Six months training alone or combined with diet alters HOMA-AD, HOMA-IR and plasma and adipose tissue adiponectin in obese women.

OBJECTIVE: We investigate the effect of 6 months aerobic training alone or in combination with diet on adiponectin in circulation and in adipose abdominal tissue (AT) in obese women. METHODS: Twenty obese subjects were randomized into a 24 weeks intervention: 1) training (TR) and 2) training and diet (TRD). Blood samples were collected at baseline, after 12 wk and 24 wk. AT biopsies were obtained only at baseline and after 24 wk. RESULTS: In the TRD group the fat loss was after 12 wk -13.74% (p<0.01) and after 24 wk -21.82% (p<0.01) with no changes in the TR group. After 12 and 24 wk, VO2max was increased by 21.81-39.54% (p<0.05) in the TRD group and 18.09-40.95% in the TR group (p<0.05). After 12 wk, plasma adiponectin was raised only in the TRD group (55.8%, p<0.05). After 24 weeks, circulating adiponectin was elevated by 110.4% (p<0.01) in the TRD group and by 27% (p<0.05) in the TR group. In AT biopsies, subjects in the TRD and TR groups exhibited a significant increase in adiponectin (p<0.05 and p<0.01, respectively). The two indices HOMA-IR and HOMA-AD for assessing insulin resistance were strongly affected by protocols. HOMA-IR decreased (p<0.05) only after 24 wk in the TRD group. HOMA-AD increased in both groups after 12 (p<0.05) and 24 wk (p<0.01). CONCLUSION: Six months chronic aerobic exercise alone or combined with diet result in a significant increase in circulating and adipose tissue adiponectin levels in obese women independent of changes in body composition and/or in HOMA-IR.

Effect of rehabilitation program on endocrinological parameters in patients with COPD and in healthy subjects.

BACKGROUND: Skeletal muscle wasting commonly occurs in patients with chronic obstructive pulmonary disease (COPD) and has been associated with the presence of systemic inflammation and endocrinological disturbance. The aim of this study is to analyze the effect of rehabilitation program on the balance of anabolic versus catabolic hormone in patients with COPD and in healthy subjects. METHODS: Nineteen patients with COPD and 16 age-matched healthy subjects undertooked exercise training 3 days/week for 8 weeks. Before and after the training program the concentration of growth hormone (GH), Insulin-Like Growth Factor-1 (IGF-1), Insulin-like Growth Factor-Binding Protein 3 (IGF-BP3), testosterone and cortisol in serum were determined. The exercise measurements included a 6-Minute Walking Test (6MWT). RESULTS: After 8 weeks, there was no significant change in lung function in patients with COPD and healthy subjects. Growth hormone, Insulin-like Growth Factor-1 and Insulin-like Growth Factor-Binding Protein 3 increased significantly after rehabilitation training (p < 0.01). The rehabilitation program improves the testosterone/cortisol ratio (T/C ratio) in both groups. There is a significant improvement in the 6-Minute Walking distance (6MWD) in both groups (p < 0.01). Dyspnea and heart rate at rest and at the peak of the 6-Minute Walking Test (6MWT) decreased significantly after training program (p < 0.01). CONCLUSION: Pulmonary rehabilitation induces an improvement of the anabolic process and reduces proteine distruction by the modifications in endocrinological factors regulating skeletal muscle in patients with COPD.

Diet and diet combined with chronic aerobic exercise decreases body fat mass and alters plasma and adipose tissue inflammatory markers in obese women.

