Serum 25-hydroxyvitamin D concentrations in 16-year-old Icelandic adolescent and its association with bone mineral density.

OBJECTIVE: The aim of the study was to assess the potential association between serum 25-hydroxyvitamin D (25(OH)D) and whole-body bone mineral density (BMD) among 16-year-old adolescents and to study the prevalence of 25(OH)D insufficiency, defined as concentration under 50 nmol/l. DESIGN: A cross-sectional study. SETTING: Reykjavik, Iceland, latitude 64°08'N. Measurements took place in the Icelandic Heart Association's research lab during April-June 2015. PARTICIPANTS: In total, 411 students in Reykjavik, Iceland, were invited to participate, 315 accepted the invitation (76·6 %) and 289 had valid data (mainly Caucasian). RESULTS: 25(OH)D < 50 nmol/l was observed in 70 % of girls and 66·7 % of boys. 25(OH)D ≥ 50 nmol/l was significantly associated with higher whole-body BMD after adjusting for the influence of sex, height, fat mass and lean mass. A linear relationship between 25(OH)D and whole-body BMD was significant for 25(OH)D < 50 nmol/l (n 199, P < 0·05) but NS for 25(OH)D ≥ 50 nmol/l (n 86, P = 0·48). CONCLUSIONS: Our results are in line with some but not all previous studies on the relationship between BMD and 25(OH)D in adolescents. The observed difference in BMD between those with above v. below a 25(OH)D concentration of 50 nmol/l was of about a fifth of one SD, which may have a clinical relevance as one SD decrease in volumetric BMD has been associated with a 89 % increase in 2 years risk of fracture. Icelandic adolescents should be encouraged to increase their vitamin D intake as it is possible that their current intake is insufficient to achieve optimal peak bone mass.

Combined aerobic and resistance training improves physical capacity in women treated for gynecological cancer.

PURPOSE: The purpose of this study was to evaluate the effects of 16 weeks combined aerobic and resistance training, twice a week, on the physical performance in women treated for gynecological cancer. METHODS: Sixty women (56.9 ± 13.3 years) who had completed curative treatment for gynecological cancer were divided into two groups: a physical training group (PT) (n = 29) or a control group (C) (n = 31). The PT group performed two sessions of combined aerobic and resistance training weekly for 16 weeks. Peak oxygen consumption (V̇O2peak) and one repetition maximum (1RM) of leg press, leg extension, and chest press were measured before group assignment, after 16 weeks and at the 1-year follow-up. RESULTS: A significant increase in V̇O2peak (ml min-1 kg-1) (29.7 ± 8.0 vs. 31.3 ± 8.3, p = .009), leg press (kg) (113.0 ± 27.3 vs. 116.7 ± 29.2, p = .047), leg extension (kg) (44.2 ± 10.1 vs. 48.0 ± 10.6, p < .001), and chest press (kg) (24.5 ± 7.5 vs. 26.9 ± 8.2, p = .001) was seen in the PT group from pre- to post-measurement. The PT group maintained the improved aerobic condition and muscle strength 1 year after the training intervention. In the C group, there were no significant differences between pre- and post-measurements, but a significant decrease (28.2 ± 7.5 vs. 27.0 ± 7.3, p = .040) in the V̇O2peak from post to 1-year follow-up measurements. CONCLUSIONS: Combined aerobic and resistance training twice a week in 16 weeks improves V̇O2peak and maximal strength in women treated for gynecological cancer. The training effects were sustained after 1 year in the PT group.

Helicobacter pylori infection in Icelandic children.

