Central obesity is detrimental to anti-inflammatory, phenotype, and exhaustion markers in mononuclear cells - A cross-sectional study.

OBJECTIVE: To investigate the role of central obesity on immunometabolic response in peripheral blood mononuclear cells (PBMCs) from normal weight and overweight/obese young men. METHODS: Eighteen individuals were classified as normal weight (NW; n = 9 - age: 25 ± 5 and BMI: 21.4 ± 1.7) and overweight/obese (OW; n = 9 - age: 29 ± 7 and BMI: 29.2 ± 2.7). The body composition was evaluated by dual-energy x-ray absorptiometry (DXA), waist circumference, and visceral and subcutaneous fat depots by ultrasound. Physical activity levels, metabolic parameters, immune phenotypic characterization, cytokine production by lipopolysaccharide (LPS) -stimulated whole blood cells and LPS or phorbol 12-myristate 13-acetate (PMA)-stimulated PBMC, and mitochondrial respiration in PBMCs were evaluated. Expression of AMP-activated protein kinase (AMPK), peroxisome proliferator-activated receptor gamma (PPAR-γ), nuclear factor-kappa B (NF-κB), toll-like receptor 4 (TLR-4), hypoxia-inducible factor-1 alpha (HIF-1α), and adrenergic receptor beta 1 and 2 (AR-ß1 and ß2) genes were evaluated in cultured PBMC using quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: Individuals with overweight/obese (OW) presented higher glucose (P = 0.009) and leptin (P = 0.010) than individuals with normal weight (NW). PBMCs of OW under stimulation with LPS presented a lower production of interleukin-10 (IL-10) (P = 0.011) and macrophage inflammatory protein-1alpha (MIP-1α) (P = 0.048) than NW. Mitochondrial respiration rates were not different between NW and OW subjects. Cultured PBMCs in LPS-stimulated condition indicated higher gene expression of AR-ß2 in OW, while PMA-stimulated PBMCs presented lower expression of AMPK (P = 0.002) and higher expression of NF-κB (P=<0.0001) than NW. OW presented higher numbers of CD3+CD4+ T cells (P = 0.009) and higher expression of programmed cell death protein 1 (PD-1) in CD8+ T cells (P = 0.001) than NW. CONCLUSION: Central obesity promoted reductions in interleukin 10 production response and increase in AR-ß2 expressions in mitogen-stimulated PBMCs. Furthermore, central obesity altered the phenotype of PBMCs, also increasing the expression of PD-1 exhaustion markers in young adults.

Mild to moderate post-COVID-19 alters markers of lymphocyte activation, exhaustion, and immunometabolic responses that can be partially associated by physical activity level- an observational sub-analysis fit- COVID study.

Aim: This study aimed to evaluate if physical activity is associated with systemic and cellular immunometabolic responses, in young adults after mild-to-moderate COVID-19 infection. Methods: Mild- to- moderate post-COVID-19 patients (70.50 ± 43.10 days of diagnosis; age: 29.4 (21.9- 34.9) years; BMI: 25.5 ± 4.3 kg m2 n = 20) and healthy age-matched controls (age: 29.3 (21.2 - 32.6) years; BMI: 25.4 ± 4.7 kg m2; n = 20) were evaluated. Physical activity levels (PAL), body composition, dietary habits, muscular and pulmonary function, mental health, sleep quality, metabolic parameters, immune phenotypic characterization, stimulated whole blood and PBMC culture (cytokine production), mRNA, and mitochondrial respiration in PBMCs were evaluated. Results: The post-COVID-19 group exhibited lower levels of moderate to vigorous physical activity (MVPA) (p = 0.038); therefore, all study comparisons were performed with adjustment for MVPA. Post-COVID-19 impacted the pulmonary function (FEV1, FEV1%pred, FVC, and FVC %pred) compared with the control (p adjusted by MVPA (p adj) <0.05). Post-COVID-19 exhibited lower levels of serum IL-6 (p adj <0.01), whereas it showed higher serum IL-10, triglyceride, leptin, IgG, ACE activity, TNFRSF1A, and PGE2 (p adj <0.05) levels compared with controls. Post-COVID-19 presented a lower percentage of Treg cells (p adj = 0.03) and altered markers of lymphocyte activation and exhaustion (lower CD28 expression in CD8+ T cells (p adj = 0.014), whereas CD4+T cells showed higher PD1 expression (p adj = 0.037)) compared with the control group. Finally, post- COVID-19 presented an increased LPS-stimulated whole- blood IL-10 concentration (p adj <0.01). When exploring mitochondrial respiration and gene expression in PBMCs, we observed a higher LEAK state value (p adj <0.01), lower OXPHOS activity (complex I) (p adj = 0.04), and expression of the Rev-Erb-α clock mRNA after LPS stimulation in the post-COVID-19 patients than in the control (p adj <0.01). Mainly, PAL was associated with changes in IL-10, triglyceride, and leptin levels in the plasma of post-COVID-19 patients. PAL was also associated with modulation of the peripheral frequency of Treg cells and the expression of PD-1 in CD8+ T cells, although it abrogated the statistical effect in the analysis of TNF-α and IL-6 production by LPS- and PMA-stimulated PBMC of post-COVID-19 patients. Conclusion: Young adults after mild-to-moderate SARS-CoV-2 infection appeared to have lower physical activity levels, which can be associated with clinical and immunometabolic responses in a complex manner.