The purpose of this study was to investigate the effect of 6 months aerobic exercise and diet alone or in combination on markers of inflammation (MOI) in circulation and in adipose abdominal tissue (AT) in obese women. Thirty obese subjects were randomized into a 24-week intervention: (1) exercise (EX), (2) diet (DI), and (3) exercise and diet (EXD). Blood samples were collected at baseline, after 12 and 24 weeks. AT biopsies were obtained only at baseline and after 24 weeks. In the EXD and DI groups, the fat loss was after 12 weeks was -13.74 and -7.8 % (P < 0.01) and after 24 weeks was -21.82 and -17 % (P < 0.01) with no changes in the EX group. After 12 and 24 weeks, maximal oxygen consumption (VO2max) was increased by 21.81-39.54 % (P < 0.05) in the EXD group and 18.09-40.95 % in the EX group with no changes in the DI group. In the EXD and DI groups, circulating levels of tumor necrosis factor α and interleukin 6 were decreased after 24 weeks for both groups (P < 0.01). No changes in the EX group. Homeostatic model assessment for insulin resistance decreased (P < 0.05) only after 24 weeks in the EXD group. In AT biopsies, subjects in the EXD and DI groups exhibited a significant decrease in MO (P < 0.01 for all). No changes in AT biopsies were found in the EX group. In conclusion, chronic aerobic exercise was found to have no effects on circulating and AT MOI despite an increased VO2max. Rather important body composition modifications were found to have beneficial effects on circulating and AT MOI in these obese women.

Effects of intense cycling training on plasma leptin and adiponectin and its relation to insulin resistance.

OBJECTIVE: Adiponectin, the most abundant protein secreted by white adipose tissue, is known for its involvement in insulin resistance (HOMA-R). The purpose of this investigation was to assess the effect of intense cycling training for six months on plasma concentrations of adiponectin and leptin and HOMA-R. METHODS: Eight trained males non professional cyclists participated in this study. They completed two times maximal exercises separated by six months heavy cycling training. Blood samples were obtained before exercise, at the end and after 30 and 60 minutes of recovery. RESULTS: Before training, adiponectin concentrations were not significantly altered after maximal exercise, but plasma leptin levels decreased significantly at the end of exercise (-21.42%, p<0.01) and after 60 min of recovery (-21.18%, p<0.05). After 6 months training, subjects exhibited a decreased in control leptin concentrations (-44.91%, p<0.05) and in HOMA-R (-30.68%, p<0.05) and showed delayed increase in adiponectin concentrations (after 30 min of recovery) (14.10%, p<0.01). CONCLUSIONS: Our results showed that adiponectin is sensitive to maximal exercise when realised after intense training and that six months heavy cycling training don't affect adiponectin concentrations, but decreases the synthesis of leptin and HOMA-R and improves aerobic capacity. Furthermore, it appears that after 6 months heavy chronic exercise adiponectin is not associated with aerobic capacity and/or insulin resistance and/or body composition modifications.

Six-minute walk test in non-insulin-dependent diabetes mellitus patients living in Northwest Africa.

INTRODUCTION: International recommendations of the exploration of non-insulin-dependent diabetes mellitus (NIDDM) are focused on deficiency and not incapacity. AIMS: (1) To estimate the incapacity of NIDDM patients through the 6-minute walk test (6MWT) data. (2) To determine their 6-minute walk distance (6MWD) influencing factors (3) To compare data of NIDDM patient group (PG; n = 100) with those of two control groups (CG): CG1 (n = 174, healthy nonobese and nonsmoker); CG2 (n = 55, obese nondiabetic free from comorbidities). POPULATION AND METHODS: The anthropometric, socioeconomic, clinical, metabolic, and 6MWT data of 100 NIDDM patients (45 females) were collected. RESULTS: Total sample means ± standard deviation of age, weight, and height were 54 ± 8 years, 81 ± 14 kg, and 1.64 ± 0.09 m. (1) Measured 6MWD (566 ± 81 m) was significantly lower than the theoretical 6MWD (90% ± 12%). The profile of the PG carrying the 6MWT, was as follows: 23% had an abnormal 6MWD; at the end of the 6MWT, 21% and 12% had, respectively, a low heart rate and a high dyspnea (>5/10), and 4% had desaturation during the walk. The estimated "cardiorespiratory and muscular chain" age (68 ± 16 years) was significantly higher than the chronological age. (2) The factors that significantly influenced the 6MWD (r(2) = 0.58) are included in the following equation: 6MWD (m) = -73.94 × gender (0, male; 1, female) - 3.25 × age (years) + 7.33 × leisure activity score - 35.57 × obesity (0, no; 1, yes) + 32.86 × socioeconomic level (0, low; 1, high) - 27.67 × cigarette use (0, no; 1, yes) + 8.89 × resting oxyhemoglobin saturation - 105.48. (3) Compared to the CGs, the PG had a significantly (P < 0.05) lower 6MWD (100%+9% and 100%+8%, respectively, for the CG1 and CG2). CONCLUSION: NIDDM seems to accelerate the decline of the submaximal aerobic capacity evaluated through the 6MWD.