OBJECTIVE: The prevalence of Helicobacter pylori (HP) infection is decreasing in the western world. The seroprevalence among 25-50-year-old Icelandic adults was recently shown to be 30-40%. Information on the seroprevalence in Nordic children is limited. We aimed at ascertaining the infection prevalence among healthy Icelandic children. METHODS: The infection status in stored frozen blood samples from two cross-sectional studies on the health of 7-9-year-old children (n = 125) and 16-18-year-old adolescents (n = 80) was determined by enzyme-linked immunosorbent assay (ELISA). Information on family demographics and GI symptoms was obtained by standardized questionnaires. RESULTS: Overall, 3.4% (7/205) of the children were infected with H. pylori. The prevalence was 2.6% (5/190), missing data n = 3, among children with both parents born in a low prevalence country compared to 17% (2/12) among those with at least one parent born in a high prevalence area (p = .026). When at least one parent was born in a high prevalence country, the odds ratio for being H. pylori seropositive was 2.2 (95% CI, 1.02-54.67), when adjusted for the educational status of the mother. There was no significant association between H. pylori infection and gastrointestinal symptoms. CONCLUSION: Prevalence of H. pylori infection in Iceland has become very low, suggesting a great reduction in transmission from older generations. There was an association between H. pylori infection and origin from high prevalence areas but not with gastrointestinal symptoms. The results mirror recent studies of children of Scandinavian ancestry.

Tracking of overweight from early childhood to adolescence in cohorts born 1988 and 1994: overweight in a high birth weight population.

OBJECTIVE: To investigate the prevalence and tracking of overweight and obesity in childhood cohorts born 1988 and 1994 in a population of high birth weight. SUBJECTS: Icelandic cohorts born in 1988 and 1994. MATERIALS AND METHODS: Out of 1328, 9- and 15-year-old children from 18 randomly selected schools all over Iceland, 934 participated (71%). Height and mass were measured by the investigators. Also, height and mass at birth, and at age 2.5, 6, 9, and 12 years, were collected from maternity wards and school health registers. RESULTS: The prevalence of overweight children ranged from 10.1% for 2.5-year-olds to 18.7% for 9-year-olds. No difference was observed between the two cohorts or sex. The prevalence of obesity in the 1994 cohort (4.3%) was significantly higher (P = 0.01) at age 6 years, compared to the 1988 cohort (1.1%). The children who were overweight at age 2.5 years were more likely to be overweight at age 6 (OR=12.2) and 9 years (OR=4.9), but not significantly at age 12 or 15 years, compared with normal weight 2.5-year-olds. Overweight children at age 6 or 9 years were much more likely (OR 10.4 and OR 18.6, respectively) to be overweight at age 15 years compared to their normal weight peers. Of overweight 6-year-olds, 51% were overweight at 15 years, and were about one-third of all overweight children at that age. The children that weighed above the 85th percentile at birth were more likely than the other children to be overweight at the age of 6 years (OR = 1.8), 9 years (OR = 2.1), and 15 (OR = 2.0) years. CONCLUSION: The results show high prevalence of overweight and obesity even before the start of compulsory schooling. Approximately, 51% of overweight 6-year-olds were still overweight after puberty. Therefore, preschool overweight prevention, along with prevention at school age, seems to be of uttermost importance.

Cross-reinnervation changes the expression patterns of the monocarboxylate transporters 1 and 4: An experimental study in slow and fast rat skeletal muscle.

The monocarboxylate transporters 1 and 4 are expressed in brain as well as in skeletal muscle and play important roles in the energy metabolism of both tissues. In brain, monocarboxylate transporter 1 occurs in astrocytes, ependymocytes, and endothelial cells while monocarboxylate transporter 4 appears to be restricted to astrocytes. In muscle, monocarboxylate transporter 1 is enriched in oxidative muscle fibers whereas monocarboxylate transporter 4 is expressed in all fibers, with the lowest levels in oxidative fiber types. The mechanisms regulating monocarboxylate transporter 1 and monocarboxylate transporter 4 expression are not known. We hypothesized that the expression of these transporters would be sensitive to long term changes in metabolic activity level. This hypothesis can be tested in rat skeletal muscle, where permanent changes in activity level can be induced by cross-reinnervation. We transplanted motor axons originally innervating the fast-twitch extensor digitorum longus muscle to the slow-twitch soleus muscle and vice versa. Four months later, microscopic analysis revealed transformation of muscle fiber types in the cross-reinnervated muscles. Western blot analysis showed that monocarboxylate transporter 1 was increased by 140% in extensor digitorum longus muscle and decreased by 30% in soleus muscle after cross-reinnervation. In contrast, cross-reinnervation induced a 62% decrease of monocarboxylate transporter 4 in extensor digitorum longus muscle and a 1300% increase in soleus muscle. Our findings show that cross-reinnervation causes pronounced changes in the expression levels of monocarboxylate transporter 1 and monocarboxylate transporter 4, probably as a direct consequence of the new pattern of nerve impulses. The data indicate that the mode of innervation dictates the expression of monocarboxylate transporter proteins in the target cells and that the change in monocarboxylate transporter isoform profile is an integral part of the muscle fiber transformation that occurs after cross-reinnervation. Our findings support the hypothesis that the expression of monocarboxylate transporter 1 and monocarboxylate transporter 4 in excitable tissues is regulated by activity.