Older adults physically inactive in occupational and commuting domains have a higher risk for osteopenia and osteoporosis: A 12-month prospective study.

The relationship between different domains of physical activity (PA) and bone health in older adults needs to be further investigated. We evaluated 379 Brazilian older adults and observed that the risk of osteopenia is higher in older adults who are physically inactive in occupational domain and for osteoporosis the risk is higher in physically inactive in commuting domain and total habitual PA. PURPOSE: Bone mineral density (BMD) usually decreases with age, and the risk of osteometabolic diseases, such as osteopenia and osteoporosis, increases in older adults. PA is strictly related to BMD. However, the relationship between different domains of PA and bone health in older adults is still unclear, and needs to be further investigated, aiming at the implementation of preventative health measures for this population. Thus, the aim of the current study was to analyze the association between different domains of PA and the risk for osteopenia and osteoporosis in older adults in a 12-month follow-up. METHODS: Prospective study that included 379 Brazilian community-dwelling older adults, aged ≥ 60 years (70 ± 7 years, 69% women). Areal bone mineral density (aBMD) total, proximal femur, and lumbar spine were measured by dual energy X-ray absorptiometry (DXA), and PA was self-reported. Binary logistic regression analysis and 95%CI were used to analyze the association between the practice of PA in different domains (at baseline and follow-up) and risk for osteopenia and osteoporosis (follow-up). RESULTS: The risk for osteopenia (total proximal femur or lumbar spine) is higher in older adults who are physically inactive in the occupational domain (OR:3.25; 95%CI:1.24-8.55). In addition, older adults who are physically inactive in the commuting domain (OR:3.43; 95%CI:1.09-10.82) and total PA (OR:5.58; 95%CI:1.57-19.88) present a higher risk for osteoporosis (total proximal femur or lumbar spine) compared to physically active older adults. CONCLUSION: The risk of osteopenia is higher in older adults who are physically inactive in occupational domain and for osteoporosis the risk is higher in physically inactive in commuting domain and total habitual PA.

Autonomic Function Recovery and Physical Activity Levels in Post-COVID-19 Young Adults after Immunization: An Observational Follow-Up Case-Control Study.

Coronavirus disease 2019 (COVID-19) has detrimental multi-system consequences. Symptoms may appear during the acute phase of infection, but the literature on long-term recovery of young adults after mild to moderate infection is lacking. Heart rate variability (HRV) allows for the observation of autonomic nervous system (ANS) modulation post-SARS-CoV-2 infection. Since physical activity (PA) can help improve ANS modulation, investigating factors that can influence HRV outcomes after COVID-19 is essential to advancements in care and intervention strategies. Clinicians may use this research to aid in the development of non-medication interventions. At baseline, 18 control (CT) and 20 post-COVID-19 (PCOV) participants were observed where general anamnesis was performed, followed by HRV and PA assessment. Thus, 10 CT and 7 PCOV subjects returned for follow-up (FU) evaluation 6 weeks after complete immunization (two doses) and assessments were repeated. Over the follow-up period, a decrease in sympathetic (SNS) activity (mean heart rate: p = 0.0024, CI = -24.67--3.26; SNS index: p = 0.0068, CI = -2.50--0.32) and increase in parasympathetic (PNS) activity (mean RR: p = 0.0097, CI = 33.72-225.51; PNS index: p = 0.0091, CI = -0.20-1.47) were observed. At follow-up, HRV was not different between groups (p > 0.05). Additionally, no differences were observed in PA between moments and groups. This study provides evidence of ANS recovery after SARS-CoV-2 insult in young adults over a follow-up period, independent of changes in PA.

