIM) was used for functionality and assistance provided by a third person, the Barthel Index was used to assess the independence, the Mini Mental State Examination (MMSE) was used for cognitive status and the Zarit scale was used for caregiver burden. The mean age was 84.4±7.8 years , and 74.5% of the subjects were female (25.5% male). According to the Barthel Index, 45% were classified with severe dependence; men had higher scores on the Barthel index and FIM. Cognitive impairment was present in 75% of the subjects according to MMSE, with a mean of 7.2±5.3 points. Women represented 85% of caregivers and 49% of these had greater burden. We obtained a significant correlation between motor FIM and Barthel Index (r=0.9710), cognitive FIM and MMSE (r=0.8148), and MMSE and educational level (r=0.6537). There was no correlation between age and cognition or functional independence. According to the data, most older adults with moderate and severe dependence have motor and cognitive impairment, which are correlated to the educational level of the subject.