Effects of physical activity on body composition and fatigue perception in patients on thyrotropin-suppressive therapy for differentiated thyroid carcinoma.

BACKGROUND: Subclinical thyrotoxicosis (scTox) may be associated with alterations in body composition and fatigue that can be possibly reversed with physical activity. The aim of the present study was to evaluate whether the systematic practice of physical activity improves lower extremity muscle mass and fatigue perception in patients with scTox. MATERIALS AND METHODS: We studied 36 patients (2 men) with median age of 48.0 (43.0-51.0) years, body mass index of 27.4 (22.1-30.2) kg/m(2), thyrotropin <0.4 mU/L, and free thyroxine between 0.8 and 1.9 ng/dL and 48 control subjects (C group; 7 men). Patients were randomly divided in two groups according to the adherence to the exercise training: scTox-Tr (n = 19)-patients who adhered to the exercise intervention and scTox-Sed (n = 17)--patients who did not adhere to it. The C group did not participate in the randomization. The exercise training was supervised by a physical education instructor, and it was composed of 60 minutes of aerobic activity and stretching exercises, twice a week, during 12 weeks. In both groups, body composition was assessed (anthropometric method), and the Chalder Fatigue Scale was determined at baseline and after 3 months of intervention (scTox-Tr group) or observation (scTox-Sed group). RESULTS: At baseline, patients with scTox had lower muscle mass and mid-thigh girth and more fatigue on the Chalder Fatigue Scale than euthyroid control subjects. The scTox-Tr group had an increase in muscle mass, reduction in the variables reflecting whole body fat, and lesser perception of fatigue during the exercise training period (p ≤ 0.05 for these parameters at the start and end of the exercise training period). CONCLUSIONS: scTox is associated with lower muscle mass and mid-thigh girth and more fatigue. Physical activity training can partially ameliorate these characteristics. More studies are needed to determine what training program would be optimum, both in terms of beneficial effects and for avoiding potential adverse responses.

Female athlete triad in elite swimmers of the city of Rio de Janeiro, Brazil.

OBJECTIVE: Female athlete triad (FAT) is a syndrome characterized by the simultaneous presence of disordered eating, amenorrhea, and osteopenia or osteoporosis. The aim of this study was to assess the prevalence of FAT in adolescent elite women swimmers. METHODS: The sample was composed of 78 athletes in the age range of 11-19 y from Rio de Janeiro (Brazil). The presence of disordered eating was assessed through three questionnaires (Eating Attitudes Test, Bulimic Investigatory Test Edinburgh, and Body Shape Questionnaire); the presence of menstrual dysfunctions, through a validated questionnaire; and bone dysfunctions, through assessment of bone mineral density by applying the method of dual-energy X-ray absorptiometry. The t test was used to compare means. The chi-square test was used to evaluate the association among categorical variables (P < 0.05). Pearson's coefficients of simple linear correlation between the variables of lean body mass and body mineral density at the spine (L1-L4) and overall in the body were calculated. Kaplan-Meier survival curves to estimate mean menarche age were obtained. All analyses were conducted in SPSS 13.0. RESULTS: The athletes' mean age at menarche was 12.38 +/- 0.2 y. It was verified that 44.9%, 19.2%, and 15.4% of the athletes met the criteria for disordered eating, menstrual irregularity, and low bone mass, respectively. Among participants, 47.4% (37 of 78) met one criterion of FAT, 15.4% (12 of 78) met two criteria, and 1.3% (1 of 78) met all three criteria, corresponding with the development of the syndrome. Only 35.9% (28 of 78) of the athletes did not present positive results for any of the criteria assessed. CONCLUSION: The prevalence of FAT was low. However, a significant number of athletes presented a partial status of FAT, especially of disordered eating. The present study suggests the need to monitor the causes of these disorders to create preventive actions that will reverse or avoid the development of the syndrome, thus preserving the athletes' health.

Exercise performance in young and middle-aged female patients with subclinical hyperthyroidism.

Subclinical hyperthyroidism (SH) may be responsible for many cardiovascular changes, including an impaired exercise performance. The aim of our study was to evaluate the response to the treadmill cardiopulmonary test in patients with SH. We studied 14 female patients from our endocrine clinic with exogenous SH, free from cardiovascular diseases, with mean age of 38.6 +/- 10.2 years, body mass index (BMI) of 24.4 +/- 4.0 kg/m(2), and disease duration of 4.9 +/- 4.9 years. The mean serum thyrotropin (TSH) was 0.03 +/- 0.03 mU/L, serum free thyroxine (FT(4)), 1.72 +/- 0.21 ng/dL, and serum triiodothyronine level, 137 +/- 32 ng/dL. The control group comprised 15 euthyroid, healthy women, with mean age of 35.4 +/- 7.4 years and BMI of 27.3 +/- 5.9 kg/m(2). Both groups had a sedentary lifestyle and underwent the cardiopulmonary test using a treadmill with the Balke protocol. Gas concentrations and the respiratory outflow were measured and the electrocardiogram (ECG) was registered in real time. We calculated the minute ventilation (V(E)), the oxygen consumption (peak VO(2)), the carbonic gas exhalation (peak VCO(2)) and the anaerobic threshold (AT). The heart rate (HR) at rest (90.9 +/- 15.7 versus 78.9 +/- 8.7 beats per minute; p = 0.03) was higher in the patients from our clinic. There was no difference between groups regarding age, BMI, fat percentage, blood pressure, peak HR, exercise duration, mean treadmill peak inclination, V(E), peak VO(2), peak VCO(2), and AT. There was no correlation between peak VO(2) and FT(4), TSH, or disease duration. Our results show that exercise capacity in young and middle-aged female patients is not significantly affected by exogenous SH.

[Bulimic behaviours in female adolescent endurance runners]. / Comportamentos bulímicos em atletas adolescentes corredoras de fundo.

OBJECTIVE: The aim of the present work is to evaluate bulimic behaviors among female adolescent endurance runners. METHODS: From a total of 40 athletes affiliated to the Track and Field Federation of Rio de Janeiro, 17 female teenager endurance runners (age: 16+/-1,8 years) were examined. The instrument used to investigate bulimic behavior and its gravity was BITE (Bulimic Investigatory of Edinburg). RESULTS: The results showed that 35,6% of the athletes (6 of them) had scores above the limit of normality (=10) 29,4% (4 of them) showed a non-usual pattern (between 10 and 19). It was found one case with score above 20 indicating a problem. With respect to the seriousness, values above 5 in the scale BITE are considered significant and a case of this type was found in the analyzed sample. CONCLUSION: Since some non-usual pattern were found and also in at least one case a major problem was indicated by the high score it was concluded that more studies are necessary, and also the development of an index to gauge the gravity of the problem in order to make in time preventive measures.