Exercise improves respiratory function, body fluid and nitric oxide in hemodialysis patients.

Emerging evidence suggests that resistance training (RT) can mitigate respiratory muscle weakness in hemodialysis (HD) patients. However, the underlying mechanisms responsible for these beneficial effects remain unclear. The purpose of this study was to assess the impact of periodized RT on respiratory muscle strength and its relationship with handgrip strength (HGS), fat-free mass (FFM), nitric oxide (NO), and interdialytic weight gain (IWG) in HD patients. Thirty-three patients were randomly assigned to two groups: control (CTL; n=18) and RT (n=15). RT group did not perform any additional exercise training specific to the respiratory tract. Maximal inspiratory (MIP) and expiratory (MEP) pressures, peak expiratory flow (PEF), HGS, FFM, NO, and IWG were measured before and after the intervention period. Participants in the RT group engaged in a 24-week RT program, three times per week. RT resulted in significant improvements in MIP, MEP, PEF, as well as enhancements in HGS, FFM, NO, and IWG (p<0.05). Notably, inverse correlations were observed between MIP (r= -0.37, p=0.03) and PEF (r= -0.4, p=0.02) with IWG. Thus, the amelioration of HGS and FFM coincided with a reduction in respiratory muscle weakness among HD patients. Decreased IWG and increased circulating NO are plausible mechanisms contributing to these improvements.

Concerns about the application of resistance exercise with blood-flow restriction and thrombosis risk in hemodialysis patients.

BACKGROUND: Hemodialysis (HD) per se is a risk factor for thrombosis. Considering the growing body of evidence on blood-flow restriction (BFR) exercise in HD patients, identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model. The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise (RE) with BFR on this molecule. METHODS: Two hundred and six HD patients volunteered for this study (all with a glomerular filtration rate of <15 mL/min/1.73 m2). The RE + BFR session consisted of 50% arterial occlusion pressure during 50 min sessions of HD (intradialytic exercise). RE repetitions included concentric and eccentric lifting phases (each lasting 2 s) and were supervised by a strength and conditioning specialist. RESULTS: Several variables were associated with elevated levels of D-dimer, including higher blood glucose, citrate use, recent cardiovascular events, recent intercurrents, higher inflammatory status, catheter as vascular access, older patients (>70 years old), and HD vintage. Furthermore, RE + BFR significantly increases D-dimer after 4 h. Patients with borderline baseline D-dimer levels (400-490 ng/mL) displayed increased risk of elevating D-dimer over the normal range (≥500 ng/mL). CONCLUSION: These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE + BFR. D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE + BFR.

Systemic Sirtuin 1 as a Potential Target to Mediate Interactions Between Body Fat and Testosterone Concentration in Master Athletes.

Evidence indicates that master athletes have higher concentration of Sirtuin 1 (Sirt1), lower body fat (BF), and greater activity of the hypothalamic-pituitary-gonadal axis in comparison to untrained peers. However, no published data have demonstrated possible mediation effect of Sirt1 in the interaction of BF and testosterone in this population. Therefore, this study compared and verified possible associations between Sirt1, BF, fat mass index (FMI), testosterone, luteinizing hormone (LH), and testosterone/luteinizing hormone (T/LH) ratio in middle-aged master athletes (n = 54; 51.22 ± 7.76 years) and control middle-aged peers (n = 21; 47.76 ± 8.47 years). Venous blood was collected for testosterone, LH, and Sirt1. BF was assessed through skinfold protocol. Although LH concentration did not differ between groups, master athletes presented higher concentration of Sirt1, testosterone, and T/LH ratio, and lower BF and FMI in relation to age-matched nonathletes. Moreover, Sirt1 correlated positively with testosterone and T/LH ratio, negatively with BF, and was not significantly correlated with LH (mediation analysis revealed the effect of BF on testosterone is mediated by Sirt1 and vice versa; R2 = .1776; p = .032). In conclusion, master athletes have higher testosterone, T/LH ratio, and Sirt1, and lower BF and FMI in relation to untrained peers. Furthermore, Sirt1 was negatively associated with BF and positively associated with testosterone and T/LH ratio. These findings suggest that increased circulating Sirt1, possibly due to the master athlete's training regimens and lifestyle, exhibits a potential mediation effect on the interaction between endocrine function and body composition.