Modulatory Effects of Physical Activity Levels on Immune Responses and General Clinical Functions in Adult Patients with Mild to Moderate SARS-CoV-2 Infections-A Protocol for an Observational Prospective Follow-Up Investigation: Fit-COVID-19 Study.

Background: This proposal aims to explain some of the gaps in scientific knowledge on the natural history of coronavirus disease (COVID-19), with a specific focus on immune, inflammatory, and metabolic markers, in parallel with temporal assessment of clinical and mental health in patients with COVID-19. The study will explore the temporal modulatory effects of physical activity and body composition on individual trajectories. This approach will provide a better understanding of the survival mechanisms provided by the immunomodulatory role of physical fitness. Methods: We will conduct a prospective observational cohort study including adult patients previously infected with the SARS-CoV-2 virus who have expressed a mild to moderate COVID-19 infection. Procedures will be conducted for all participants at baseline, six weeks after vaccination, and again at 12 months. At each visit, a venous blood sample will be collected for immune phenotypic characterization and biochemistry assays (inflammatory and metabolic parameters). Also, body composition, physical activity level, cardiovascular and pulmonary function, peripheral and respiratory muscle strength, functional exercise capacity, and mental health will be evaluated. Using the baseline information, participants will be grouped based on physical activity levels (sedentary versus active), body composition (normal weight versus overweight or obese), and SARS-CoV-2 status (positive versus negative). A sub-study will provide mechanistic evidence using an in-vitro assay based on well-trained individuals and age-matched sedentary controls who are negative for SARS-CoV-2 infection. Whole blood will be stimulated using recombinant human coronavirus to determine the cytokine profile. Peripheral blood mononuclear cells (PBMCs) from healthy well-trained participants will be collected and treated with homologous serum (from the main study; samples collected before and after the vaccine) and recombinant coronavirus (inactive virus). The metabolism of PBMCs will be analyzed using Respirometry (Seahorse). Data will be analyzed using multilevel repeated-measures ANOVA. Conclusions: The data generated will help us answer three main questions: (1) Does the innate immune system of physically active individuals respond better to viral infections compared with that of sedentary people? (2) which functional and metabolic mechanisms explain the differences in responses in participants with different physical fitness levels? and (3) do these mechanisms have long-term positive modulatory effects on mental and cardiovascular health? Trial registration number: Brazilian Registry of Clinical Trials: RBR-5dqvkv3. Registered on 21 September 2021.

Resistance but not elastic tubes training improves bioimpedance vector patterns and body composition in older women: A randomized trial.

The present study aimed to investigate the effects of traditional resistance training compared to elastic tubes training on bioimpedance vector patterns, body composition, and strength in older women. Thirty-eight older women (age 68.7 ±â€¯6.9 years, body mass index 28.8 ±â€¯7.2 kg/m2) were randomly assigned to perform traditional resistance or elastic tubes training three times per week for 12 weeks. Body composition was assessed by dual energy X-ray absorptiometry and bioelectrical impedance vector analysis. In addition, handgrip strength was measured using a dynamometer. Only the participants who followed the 12-week traditional resistance training program significantly (p < 0.05) decreased fat mass (ES: -0.69) and extracellular water (ES: -1.06), and increased total body water (ES: 0.49), intracellular water (ES: 1.11), body cell mass (ES: 0.82), muscle mass (ES: 0.94), and phase angle (ES: 0.99), while no change occurred in the elastic tubes training group. Furthermore, a vector leftward displacement (ES: 1.11) into the resistance-reactance graph was found only after the traditional resistance training program. The handgrip strength increased for both traditional and elastic tubes training groups (ES: 0.64, ES: 0.71, respectively). Traditional resistance training improved body composition and strength in the older women group, while training using elastic tubes was effective only for the latter. The present outcomes encourage the use of systematic resistance training to counteract the effects of aging in older women.