Upregulation of the cardiac monocarboxylate transporter MCT1 in a rat model of congestive heart failure.

BACKGROUND: Cardiac metabolism becomes more dependent on carbohydrates in congestive heart failure (CHF), and lactate may be used as an important respiratory substrate. Monocarboxylate transporter 1 (MCT1) promotes cotransport of lactate and protons into and out of heart cells and conceivably flux of lactate between cells, because it is abundantly present in the intercalated disk. METHODS AND RESULTS: Six weeks after induction of myocardial infarction (MI) in Wistar rats, left ventricular end-diastolic pressures were >15 mm Hg, signifying CHF. MCT1 and connexin43 protein levels in CHF were 260% and 20%, respectively, of those in sham-operated animals (Sham), and the corresponding mRNA signals were 181% and not significantly changed, respectively. Confocal laserscan immunohistochemistry and quantitative immunogold cytochemistry showed that MCT1 density was much higher in CHF than in Sham both at the surface membrane and in the intercalated disk. In CHF, a novel intracellular pool of MCT1 appeared to be associated with cisternae, some close to the T tubules. In contrast, connexin43 particles, seen exclusively at gap junctions, were substantially fewer. Maximum lactate uptake was 107+/-15 mmol. L(-1). min(-1) in CHF and 42+/-6 mmol. L(-1). min(-1) in Sham cells (P<0.05). The K(m) values were between 7 and 9 mmol/L (P=NS). CONCLUSIONS: In cardiomyocytes from CHF rats, (1) the amount of functional MCT1 in the sarcolemma, including in the intercalated disk, is increased several-fold; (2) a new intracellular pool of MCT1 appears; (3) another disk protein, connexin43, is much reduced; and (4) increased reliance on lactate and other monocarboxylates (eg, pyruvate) could provide tight metabolic control of high-energy phosphates.

Cellular and subcellular expression of monocarboxylate transporters in the pigment epithelium and retina of the rat.

The cellular and subcellular expression of the monocarboxylate transporters MCT1, MCT2 and MCT4 [corresponding to MCT3 of Price N. T. et al. (1998) Biochem. J. 329, 321-328] were investigated in the pigment epithelium and outer retina of rats. Immunofluorescence and postembedding immunogold analyses revealed strong MCT1 labelling in the apical membrane of the pigment epithelial and no detectable signal in the basolateral membrane. In contrast, antibodies to the glucose transporter GLUT1 produced intense labelling in both membranes. Neither MCT1 nor GLUT1 was enriched in intracellular compartments. The monocarboxylate transporter MCT4 was very weakly expressed in the retinal pigment epithelium of adult animals, but occurred at higher concentrations at this site in 14-day-old rats. However, even at the latter stage, the immunolabelling of MCT4 was weak compared to that of MCT1. In the neural retina, the data were consistent with a predominant glial localization of MCT1. Specifically, immunogold particles signalling MCT1 occurred in Müller cell microvilli and in the velate processes between the photoreceptors. No labelling was obtained with antibodies to MCT2. Taken together with previous biochemical analyses, the present findings indicate that MCT1 is involved in the outward transport of lactate through the retinal pigment epithelial cells, and in the transfer of lactate between Müller cells and photoreceptors.