Exercise-Induced Transient Oxidative Stress Is Mitigated in Down Syndrome: Insights About Redox Balance and Muscle Strength.

ABSTRACT: Reis, AL, Deus, LA, Neves, RVP, Corrêa, HL Reis, TL, Aguiar, LS Honorato, FS, Barbosa, JMS, Araújo, TB, Palmeira, TRC, Simões, HG, Prestes, J, Sousa, CV, Ide, BN, and Rosa, TdS. Exercise-induced transient oxidative stress is mitigated in Down syndrome: insights about redox balance and muscle strength. J Strength Cond Res 38(3): e125-e34, 2024-This study aimed to evaluate the acute effects of a session of resistance exercise (RE) performed with elastic tubes on the redox balance and inflammatory profile in individuals with Down syndrome (DS). Subjects ( n = 23) were allocated into 2 groups: individuals with DS (DS; n = 11) and individuals without DS (WDS; n = 12), who performed an acute RE session. Diagnostic assessment included medical history, anthropometric measures (body height, body mass, body mass index, and body composition assessment), biological collections, muscle strength assessments (handgrip and maximal voluntary isometric contraction tests), and exercises. The redox balance and inflammatory profile were assessed in urine and saliva samples before and after an acute RE session. There were no differences between WDS and DS groups for body composition ( p > 0.05). The DS group presented higher values pre and post an acute RE session with elastic tubes for oxidative and proinflammatory markers compared with WDS ( p < 0.05). Uric acid values increased from pre-acute RE session to post-acute RE session for WDS ( p < 0.0001). No differences were identified within groups for the delta analysis ( p > 0.05). Inverse correlations were found between total force and F2-isoprostane, 8OHdG, uric acid, allantoin, IL-6, TNF-α, and the TNF-α:IL-10 ratio. A positive correlation was found between IL-10 and total force. The DS group presented increased peak force in the knee extension and elbow flexion exercises (∼25 and 12%, respectively) but decreases in handgrip strength of ∼7%. The WDS group showed higher peak force values for knee extension, elbow flexion, and handgrip (∼16, 10, and 14%, respectively). The DS group had lower transient elevation of oxidative stress after an acute RE session compared with WDS. Oxidative stress and inflammation responses of DS to an acute RE session with elastic tubes may be insufficient to induce health adaptations for the same relative load compared with WDS.

Geriatric and Gerontology Research: A Scientometric Investigation of Open Access Journal Articles Indexed in the Scopus Database.

BACKGROUND: Scientometric analyses of specific topics in geriatrics and gerontology have grown robustly in scientific literature. However, analyses using holistic and interdisciplinary approaches are scarce in this field of research. This article aimed to demonstrate research trends and provide an overview of bibliometric information on publications related to geriatrics and gerontology. METHODS: We identified relevant articles on geriatrics and gerontology using the search terms "geriatrics," "gerontology," "older people," and "elderly." VOSviewer was used to perform bibliometric analysis. RESULTS: A total of 858 analyzed articles were published in 340 journals. Among the 10 most contributory journals, five were in the United States, with the top journal being the Journal of the American Geriatrics Society. The United States was the leading country in research, followed by Japan, Canada, and the United Kingdom. A total of 5,278 keywords were analyzed. In the analysis of research hotspots, the main global research topics in geriatrics and gerontology were older adults (n=663), education and training (n=471), and adults aged 80 years (n=461). These were gradually expanded to include areas related to caring for older adults, such as geriatric assessments (n=395). CONCLUSION: These results provide direction for fellow researchers to conduct studies in geriatrics and gerontology. In addition, they provide government departments with guidance for formulating and implementing policies that affect older adults, not only in setting academic and professional priorities but also in understanding key topics related to them.

Higher sirt1 is associated with a better body composition in master sprinters and untrained peers.