Predictive equation for assessing appendicular lean soft tissue mass using bioelectric impedance analysis in older adults: Effect of body fat distribution.

BACKGROUND: Low muscle mass is associated with sarcopenia and increased mortality. Muscle mass, especially that of the limbs, is commonly estimated by dual-energy X-ray absorptiometry (DXA) or bioimpedance analysis (BIA). However, BIA-based predictive equations for estimating lean appendicular soft tissue mass (ALST) do not take into account body fat distribution, an important factor influencing DXA and BIA measurements. OBJECTIVES: To develop and cross-validate a BIA-based equation for estimating ALST with DXA as criterion, and to compare our new formula to three previously published models. METHODS: One-hundred eighty-four older adults (140 women and 44 men) (age 71.5 ±â€¯7.3 years, body mass index 27.9 ±â€¯5.3 kg/m2) were recruited. Participants were randomly split into validation (n = 118) and cross-validation groups (n = 66). Bioelectrical resistance was obtained with a phase-sensitive 50 kHz BIA device. RESULTS: A BIA-based model was developed for appendicular lean soft tissue mass [ALST (kg) = 5.982 + (0.188 × S2 / resistance) + (0.014 × waist circumference) + (0.046 × Wt) + (3.881 × sex) - (0.053 × age), where sex is 0 if female or 1 if male, Wt is weight (kg), and S is stature (cm) (R2 = 0.86, SEE = 1.35 kg)]. Cross validation revealed r2 of 0.91 and no mean bias. Two of three previously published models showed a trend to significantly overestimate ALST in our sample (p < 0.01). CONCLUSIONS: The new equation can be considered valid, with no observed bias and trend, thus affording practical means to quantify ALST mass in older adults.

Are bioelectrical parameters and functionality associated with postural control in the elderly?

BACKGROUND: Alterations in bioimpedance parameters and postural control occur with aging and contribute to the increased risk of falls. The aim of this study was to evaluate the balance behavior in relation to bioimpedance and functionality. METHODS: We evaluated 21 elderly (men: 77.3 ± 9.5 years; women: 74.2 ± 9.6 years). The balance in standing posture was measured by the movement of the pressure center in seven positions. Bioimpedance was defined by its parameters resistance, reactance and phase angle, and functionality through the Timed Up and Go Test and Short Physical Performance Battery. FINDINGS: In the analysis of the mediolateral velocity at the positions feet separated with open and closed eyes, feet together with eyes closed and semi-tandem with eyes open on the platform, an inverse correlation between balance and bioimpedance variables were verified for all models, with a coefficient of determination varying between 20% and 74%. Inverse and significant correlations between reactance and phase angle in the one-legged-support position were verified, in all adjustment models, with coefficient of determination varying between 62% and 91%. In the analysis of mediolateral velocity for the semi-tandem eyes closed position, positive correlation with TUG and an inverse correlation with bioimpedance parameters and pennation angle were observed, with coefficient of determination varying between 21% and 67%. INTERPRETATION: The postural control is linearly related to bioimpedance parameters and functionality in the elderly. The assessment of balance can provide important information and furnishes useful insights for prevention and treatment strategies in elderly.

Occupational and leisure-time physical activity decreases the odds of disability in older adults: Prospective study.

AbstractAging decreases physical function which can increase dependence in activities of daily living (ADL) and disability. However, physical activity (PA) may improve physical function and prevent disability in older adults. In addition, it is important to emphasize that research concerning the domains in which PA is practiced and the benefits for physical function of older adults is also important for the elaboration of preventative health measures for this population. Thus, the aim of this study was to analyse the association of total PA and PA in different domains and odds of disability in older adults in a 24-month follow-up. The study included 211 older adults, aged ≥60 years (72 ± 7 years, 72% women). Handgrip strength was measured using a digital dynamometer, gait speed and chair stand by functional tests. PA and dependence in ADL were self-reported. Older adults who remained sufficiently active in the occupational (OR:0.11;CI95%:0.01-0.93, OR:0.21;CI95%:0.07-0.69, and OR:0.13;CI95%:0.05-0.34) domain presented protection for high dependence in basic (BADL), instrumental (IADL) and advanced (AADL), respectively, as well as in total ADL (OR:0.25;CI95%:0.07-0.92). Older adults who remained sufficiently active in the leisure-time exercise (OR:0.28;CI95%:0.11-0.72, OR:0.44;CI95%:0.20-0.93 and OR:0.15;CI95%:0.04-0.49) domain presented protection for high dependence in IADL, AADL and total ADL, respectively. Moreover, older adults who remained sufficiently active in total PA (OR:0.11;CI95%:0.01-0.94, OR:0.30;CI95%:0.11-0.80 and OR:0.21CI95%:0.10-0.46) presented protection for high dependence in BADL, IADL and AADL, respectively, as well as in total ADL (OR:0.28;CI95%:0.09-0.86). The odds of disability are lower in older adults who are sufficiently active, especially in occupational and leisure-time exercise domains.

