Matrix Metalloproteinases and Their Inhibitors as Potential Prognostic Biomarkers in Head and Neck Cancer after Radiotherapy.

Head and neck cancer (HNC) is among the ten most frequent tumours, with 5-year survival rates varying from 30% to 70% depending on the stage and location of the tumour. HNC is traditionally known as head and neck squamous cell carcinoma (HNSCC), since 90% arises from epithelial cells. Metastasis remains a major cause of mortality in patients with HNSCC. HNSCC patients with metastatic disease have an extremely poor prognosis with a survival rate of less than a year. Matrix metalloproteinases (MMPs) have been described as biomarkers that promote cell migration and invasion. Radiotherapy is widely used to treat HNSCC, being a determining factor in the alteration of the tumour's biology and microenvironment. This review focuses on analysing the current state of the scientific literature on this topic. Although few studies have focused on the role of these proteinases in HNC, some authors have concluded that radiotherapy alters the behaviour of MMPs and tissue inhibitors of metalloproteinases (TIMPs). Therefore, more research is needed to understand the roles played by MMPs and their inhibitors (TIMPs) as prognostic biomarkers in patients with HNC and their involvement in the response to radiotherapy.

Reducción de marcadores de disfunción endotelial mediante ejercicio en adultos sedentarios con lesión medular crónica / Reduction of exercise-mediated endothelial dysfunction markers in sedentary adults with chronic spinal cord injury

Fundamento y objetivo: La morbimortalidad cardiovascular se ha incrementado entre las personas con lesión medular crónica (LMC). Se planteó como objetivo determinar el efecto del ejercicio sobre marcadores de disfunción endotelial en adultos sedentarios con LMC. Método: Estudio prospectivo aleatorizado en 17 adultos varones con LMC a nivel o debajo de T5. Nueve de ellos realizaron un programa supervisado de ejercicios en ergómetro de manivela a intensidad moderada (12 semanas, 3 sesiones/semana). Se determinaron mediante enzimoinmunoanálisis los valores plasmáticos de endotelina-1, fracción soluble de la molécula de adhesión celular vascular tipo-1, y fracción soluble de la molécula de adhesión intercelular tipo-1 (sICAM-1), antes y después del programa de ejercicio. La capacidad aeróbica y el porcentaje de masa grasa también fueron evaluados. Resultados: Tras completar el programa de entrenamiento, tanto en el estudio comparativo como en el estudio antes-después, se observó una disminución significativa de los valores de endotelina-1 y fracción soluble de la molécula de adhesión intercelular tipo-1. Asimismo, se observó una mejora estadísticamente significativa de la capacidad aeróbica y la composición corporal. Conclusión: El ejercicio mejoró la disfunción endotelial en varones adultos con LMC (AU)

Background and objective: Recent studies have found increased markers of endothelial activation in men with chronic spinal cord injury. This study was conducted to determine the effects of arm-cranking exercise on endothelial dysfunction in male adults with chronic SCI. Method: A prospective randomized study of 17 sedentary adult males with chronic SCI at or under T5 level. Nine performed a supervised exercise program at a moderate intensity (arm-cranking: 12 weeks, 3 sessions/week). Plasma levels of endothelin-1, soluble intercellular adhesion molecule type 1 (sICAM-1), and soluble vascular adhesion molecule type 1 (sVCAM-1) were assessed by ELISA. Outcome measurements also included physical fitness and total body fat mass percentage. Results: We observed both in the randomized and in the before-after studies a significant reduction of the levels of endothelin-1 and sICAM-1. Furthermore, significant improvements of both physical fitness and body composition were also found. Conclusion: Arm-cranking exercise improved endothelial dysfunction in adult males with chronic SCI. Long-term studies are still required to determine whether the correction of endothelial dysfunction improves the clinical outcomes of adults with chronic SCI (AU)

[Reduction of exercise-mediated endothelial dysfunction markers in sedentary adults with chronic spinal cord injury]. / Reducción de marcadores de disfunción endotelial mediante ejercicio en adultos sedentarios con lesión medular crónica.

BACKGROUND AND OBJECTIVE: Recent studies have found increased markers of endothelial activation in men with chronic spinal cord injury. This study was conducted to determine the effects of arm-cranking exercise on endothelial dysfunction in male adults with chronic SCI. METHOD: A prospective randomized study of 17 sedentary adult males with chronic SCI at or under T5 level. Nine performed a supervised exercise program at a moderate intensity (arm-cranking: 12 weeks, 3 sessions/week). Plasma levels of endothelin-1, soluble intercellular adhesion molecule type 1 (sICAM-1), and soluble vascular adhesion molecule type 1 (sVCAM-1) were assessed by ELISA. Outcome measurements also included physical fitness and total body fat mass percentage. RESULTS: We observed both in the randomized and in the before-after studies a significant reduction of the levels of endothelin-1 and sICAM-1. Furthermore, significant improvements of both physical fitness and body composition were also found. CONCLUSION: Arm-cranking exercise improved endothelial dysfunction in adult males with chronic SCI. Long-term studies are still required to determine whether the correction of endothelial dysfunction improves the clinical outcomes of adults with chronic SCI.

[Association between abdominal obesity and seminal oxidative damage in adults with metabolic syndrome]. / Asociación entre obesidad abdominal y daño oxidativo seminal en pacientes con síndrome metabólico.