Sirt1 is an enzyme involved in several anti-aging pathways. Associations between Sirt1, age, and body fat (BF) were assessed in master sprinters (MS; n = 35; 50.25 ±5.93 yr.), untrained young non-athletes (UY; n = 32; 23.78 ±3.98 yr.), and untrained middle-aged (UMA; n = 24; 47.29 ±8.04 yr.). BF was assessed using a skinfold protocol, and Sirt1 was measured in plasma by using commercial kits. Sirt1 of MS (17.18 ±4.77 ng/mL) was higher than UMA (6.36 ±2.29 ng/mL; p<0.0001) and did not differ from UY (20.26 ±6.20 ng/mL). Relative BF of MS was lower than UMA (12.71 ±4.07% vs. 22.13 ±4.18%; p<0.0001). Sirt1 was negatively correlated with chronological age (r = -0.735; p<0.0001) when combining UY and UMA in the analysis. However, when Sirt1 of MS and UY was analyzed together, no significant relationship between Sirt1 and chronological age was observed (r = -0.243; p = 0.083). Sirt1 correlated inversely with BF (r = -0.743; p<0.0001) for UY and UMA. Stepwise multiple regression revealed that being either a young or master athlete and body adiposity are possible predictors of Sirt1 levels. MS and UY were associated with higher levels of Sirt1, while UMA and increased BF were associated with lower levels of this enzyme. The relationships among Sirt1, BF, and chronological age of young and middle-aged non-athletes were not statistically significant when the middle-aged participants were MS. These findings suggest possible links between Sirt1 and body composition, which may play roles in the rate of biological aging.HighlightsLower levels of Sirt1 are associated with higher body fat.Master athlete lifestyle seems to promote higher Sirt1 Levels.

High Prevalence of Long-COVID Among Kidney Transplant Recipients: A Longitudinal Cohort Study.

BACKGROUND: Kidney transplant recipients are at a higher risk to develop more severe clinical forms of coronavirus disease 2019 (COVID-19), perhaps increasing the risk of presenting its long-term clinical complications, labeled as Long-COVID. METHODS: This single-center, observational, prospective study included adult kidney transplant recipients with COVID-19 confirmed by reverse transcription polymerase chain reaction between March 20, 2020, and May 31, 2021, who were alive and with functioning graft 3 mo after the onset of symptoms. The prevalence of Long-COVID was investigated by a phone survey using a structured questionnaire of organic symptoms. Adjusted multivariable logistic regression models were used to investigate independent risk factors. RESULTS: Of 1741 patients who developed COVID-19, 465 died, and 37 returned to dialysis. Of the 1239 eligible patients, 780 (63%) answered the survey during the window period. The mean age was 48 ± 12 y, 41% were women, and the mean time from transplantation was 8 ± 6 y. During acute illness, 45% needed hospitalization. Long-COVID was identified in 214 (27%) of the subjects, with body aches being the most prevalent symptom (44%). Of 233 who provided working status, 17% did not return to work within 3 mo. No baseline characteristics or infection-related variables predicted Long-COVID; actually, the number of symptoms in the acute illness was the only independent risk factor identified (hazard ratio, 1.12; 95% confidence interval, 1.02-1.22). CONCLUSION: In this cohort of kidney transplant recipients, Long-COVID was prevalent and associated with a reduced return to work. The burden of acute phase symptoms was the only risk factor associated with Long-COVID.

A systematic review and meta-analysis demonstrating Klotho as an emerging exerkine.

Klotho is an anti-aging protein with several therapeutic roles in the pathophysiology of different organs, such as the skeletal muscle and kidneys. Available evidence suggests that exercise increases Klotho levels, regardless of the condition or intervention, shedding some light on this anti-aging protein as an emergent and promising exerkine. Development of a systematic review and meta-analysis in order to verify the role of different exercise training protocols on the levels of circulating soluble Klotho (S-Klotho) protein. A systematic search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE through PubMed, EMBASE, CINAHL, CT.gov, and PEDro. Randomized and quasi-randomized controlled trials that investigated effects of exercise training on S-Klotho levels. We included 12 reports in the analysis, comprising 621 participants with age ranging from 30 to 65 years old. Klotho concentration increased significantly after chronic exercise training (minimum of 12 weeks) (Hedge' g [95%CI] 1.3 [0.69-1.90]; P < 0.0001). Moreover, exercise training increases S-Klotho values regardless of the health condition of the individual or the exercise intervention, with the exception of combined aerobic + resistance training. Furthermore, protocol duration and volume seem to influence S-Klotho concentration, since the effect of the meta-analysis changes when subgrouping these variables. Altogether, circulating S-Klotho protein is altered after chronic exercise training and it might be considered an exerkine. However, this effect may be influenced by different training configurations, including protocol duration, volume, and intensity.

