Cut-Off Points of Visceral Adipose Tissue Associated with Metabolic Syndrome in Military Men.

Visceral adipose tissue (VAT) has high metabolic activity and secretes a larger number of adipokines that are related to the inflammatory process. Quantifying VAT could estimate the risk of developing Metabolic Syndrome (MetS). This study was designed to determine the VAT cut-off points assessed by DXA associated with MetS in military men. In total, 270 (37.5 ± 6.9 years) military men from the Brazilian Army (BA) participated in the study. Anthropometric measurements, assessment of body composition by dual X-ray absorptiometry (DXA), hemodynamics and biochemical tests were performed. The Student's t test, independent samples, Person's correlation, ROC curve, Youden Index and positive (PPV) and negative predictive value (NPV) were used. The MetS prevalence was 27.4%, which means that 74 (38.0 ± 7.3 years) military men had at least three risk factors of MetS present. The cutoff point of VAT with the highest balance between sensitivity (77.0%) and specificity (69.9%) was 1025.0 cm3 (1086.0 g). An area on the ROC curve was 0.801 (p < 0.000), which was very good precision. VAT ≥ 1025.0 cm3 (1086.0 g) is associated with the risk factors of MetS and is, therefore, a predictor of the disease with good indicators of sensitivity and specificity and a robust indicator of MetS.

Influência de um método de treinamento físico militar sobre marcadores indiretos de dano muscular / Influence of a military physical training method on indirect markers of muscle damage

O Exército Brasileiro (EB) desenvolveu recentemente o método de treinamento físico militar Cross Operacional (CO), caracterizado por exercícios combinados aeróbios e resistidos de moderada/alta intensidade. O caráter de moderada/alta intensidade do CO pode levar ao comprometimento das fibras musculares, aumentando o risco de lesão e exacerbação de uma resposta inflamatória aguda. Nesse contexto, a análise de marcadores indiretos de dano muscular pode ser utilizada para avaliação do nível de intensidade do CO e recuperação pós-exercício. O objetivo desse estudo foi observar o efeito agudo do CO sobre os marcadores indiretos de dano muscular em militares do EB. Vinte e quatro militares voluntários, do sexo masculino, com idade média de 20,8 ± 1,8 anos participaram desse estudo. As quatro sessões correspondentes aos níveis do CO foram executadas conforme delineamento cruzado, com washout de sete dias, e as amostras sanguíneas foram coletadas no repouso, imediatamente após, 24 e 48 horas após as sessões de CO. Os marcadores dosados nas amostras foram creatinoquinase (CK), lactato desidrogenase (LDH), aspartato aminotransferase (AST), mioglobina (Mb), lactato (Lac), proteína C reativa (PCR) e haptoglobina (Hp). Em todos os níveis do CO, a CK teve um aumento significativo após 24 horas e o Lac, a LDH e a Mb no momento imediatamente após o CO. Já a AST teve aumento significativo nos níveis 2, 3 e 4, com pico de concentração após 24 horas. Os níveis séricos de PCR aumentaram apenas no momento 24 horas do nível 4 e a Hp após 48 horas do nível 3 do CO. O presente estudo demonstrou que o CO foi capaz de alterar os marcadores indiretos de dano muscular. Todavia, após 48 horas de repouso, os marcadores indiretos de dano muscular apresentaram redução, indicando um processo de recuperação. Apesar das elevações nos marcadores musculares indicadores de dano, a ausência de alterações conclusivas nos níveis séricos das proteínas inflamatórias de fase aguda sugere que o CO pode não ter uma duração ou intensidade suficiente para induzir uma resposta inflamatória sistêmica substancial

The Brazilian Army (EB) recently developed a military physical training method called Cross Operational (CO), which contains combined aerobic and resistance exercises at moderate / high intensity. The moderate / high intensity character of CO can cause impairment of muscle fibers, increasing risk of injury and exacerbation of an acute inflammatory response. In this context, analysis of indirect markers of muscle damage can be used to assess the level of intensity of CO and post-exercise recovery. The aim of this study was to observe the acute effect of CO on indirect markers of muscle damage in military personnel of EB. Twenty-four volunteers, military, male, 20,8 ± 1,8 years old participated in this study. The four sessions corresponding to the CO levels were performed according to a crossover design, with a seven-day washout and the blood samples were collected at rest, after 24 hours and 48 hours after CO sessions. The markers measured in the samples were creatinekinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), myoglobin (Mb), lactate (Lac), C-reactive protein (PCR) and haptoglobin (Hp). At all levels of CO, CK had a significant increase after 24 hours and Lac, LDH and Mb increased at the moment immediately after CO. AST had a significant increase in levels 2, 3 and 4 and a peak of concentration after 24 hours. The PCR levels increased only at the 24-hour moment after level 4 and Hp after 48 hours of level 3 of CO. This study demonstrates that CO was able to change the indirect markers of muscle damage. However, after 48 hours of rest, indirect markers of muscle damage were reduced, indicating a recovery process. Despite the elevations in muscle markers indicating damage, the absence of conclusive changes in the levels of the acute phase inflammatory proteins suggests that CO may not have sufficient duration or intensity to induce a substantial systemic inflammatory response

Effect of apoptotic cell recognition on macrophage polarization and mycobacterial persistence.

Intracellular Mycobacterium leprae infection modifies host macrophage programming, creating a protective niche for bacterial survival. The milieu regulating cellular apoptosis in the tissue plays an important role in defining susceptible and/or resistant phenotypes. A higher density of apoptotic cells has been demonstrated in paucibacillary leprosy lesions than in multibacillary ones. However, the effect of apoptotic cell removal on M. leprae-stimulated cells has yet to be fully elucidated. In this study, we investigated whether apoptotic cell removal (efferocytosis) induces different phenotypes in proinflammatory (Mϕ1) and anti-inflammatory (Mϕ2) macrophages in the presence of M. leprae. We stimulated Mϕ1 and Mϕ2 cells with M. leprae in the presence or absence of apoptotic cells and subsequently evaluated the M. leprae uptake, cell phenotype, and cytokine pattern in the supernatants. In the presence of M. leprae and apoptotic cells, Mϕ1 macrophages changed their phenotype to resemble the Mϕ2 phenotype, displaying increased CD163 and SRA-I expression as well as higher phagocytic capacity. Efferocytosis increased M. leprae survival in Mϕ1 cells, accompanied by reduced interleukin-15 (IL-15) and IL-6 levels and increased transforming growth factor beta (TGF-ß) and IL-10 secretion. Mϕ1 cells primed with M. leprae in the presence of apoptotic cells induced the secretion of Th2 cytokines IL-4 and IL-13 in autologous T cells compared with cultures stimulated with M. leprae or apoptotic cells alone. Efferocytosis did not alter the Mϕ2 cell phenotype or cytokine secretion profile, except for TGF-ß. Based on these data, we suggest that, in paucibacillary leprosy patients, efferocytosis contributes to mycobacterial persistence by increasing the Mϕ2 population and sustaining the infection.