Electrical stimulation induces fiber type-specific translocation of GLUT-4 to T tubules in skeletal muscle.

Insulin and contraction independently stimulate glucose transport in skeletal muscle. Whereas insulin activates glucose transport more in muscles composed of type I and IIa fibers, electrical stimulation increases glucose transport at least as much in type IIb fiber-enriched muscles despite the fact that the latter fiber type contains less GLUT-4 glucose transporters. The aim of the present study was to test the hypothesis that a greater GLUT-4 translocation to the cell surface may underlie the higher contraction-stimulated glucose transport in type IIb myofibers. Leg muscles from rats were stimulated in situ at 100 Hz (200 ms) each 2 s via the sciatic nerve over a period of 20 min while the contralateral leg was kept at rest. Muscle 2-[3H]deoxy-D-glucose uptake (2-DG) was measured in separated red gastrocnemius (RG, type I and IIa fibers) and white gastrocnemius (WG, type IIb fibers) muscles. Resting 2-DG uptake was greater in RG than WG. Electrical stimulation increased 2-DG uptake over resting values similarly in WG and RG. Fractions enriched with either plasma membranes, transverse (T) tubules, triads, or GLUT-4-enriched intracellular membranes were isolated from RG and WG using a recently developed subcellular fractionation procedure. Electrical stimulation similarly increased GLUT-4 protein content in plasma membranes of RG and WG, whereas it stimulated GLUT-4 translocation more (approximately 50%) in T tubules of WG than in RG. GLUT-4 content was not changed in triads of both muscle types. The increments in cell surface GLUT-4 protein levels were paralleled by significant reductions in the amount of the transporter in the intracellular membrane fractions of both muscle types (by 60% in RG and 56% in WG). It is concluded that electrically induced contraction stimulates GLUT-4 translocation more in T tubules of WG than RG. The physiological implications of this finding for glucose uptake by contracting RG and WG muscles is discussed.

Cellular and subcellular expression of the monocarboxylate transporter MCT1 in rat heart. A high-resolution immunogold analysis.

An antibody to the C-terminus of the monocarboxylate transporter MCT1 was used to study the precise cellular and subcellular distribution of this transporter in rat heart. Postembedding immunogold procedures revealed that the labeling in the heart was restricted to cardiomyocytes and concentrated along the plasma membrane, including the transverse tubules. Gold particles occurred with highest densities in intercalated disks, where they avoided desmosomes and gap junctions. Labeling was also associated with plasmalemmal invaginations having ultrastructural features typical of caveolae. Internal membrane compartments were unlabeled. Quantitative analyses following postembedding labeling showed that the distribution of gold particles across the plasma membrane was nearly symmetrical, indicating that the C-terminus of the transporter is situated very close to the cell membrane. In preembedding immunogold experiments, the gold particles were localized at the external aspect of the plasma membrane, suggesting that the C-terminus is extracellular. From the present data, it can be concluded that even under basal conditions the majority of the MCT1 molecules in heart is present in the myocyte plasma membrane, implying that there is a constitutive functional expression of this transporter. It follows that the increased transmembrane flux of lactate during exercise or in pathological conditions such as ischemia must be a result of altered substrate gradients rather than of translocation of MCT1 molecules to the plasma membrane.

Effect of overexpressing GLUT-1 and GLUT-4 on insulin- and contraction-stimulated glucose transport in muscle.