Sedentary Patterns Are Associated with Bone Mineral Density and Physical Function in Older Adults: Cross-Sectional and Prospective Data.

Aging causes some unfavorable morphological and functional changes, such as the decline in bone mineral density (BMD) and physical function. Moderate-to-vigorous physical activity (MVPA) and sedentary time seem to be related with these alterations, but the impact of distinct patterns remains unclear. The aim of this study was to cross-sectionally and prospectively assess the association between objectively measured MVPA and sedentary patterns (bouts and breaks) with BMD and physical function in older adults. The study considered 151 Brazilians (aged ≥ 60 years), out of which 68 participants completed 2-year follow-up measurements. MVPA and sedentary patterns were measured by means of accelerometry, BMD-(total proximal femur and lumbar spine (L1-L4)) by means of dual-energy X-ray absorptiometry (DXA), and physical function-by means of physical tests. In older women, sedentary bouts >60 min were inversely associated with handgrip strength (ß = -2.03, 95% CI: from -3.43 to -0.63). The prospective analyses showed that changes in sedentary bouts (20 to 30 min and >60 min) were inversely associated with changes in the lumbar spine's BMD (ß = -0.01, 95% CI: from -0.01 to -0.00 and ß = -0.03, 95% CI: from -0.06 to -0.01) and the lumbar spine's T-score (ß = -0.06, 95% CI: from -0.10 to -0.01 and ß = -0.27, 95% CI: from -0.49 to -0.04), respectively. In older women, sedentary patterns are cross-sectionally associated with handgrip strength and prospectively associated with BMD independent of MVPA.

Physical activity is associated with functional capacity of older women with osteosarcopenic obesity: 24-month prospective study.

BACKGROUND/OBJECTIVES: Physical activity (PA) could be effective in the prevention of functional disability in older women, especially for those with body composition abnormalities. The aim this study was to analyze the association of total PA and in different domains with physical function and functional capacity in older women with or without osteosarcopenic obesity (OSO), as well as to assess the risk of functional disability in osteosarcopenic obesity older women insufficiently active. SUBJECTS/METHODS: The study included 152 Brazilian older women, aged 60 years and older. Body composition was measured by dual energy X-ray absorptiometry (DXA) and physical function by physical tests. Functional capacity and PA were self-reported. RESULTS: In older women without OSO, the practice of leisure-time exercise (ß:-0.23; 95%CI -0.40 to -0.06) and total PA (ß:-0.40; 95%CI -0.57 to -0.23) is inversely associated with dependence in ADL. In older women with OSO, the practice of leisure-time exercise was inversely associated with physical function (ß:0.88; 95%CI 0.31-1.46) and functional capacity (ß:-1.05; 95%CI 1.64 to -0.45), while total PA (ß:-1.03; 95%CI -1.93 to -0.13) was inversely associated with functional capacity, independent of control variables. In addition, older women with OSO who remained insufficiently active in leisure-time exercise (HR:2.28; 95%CI 1.04-4.99) and locomotion (HR:2.62; 95%CI 1.28-5.36) domains presented risk for functional disability. CONCLUSIONS: PA is inversely associated with physical function and functional capacity in older women with or without OSO, and older women with OSO who are insufficiently active in leisure-time exercise and locomotion domains presented a higher risk for functional disability.

Practice of physical activity and dysmobility syndrome in community-dwelling older adults.