Potential implications of blood flow restriction exercise on patients with chronic kidney disease: a brief review.

Combining blood flow restriction (BFR) with exercise is considered a relevant, helpful method in load-compromised individuals and a viable replacement for traditional heavy-load strength training. BFR exercise may be particularly useful for those unable to withstand high mechanical stresses on joints resulting in skeletal muscle dysfunction, such as patients with chronic kidney disease (CKD). Current literature suggests that BFR training displays similar positive health benefits to exercise training alone for CKD patients, including maintenance of muscle strength, glomerular filtration rate maintenance, uremic parameters, inflammatory profile, redox status, glucose homeostasis, blood pressure adjustments, and low adverse reports. In this review of nine studies in CKD patients, we clarify the potential safety and health effects of exercise training with BFR compared to exercise training alone and recommend insights for future research and practical use. Furthermore, we introduce relevant gaps in this emerging field, providing substantial guidance, critical discussion, and valuable preliminary conclusions in this demographic of patients. However, based on the limited studies in this area, more research is necessary to determine the optimal BFR exercise programming.

The Effect of Progressive Resistance Training on Functionality and Handgrip Strength in the Older Individuals of a Community: A Quasi-Experimental Study.

Muscle weakness is associated with negative outcomes, in addition to being related to the pathogenesis of frailty and functional disability in the older individuals. Muscle strength and functionality are considered biomarkers of aging. Progressive resistance training (PRT) is a type of training that has been the subject of studies as it presents itself as a therapeutic option to fight the reduction of muscle strength and functionality in older individuals. However, few studies have assessed the clinically relevant gains in the levels of muscle strength and functionality of older individuals after PRT, in addition to the need of testing new PRT approaches, including individualization and periodization in training programs. Therefore, this article aims to assess the effect of an individual and periodized PRT protocol on handgrip strength (HS) and functionality in older individuals. Thus, the study sample included 69 older individuals, divided into 2 groups: case (n = 41) and control (n = 28). The case group participated in a PRT protocol for 12 weeks, with two weekly sessions. When compared to the control group, which received only health education, the individuals in the case group had a greater magnitude of improvement in all variables related to the assessed functionality (Timed up and go test, gait speed, and HS), proving the applicability of the assessed protocol to improve strength and functionality in the older individuals of a community.

Anaerobic Threshold Determination in Cycle Ergometer From Rating of Perceived Exertion.

ABSTRACT: Santos, GAd, Numata-Filho, ES, Rosa, TdS, Passos Neves, RV, Simões, HG, and Moreira, SR. Anaerobic threshold determination in cycle ergometer from rating of perceived exertion. J Strength Cond Res 36(5): 1277-1281, 2022-The objective of the study was to investigate the validity of the rating of perceived exertion threshold (TRPE) for anaerobic threshold (AT) estimation during an incremental test (IT) on a cycle ergometer. Nineteen physically active and healthy men performed an IT on a cycle ergometer. The intensity corresponding to the AT was considered as the point immediately before the abrupt increase in blood lactate concentration ([La]) in the IT. TRPE was determined in the last intensity corresponding to perceptual response previous the 15 arbitrary units (AU) in the 15-point RPE scale. The heart rate (HR), [La], and RPE were obtained at the end of each stage of the IT. There was no significant difference between workload obtained from the AT (150 [120-150] watts) and TRPE (150 [120-150] watts) (p > 0.05). In addition, there were no differences between HR (AT, 139.5 ± 12.7 b·min-1 vs. TRPE, 141.9 ± 14.6 b·min-1, p > 0.05) and [La] (AT, 3.1 [2.8-3.2] mM vs. TRPE, 3.1 [2.9-3.7] mM, p > 0.05). There was a strong correlation between the intensities in AT and TRPE during the IT (r = 0.88). A substantial reliability (intraclass correlation coefficient = 0.84 [0.64-0.94 confidence interval 95%]) was evidenced, as well as a substantial agreement between the AT and TRPE intensities (Pc = 0.84), as confirmed by the Bland-Altman plot (-4.7 [-34.2/24.7]). TRPE was a predictor of the AT (ß = 1.146, R = 0.770, SEE = 15.070, p < 0.01). It can be concluded that TRPE is valid for AT estimation during an IT on a cycle ergometer.