To examine the effects of GLUT-1 on GLUT-4-dependent, insulin-stimulated, and contraction-stimulated 2-deoxy-D-glucose (2-DG) transport, we overexpressed GLUT-1 in metabolically heterogeneous skeletal muscles [red and white tibialis anterior (TA) and extensor digitorum longus (EDL)] via 7 days of chronic electrical stimulation. GLUT-1 was increased 1.6- to 16.4-fold (P < 0.05). Basal 2-DG transport was increased 1.7- to 3.0-fold (P < 0.05) and was equal to (red TA and EDL; P > 0.05) or exceeded insulin-stimulated 2-DG transport by 50% (white TA; P < 0.05) in the control muscles. GLUT-4 was concomitantly overexpressed (2.1- to 4.4-fold; P < 0.05). Insulin-stimulated 2-DG transport was increased 1.6- to 2.5-fold (P < 0.05). During muscle contractions, 2-DG transport increased 9- to 12-fold (P < 0.05) in control muscles, but this was reduced by approximately 25% (P < 0.05) in muscles overexpressing GLUT-1 and GLUT-4 (red TA and EDL). In contrast, in the experiment, white TA contraction-stimulated 2-DG transport was increased 1.7-fold (P < 0.05). Therefore, overexpression of GLUT-1, when GLUT-4 is also overexpressed, does not impair insulin-stimulated 2-DG transport, although contraction-stimulated transport may be reduced in some muscles.

Effect of electrical stimulation patterns on glucose transport in rat muscles.

Transport of 2-[3H]deoxy-D-glucose (2-DG) was investigated during supramaximal stimulations of different muscles. In addition, we varied the net stimulation time (NST). In different treatments, NST occupied either 5, 7.5, 10, 15, 20, 30, or 50% of a 20-min stimulation period. After a bolus injection of 3H-labeled 2-DG, the greatest transport occurred in the extensor digitorum longus. In red gastrocnemius (RG; type IIa fibers) and white gastrocnemius (WG; type IIb fibers), the 2-DG transport rate was highest at 10% NST (8- to 12-fold increase) and decreased thereafter. In soleus (type I fibers), the 2-DG transport increased from 5 to 50% NST. Below 30% NST, 2-DG transport was greater in RG and WG muscles than in soleus (P < 0.05). GLUT-4 and 2-DG transport were not correlated during the contractions. Therefore, the percent NST affects 2-DG transport differentially in muscles of varying fiber types, and the transport rate is not related to the GLUT-4 content of the muscles.

Effect of cross-reinnervation on the expression of GLUT-4 and GLUT-1 in slow and fast rat muscles.

We determined whether the twitch-velocity phenotype or the metabolic phenotype of a muscle influences the content of GLUT-4 and GLUT-1 proteins. The soleus (Sol) and extensor digitorum longus (EDL) muscles were cross-reinnervated (X-Sol, X-EDL). After 3 mo the X-EDL had become enriched in slow-twitch oxidative (SO) fibers (70.5% SO) compared with its control (3.8% SO), whereas the X-Sol became enriched in fast-twitch oxidative-glycolytic (FOG) fibers (78.6% FOG) compared with its control (10% FOG). Thus the twitch phenotype of X-Sol shifted to fast-twitch muscle, whereas X-EDL shifted to a slow-twitch muscle. In the X-EDL, the oxidative nature of the X-EDL was increased to 97% oxidative fibers compared with 43% oxidative fibers in the normal EDL. In the Sol the oxidative nature of the X-Sol was retained at 100%. GLUT-4 content was increased 1.6-fold in the X-EDL (P < 0.05) but was not changed in the X-Sol (P > 0.05). GLUT-1 content was increased fourfold in X-EDL but was not altered in the X-Sol. We conclude that GLUT-4 and GLUT-1 content in muscle is related to the oxidative phenotype of the muscle rather than the twitch-velocity phenotype.

Soccer injuries in Iceland.

We investigated the frequency, cause and location of injuries in Icelandic elite soccer in 1991. The incidence of injuries for the individual player was 34.8 +/- 5.7 per 1000 game-hours and 5.9 +/- 1.1 per 1000 practice-hours. The most common types of injuries were muscle strains (29%), ligament sprains (22%), contusions (20%), and other injuries (29%). The frequency of reinjury was markedly high, where 44% of the strains and 58% of the sprains were registered as reinjuries. Strains occurred mainly during sprinting, sprains by tackling, and contusion during other contact. Significantly more injuries occurred on artificial turf than on grass or gravel in correlation to number of hours in games and practices. Teams who had the longest pre-season preparation period obtained significantly fewer injuries during the season.