The aim this study was to analyze the association between insufficient physical activity and dysmobility syndrome (DS) in community-dwelling older adults. In total, 375 subjects were evaluated aged ≥60 years. For the diagnosis of DS the presence of ≥3 clinical factors was considered: (a) low muscle mass; (b) low muscular strength; (c) low gait speed; (d) high body fat, and (e) osteoporosis. Information relating to the practice of habitual physical activity (HPA) was obtained using a questionnaire and accelerometry. The chi-square test was used to verify the association between HPA and DS and analysis of binary logistic regression to build multiple models. Insufficiently active older adults are approximately 2 times (95% confidence interval, 1.14-3.79) more likely to have DS, independent of body mass index, smoking and ethnicity. The insufficient practice of physical activity is associated with DS in older adults, mainly in women and older.

Elastic resistance training improved glycemic homeostasis, strength, and functionality in sarcopenic older adults: a pilot study.

The purpose of this study was to verify the effects of 12 weeks of elastic resistance training on the glucose homeostasis, strength and functionally in sarcopenic older adults. Seven sarcopenic subjects (age, 70.71± 8.0 years; body mass index, 22.75±3.1 kg/m2) participated of training protocol with 12 weeks of elastic resistance training. The oral glucose tolerance test, handgrip strength, sit-to-stand test, 4-m walk test, and coordination test were measured at baseline and after training. According to the results, baseline values of area under the curve of glucose and homeostatic model assessment-insulin resistance were significantly lower than after 12 weeks, respectively (808.2±185.0 mmol/L vs. 706.6±114.8 mmol/L, P=0.049; 1.44±0.48 vs. 0.73±0.32, P=0.040). There were a significant improve of HGS (24.3±5.7 kg vs. 27.3±7.3 kg, P=0.01), 4-m walking test (3.64±0.4 sec vs. 3.23±0.3 sec, P=0.04), and STS (10.2±2.3 sec vs. 9.0±1.9 sec, P=0.04) compared with baseline. In conclusion, these findings suggest that elastic resistance training improved glucose homeostasis, strength, and functionality in sarcopenic older adults.

Osteoarticular diseases and physical performance of Brazilians over 80 years old.

OBJECTIVE: To investigate the physical performance of Brazilian individuals older than 80 years with and without OD. METHODS: The sample consisted of 135 individuals (aged > 80 years) of both gender. Identification of osteopenia/osteoporosis was verified by Dual Energy X-ray Absorptiometry, and the presence of others osteoarticular diseases (OD) was obtained using a questionnaire of morbidities. Physical performance was analyzed by motor tests. RESULTS: Men presented higher proportion of osteopenia/osteoporosis compared to women (p = 0.013). The proportion of older people with arthritis/osteoarthritis for women and men was 33% and 26%, respectively, and with OD in the spine was 19% and 12%, respectively. No significant difference for physical performance, measured by each test and overall score, was observed between groups of OD. According to gender, male with OD presented lower performance in gait speed, balance and overall score (p < 0.05), while older people with osteopenia/osteoporosis are at higher risk for low physical performance (OR 2.73; CI 95% 1.31-5.66). CONCLUSION: In conclusion it was verified in older people with age of 80 years or more, a high prevalence of OD, especially in men, and the presence of these diseases interfered negatively their physical performance.

Is dynamometry able to infer the risk of muscle mass loss in patients with COPD?

INTRODUCTION: Sarcopenia is characterized by a progressive and generalized decrease of strength and muscle mass. Muscle mass loss is prevalent in patients with chronic obstructive pulmonary disease (COPD) as a result of both the disease and aging. Some methods have been proposed to assess body composition (and therefore identify muscle mass loss) in this population. Despite the high accuracy of some methods, they require sophisticated and costly equipment. AIM: The purpose of this study was to infer the occurrence of muscle mass loss measured by a sophisticated method (dual energy X-ray absorptiometry [DEXA]) using a more simple and affordable equipment (dynamometer). METHODS: Fifty-seven stable subjects with COPD were evaluated for anthropometric characteristics, lung function, functional exercise capacity, body composition, and peripheral muscle strength. A binary logistic regression model verified whether knee-extension strength (measured by dynamometry) could infer muscle mass loss (from DEXA). RESULTS: Patients with decreased knee-extension strength were 5.93 times more likely to have muscle mass loss, regardless of sex, disease stage, and functional exercise capacity (P=0.045). CONCLUSION: Knee-extension dynamometry was able to infer muscle mass loss in patients with COPD.

Association between bone mass and functional capacity among elderly people aged 80 years and over.