Hemodynamics and functional outcomes after resistance training in hypertensive and normotensive elderly: An experimental study

Abstract Aim: To evaluate the chronic effects of resistance training on resting blood pressure, handgrip strength, gait speed, and Timed Up and Go test (TUG) in normotensive and hypertensive elderly individuals. Methods: Experimental study based on TREND. Hypertensive patients were diagnosed by an independent doctor. Before and after 12 weeks of progressive resistance training, we evaluated blood pressure, heart rate, body composition, Timed Up and Go test, gait speed, and handgrip strength. Results: Sample consisted of 41 participants divided into two groups (normotensive n = 28; hypertensive n = 13). We observed significant values in the reduction of blood pressure levels only in the group of hypertensive participants. In functionality outcomes, we observed significant values in all tests and both groups. Outcomes contemplate effect sizes ranging from small to moderate. Conclusion: Progressive resistance training lowers resting blood pressure levels, increases handgrip strength, and improves physical functional performance. Although the normotensive group did not show a reduction in blood pressure levels, an improvement was observed in the functional physical tests.

Is lifelong endurance training associated with maintaining levels of testosterone, interleukin-10, and body fat in middle-aged males?

BACKGROUND: Aging is associated with a gradual physiological decline, including an imbalance in hormone profile, increased adiposity, and reduced anti-inflammatory cytokines. However, lifelong physical exercise mitigates aging, as observed in endurance-trained middle-aged athletes (EMA). AIM: We compared and associated testosterone, interleukin 10 (IL-10), and body fat in EMA and untrained age-matched individuals (UAM). METHODS: Participants were EMA (n=25; 51.48±9.49 years) and UAM (n=23; 46.0±9.37 years). Both groups underwent body composition measurements (evaluated by a skinfold protocol) and blood sampling for IL-10 (assessed through ELISA® kit) and testosterone (assessed with Roche Diagnostics® kit, Mannheim, Germany, by chemiluminescence technique in a third-party laboratory). RESULTS: EMA had lower body fat (14.15±3.82% vs. 23.42±4.95%; P<0.05), higher testosterone (751.68±191.45 ng/dL vs. 493.04±175.15 ng/dL; P<0.05), and higher IL-10 (8.00±1.21 pg/mL vs. 5.89±1.16 pg/mL; P<0.05) compared to UAM. A significant linear correlation was found between testosterone and IL-10 (r=0.56; P=0.001), whereas significant inverse correlations were observed between body fat and testosterone (r=-0.52; P=0.001) and body fat and IL-10 (r=-0.69; P=0.001). CONCLUSIONS: EMA had higher levels of IL-10 and testosterone and lower body fat in comparison with UAM. In addition, higher IL-10 was associated with increased levels of circulating testosterone and lower body fat. RELEVANCE FOR PATIENTS: The adoption of endurance training as part of a healthy lifestyle may contribute to decreasing age-related testosterone reduction, besides reducing markers of inflammaging, preventing the occurrence of chronic age-related diseases, and thus contributing to healthy aging. For people who already have chronic diseases, physical exercise can shift the immune system toward a more anti-inflammatory profile and, thus, improve their pathological condition. In both cases, physical exercise can help attenuate the decline in testosterone, decrease body fat, and increase anti-inflammatory levels.

Does the Combined Effect of Resistance Training with EPO and Iron Sulfate Improve Iron Metabolism in Older Individuals with End-Stage Renal Disease?