6-minute walk distance in healthy North Africans older than 40 years: influence of parity.

The need for a 6-min walk distance (6-MWD) reference equation for healthy North African adults older than 40 years was assessed in a prospective cross-sectional study. Anthropometric data and 6-MWD were measured in 229 healthy Tunisian adults (125 women) over 40 years old. Two subgroups of 38 women were identified according to the parity (lowor=6). The published reference equations did not reliably predict measured 6-MWD. The 6-MWD was significantly correlated with gender, age, weight and height (p<0.001). The combination of these parameters explained 77% of the 6-MWD variability in the equation: 6-MWD (m)=-160.27 x gender (0: men; 1: women) - 5.14 x age (yr) - 2.23 x weight (kg)+2.72 x height (cm)+720.50. Parity accelerated the 6-MWD decline (r=-0.39, p<0.05) and women distinguished only by parity (or=6) showed different 6-MWD (589+/-60 m vs. 555+/-57 m, p<0.05). In an additional group of 30 adults prospectively studied to validate the equation, the agreement between the measured and equation-predicted 6-MWD was satisfactory. In conclusion, this reliable 6-MWD reference equation enriches the World Bank and provides an important element of interpretation for women with high parity.

The forgotten message from gold: FVC is a primary clinical outcome measure of bronchodilator reversibility in COPD.

BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends the use of forced expiratory volume in 1s (FEV(1)) to assess airways reversibility. The American Thoracic Society (ATS) and the European Respiratory Society (ERS) recommend FEV(1) and/or forced vital capacity (FVC). This study assessed whether FVC detects reversibility in more chronic obstructive pulmonary disease (COPD) patients than FEV(1) after acute short-acting bronchodilator inhalation. METHODS: Plethysmographic data of 168 consecutive stable male COPD patients who underwent reversibility testing were analyzed. RESULTS: Seventy-seven patients showed a clinically significant increase in FVC, whereas only 49 patients showed a clinically significant increase in FEV(1). Thus, FVC detected reversibility in 57% more patients than FEV(1). Of the 90 patients showing clinically significant reversibility, FEV(1) did not detect 41 patients that FVC detected, indicating a 45% difference. CONCLUSION: FEV(1) underestimates acute bronchodilation effects. FVC should thus be a primary clinical outcome measure of bronchodilator reversibility in COPD, as it detects reversibility in more patients. This message, forgotten by GOLD, should be promoted in future consensus statements.

[Non invasive exploration of pulmonary capillary blood volume]. / Exploration non invasive du volume sanguin capillaire pulmonaire.

The exploration of the deep lung remains very limited. Indeed, all the current examinations give only indirect information on this part of the lung. Thus, the new technique of double transfer of carbon monoxide (CO) and nitric oxide (NO) allows a more precise study of the pulmonary gas exchange by analyzing separately the characteristics of the membrane, by measurement of the membrane diffusion (Dm), and of the pulmonary capillary, by measurement of pulmonary capillary blood volume (Vc). With this technique, a more objective and non invasive study of the physiological changes, as age and the exercise, and pathological factors like systemic, cardio-vascular or pulmonary diseases on alveolo capillary membrane is possible.