OBJECTIVE: Analyzed the association of bone mass with the functional capacity of elderly aged 80 or more. METHODS: The sample consisted of 93 elderly aged 80 and 91 years (83.2±2.5 years) being 61 women (83.3±2.7 years) and 32 men (83.1±2.2 years) living in the city of Presidente Prudente - São Paulo/Brazil. The assessment of bone mass was realized by absorptiometry dual-energy X-ray (DXA), where have been measured values bone mineral content (BMC) and bone mineral density (BMD) of the femur and spine (L1-L4). The functional capacity was evaluated by means of walking speed tests, static equilibrium and strength of lower limbs contained in the questionnaire Wellness Health and Aging (SABE). The variables of bone mass and functional capacity were categorized according to the median values and score tests, respectively. For statistical analysis we carried out the chi-square test, the software used was SPSS (13.0) and the significance level was set at 5%. RESULTS: Elderly male with higher performance in the functional tests showed higher femur BMC compared to lower performance, result not found when evaluated women. CONCLUSION: Thus, the bone of the femur for the oldest old male is associated with functional capacity. The constant assessment of the bone mineral mass and practive of physical activity throughout life would be measures to prevent falls in the elderly.

OBJETIVO: Analisar a associação entre a massa óssea e capacidade funcional de idosos com 80 anos ou mais. MÉTODOS: A amostra foi composta por 93 idosos entre 80 e 91 anos (83,2±2,5 anos), 61 mulheres (83,3±2,7 anos) e 32 homens (83,1±2,2 anos) da cidade de Presidente Prudente. A avaliação da massa óssea foi feita pela absorptiometria de dupla energia de raios X (DXA), na qual foram mensurados os valores de conteúdo mineral ósseo (BMC) e densidade mineral óssea (BMD) do fêmur e da coluna (L1­L4). A capacidade funcional foi avaliada por meio dos testes de velocidade para caminhar, equilíbrio estático e força de membros inferiores contidos no questionário Saúde, Bem-Estar e Envelhecimento (Sabe). As variáveis da massa óssea e capacidade funcional foram categorizadas de acordo com os valores de mediana e a pontuação obtida nos testes, respectivamente. Para tratamento estatístico fez-se o teste qui-quadrado, o software usado foi SPSS (13.0) e o nível de significância estabelecido foi de 5%. RESULTADOS: Os idosos do sexo masculino com maior desempenho nos testes funcionais apresentaram maiores valores de BMC de fêmur comparados com os de menor desempenho, resultado não encontrado quando avaliadas as mulheres. CONCLUSÃO: Dessa forma, a massa óssea do fêmur para idosos longevos do sexo masculino está associada à capacidade funcional. A avaliação constante da massa mineral óssea e a prática de atividade física ao longo da vida seriam medidas para prevenção das quedas em idosos.

Indices of body fat distribution for assessment of lipodysthrophy in people living with HIV/AIDS.

BACKGROUND: Metabolic and morphological changes associated with excessive abdominal fat, after the introduction of Antiretroviral Therapy, increase the risk of cardiovascular disease in people living with HIV/AIDS(PLWHA). Accurate methods for body composition analysis are expensive and the use of anthropometric indices is an alternative. However the investigations about this subject in PLWHA are rare, making this research very important for clinical purpose and to advance scientific knowledge. The aim of this study is to correlate results of anthropometric indices of evaluation of body fat distribution with the results obtained by Dual-energy X-Ray Absorptiometry(DEXA), in people living with HIV/AIDS. METHODS: The sample was of 67 PLWHA(39 male and 28 female), aged 43.6±7.9 years. Body mass index, conicity index, waist/hip ratio, waist/height ratio and waist/thigh were calculated. Separated by sex, each index/ratio was plotted in a scatter chart with linear regression fit and their respective Pearson correlation coefficients. Analyses were performed using Prism statistical program and significance was set at 5%. RESULTS: The waist/height ratio presented the highest correlation coefficient, for both male (r=0.80, p<0.001) and female (r=0.87, p <001), while the lowest were in the waist/thigh also for both: male group (r=0.58, p<0.001) and female group (r=0.03, p=0.86). The other indices also showed significant positive correlation with DEXA. CONCLUSION: Anthropometric indices, especially waist/height ratio may be a good alternative way to be used for evaluating the distribution of fat in the abdominal region of adults living with HIV/ADIS.