We sought to investigate the effects of resistance training (RT) combined with erythropoietin (EPO) and iron sulfate on the hemoglobin, hepcidin, ferritin, iron status, and inflammatory profile in older individuals with end-stage renal disease (ESRD). ESRD patients (n: 157; age: 66.8 ± 3.6; body mass: 73 ± 15; body mass index: 27 ± 3), were assigned to control (CTL; n: 76) and exercise groups (RT; n: 81). The CTL group was divided according to the iron treatment received: without iron treatment (CTL-none; n = 19), treated only with iron sulfate or EPO (CTL-EPO or IRON; n = 19), and treated with both iron sulfate and EPO (CTL-EPO + IRON; n = 76). The RT group followed the same pattern: (RT-none; n = 20), (RT-EPO or IRON; n = 18), and (RT-EPO + IRON; n = 86). RT consisted of 24 weeks/3 days per week at moderate intensity of full-body resistance exercises prior to the hemodialysis section. The RT group, regardless of the iron treatment, improved iron metabolism in older individuals with ESRD. These results provide some clues on the effects of RT and its combination with EPO and iron sulfate in this population, highlighting RT as an important coadjutant in ESRD-iron deficiency.

Influence of Angiotensin Converting Enzyme I/D Polymorphism on Hemodynamic and Antioxidant Response to Long-Term Intradialytic Resistance Training in Patients With Chronic Kidney Disease: A Randomized Controlled Trial.

ABSTRACT: Corrêa, HdL, Deus, LA, Neves, RVP, Reis, AL, de Freitas, GS, de Araújo, TB, da Silva Barbosa, JM, Prestes, J, Simões, HG, Amorim, CE, dos Santos, MAP, Haro, A, de Melo, GF, Gadelha, AB, Neto, LS, and Rosa, TdS. Influence of angiotensin converting enzyme I/D polymorphism on hemodynamic and antioxidant response to long-term intradialytic resistance training in patients with chronic kidney disease: a randomized controlled trial. J Strength Cond Res 35(10): 2902-2909, 2021-The aim of the study was to verify the influence of Angiotensin-converting enzyme (ACE) I/D genotype on blood pressure, muscle mass, and redox balance response to long-term resistance training (RT) in end-stage renal disease patients. Three hundred and twenty subjects were randomized into 4 groups: II + ID control (II + ID CTL, n = 80), II + ID RT (II + ID RT, n = 79), DD control (DD CTL n = 83), and DD RT (DD RT, n = 78). The RT lasted 24 weeks with a frequency of 3 times per week, on alternative days. Each section consisted of 3 sets of 8-12 repetitions in 11 exercises, with training loads at 6 point (somewhat hard) to 8 point (hard) based on OMNI-RES scale and was prescribed during dialysis (intradialytic). Statistical significance was accepted with p < 0.05. The most relevant benefits in blood pressure were found for DD homozygotes (p < 0.0001), whereas allele I carriers displayed a higher increase in muscle mass (p < 0.0001). Hemodialysis clinics that already use RT for their patients could include the genotyping of ACE to identify the predisposal of the patients to respond to RT and to counteract kidney disease-related comorbidities.

Age-related Decline in Renal Function is Attenuated in Master Athletes.

This study analyzed the kidney function and biomarkers of health in lifelong-trained sprinters and endurance runners, and compared them to untrained aged-matched and young controls. Sixty-two men (21-66 yr.) were recruited and allocated as master athletes from sprints (n=25), master athletes from endurance events (n=8), untrained middle-aged (n=14) and young controls (n=15). Participants underwent anamnesis, anthropometric measures and blood sampling for biochemical analyses of klotho, FGF23 and estimated glomerular filtration rate. Master sprinters presented better kidney function in relation to endurance athletes and their untrained peers (P<0.0001). A number of biochemical variables were observed that negatively (i. e., GDF-15, TGF-Beta, IL-18) or positively (i. e., klotho/FGF23 ratio and sestrin-2) correlated with eGFR. Sestrin-2 presented the strongest association with eGFR (r=0.5, P=0.03). Results also revealed that lifelong-trained individuals presented the highest probability of having better values for cystatin C and thus an estimated glomerular filtration rate that was 37-49% higher than untrained peers. Master sprinters presented better kidney function in relation to endurance athletes and middle-aged untrained peers. Sestrin-2 may play a role in exercise-induced kidney function protection.

Association between dynapenic abdominal obesity and inflammatory profile in diabetic older community-dwelling patients with end-stage renal disease.

BACKGROUND: Obesity and poor strength impose higher risk factor for end-stage renal disease (ESRD) patients. It is expected that the combination of both conditions might be critically associated with the inflammatory profile in this population, especially in community-dwelling elderly. So, diagnosis of dynapenic obesity and inflammation is an important tool in the management of chronic kidney disease patients at imminent risk of hospitalization. PURPOSE: To investigate the association between dynapenic abdominal obesity and inflammatory markers in community-swelling elderly with ESRD. METHODS: Two hundred and forty-seven community-dwelling older patients (66.74 ± 3.20 years; n = 150, 60.73%, males) undergoing maintenance phase hemodialysis volunteered for this study. The study sample was categorized into four groups according to handgrip strength and waist circumference as follows: control, dynapenia (low strength alone), abdominal obesity (high waist circumference alone), and dynapenic obesity (D/AO) (the combination of low strength and high waist circumference). Blood samples were collected for tumor necrosis factor alpha (TNF-α), interleukin (IL)- 6 and IL- 10. Results were considered significant at P < 0.05. RESULTS: Proportions for control, abdominal obesity, dynapenic, and D/AO were 38.5%, 15.8%, 25.9%, and 19.8%, respectively. Higher concentrations of TNF-α were found in the D/AO group (P < 0.0001). This group also displayed lower levels of IL-10 (P < 0.0001). Further, the D/AO traits were strongly associated with TNF-α and IL-10 (P < 0.0001). CONCLUSION: The closely relation between D/AO and inflammatory profile provides evidence that the pooled information of low muscle strength and abdominal obesity may be clinically relevant for the management of ESRD patients.

Biomarkers and Redox Balance in Aging Rats after Dynamic and Isometric Resistance Training.

Aging muscle is prone to sarcopenia and its associated telomere shortening and increased oxidative stress. Telomeres are protected by a shelterin protein complex, proteins expressed in response to DNA damage. Aerobic exercise training has shown to positively modulate these proteins while aging, but the effects of resistance training are less clear. This investigation was to examine the role of dynamic and isometric RT on markers of senescence and muscle apoptosis: checkpoint kinase 2, 53 kDa protein, shelterin telomere repeat binding 1 and 2, DNA repair, telomere length and redox state in the quadriceps muscle. Fifteen 49-week-old male rats were divided into three groups: control, dynamic resistance training, and isometric resistance training. Dynamic and isometric groups completed five sessions per week during 16 weeks at low to moderate intensity (20-70% maximal load). Only dynamic group decreased expression of 53 kDa protein, proteins from shelterin complex, oxidative stress, and improved antioxidant defense. There was no difference among groups regarding telomere length. In conclusion, dynamic resistance training was more effective than isometric in reducing markers of aging and muscle apoptosis in elderly rats. This modality should be considered as valuable tool do counteract the deleterious effects of aging.

Obese elderly with diabetes experience more pain and reduced quality of life compared to obese elderly with hypertension.

BACKGROUND AND AIM: Growth of elderly population is a worldwide phenomenon that impacts public health. The objective of this study was to compare the pain levels, strength, and quality of life among elderly obese with diabetes or hypertension. MATERIALS AND METHODS: The study cohort comprised 52 obese elderly subjects with hypertension (n = 35) and diabetes (n = 17). The parameters measured were anthropometric features, handgrip strength, visual analog scale for pain, and quality of life using the World Health Organization questionnaire. RESULTS: The level of pain reported by obese hypertensive elderly subjects (5.3 ± 3.4) was lower than reported by obese diabetic elderly subjects (7.4 ± 2.4). Obese hypertensive elderly scored higher on quality of life (sensory functioning and past, present, and future [PPF] activities) than obese diabetic elderly. No differences were observed for the other parameters. Strength, pain, anthropometrics, and hemodynamics were not correlated to quality of life. CONCLUSIONS: Obese elderly diabetics exhibit worse pain scores, sensorial abilities, and PPF activities than obese hypertensive elderly individuals. RELEVANCE FOR PATIENTS: The difference in pain and quality of life aspects between obese elderly individuals with hypertension and diabetes should be accounted for in health-care programs designed for these individuals.