BACKGROUND: Abdominal obesity, metabolic syndrome (MS) and oxidative stress may impair seminal quality leading to derangements in fertility. AIM: To identify an association between abdominal obesity and markers of seminal oxidative damage in adults with MS. MATERIAL AND METHODS: Seventy males aged 25 to 40 years, with MS according to ATP-III criteria volunteered for this cross-sectional study. The control group included 70 healthy and normal weight adults. Semen analysis included volume, sperm concentration, motility and normal morphologic features. Body mass index (BMI) and waist circumference (WC) were measured, fat mass was determined by bioelectrical impedance. RESULTS: Sperm concentration and the percentage of sperms with normal motility and morphology were significantly lower in adults with MS, when compared to their healthy normal weight counterparts. Seminal levels of malondialdehyde and 8-hydroxy-2'-deoxyguanosine were significantly higher among participants with MS. Significant correlations were found between WC and seminal markers of oxidative stress. CONCLUSIONS: Individuals with MS had an impaired seminal quality that may be explained, at least in part, by increased seminal oxidative damage.

A short-term arm-crank exercise program improved testosterone deficiency in adults with chronic spinal cord injury.

PURPOSE: To determine the influence of arm-crank exercise in reproductive hormone levels in adults with chronic SCI. Further objectives were to assess the influence of arm-crank exercise on muscle strength and body composition. MATERIALS AND METHODS: Seventeen male adults with complete SCI at or below the 5th thoracic level (T5) volunteered for this study. Participants were randomly allocated to the intervention (n = 9) or control group (n = 8) using a concealed method. The participants in the intervention group performed a 12-week arm-crank exercise program, 3 sessions/week, consisting of warming-up (10-15 min) followed by a main part in arm-crank (20-30 min [increasing 2 min and 30 seconds each three weeks]) at a moderate work intensity of 50-65% of heart rate reserve (HRR) (starting at 50% and increasing 5% each three weeks) and by a cooling-down period (5-10 min). Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone and estradiol were determined by ELISA. Muscle strength (handgrip) and body composition (waist circumference [WC]) were assessed. RESULTS: After the completion of the training program, testosterone level was significantly increased (p = 0.0166;d = 1.14). Furthermore, maximal handgrip and WC were significantly improved. Lastly, a significant inverse correlation was found between WC and testosterone (r =- 0.35; p = 0.0377). CONCLUSION: The arm-crank exercise improved reproductive hormone profile by increasing testosterone levels in adults with chronic SCI. A secondary finding was that it also significantly improved muscle strength and body composition in this group.

Asociación entre obesidad abdominal y daño oxidativo seminal en pacientes con síndrome metabólico / Association between abdominal obesity and seminal oxidative damage in adults with metabolic syndrome

Abdominal obesity, metabolic syndrome (MS) and oxidative stress may impair seminal quality leading to derangements in fertility. Aim: To identify an association between abdominal obesity and markers of seminal oxidative damage in adults with MS. Material and Methods: Seventy males aged 25 to 40 years, with MS according to ATP-III criteria volunteered for this cross-sectional study. The control group included 70 healthy and normal weight adults. Semen analysis included volume, sperm concentration, motility and normal morphologic features. Body mass index (BMI) and waist circumference (WC) were measured, fat mass was determined by bioelectrical impedance. Results: Sperm concentration and the percentage of sperms with normal motility and morphology were significantly lower in adults with MS, when compared to their healthy normal weight counterparts. Seminal levels of malondialdehyde and 8-hydroxy-2’-deoxyguanosine were significantly higher among participants with MS. Significant correlations were found between WC and seminal markers of oxidative stress. Conclusions: Individuals with MS had an impaired seminal quality that may be explained, at least in part, by increased seminal oxidative damage.

A short-term arm-crank exercise program improved testosterone deficiency in adults with chronic spinal cord injury

Purpose To determine the influence of arm-crank exercise in reproductive hormone levels in adults with chronic SCI. Further objectives were to assess the influence of arm-crank exercise on muscle strength and body composition. Materials and Methods Seventeen male adults with complete SCI at or below the 5th thoracic level (T5) volunteered for this study. Participants were randomly allocated to the intervention (n = 9) or control group (n = 8) using a concealed method. The participants in the intervention group performed a 12-week arm-crank exercise program, 3 sessions/week, consisting of warming-up (10-15 min) followed by a main part in arm-crank (20-30 min [increasing 2 min and 30 seconds each three weeks]) at a moderate work intensity of 50-65% of heart rate reserve (HRR) (starting at 50% and increasing 5% each three weeks) and by a cooling-down period (5-10 min). Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone and estradiol were determined by ELISA. Muscle strength (handgrip) and body composition (waist circumference [WC]) were assessed. Results After the completion of the training program, testosterone level was significantly increased (p = 0.0166;d = 1.14). Furthermore, maximal handgrip and WC were significantly improved. Lastly, a significant inverse correlation was found between WC and testosterone (r =- 0.35; p = 0.0377). Conclusion The arm-crank exercise improved reproductive hormone profile by increasing testosterone levels in adults with chronic SCI. A secondary finding was that it also significantly improved muscle strength and body composition in this group. .

Low-grade systemic inflammation and leptin levels were improved by arm cranking exercise in adults with chronic spinal cord injury.

OBJECTIVE: To ascertain the effect of arm cranking exercise on improving plasma levels of inflammatory cytokines and adipokines in untrained adults with chronic spinal cord injury (SCI). DESIGN: Longitudinal study. SETTING: Community-based supervised intervention. PARTICIPANTS: Men (N=17) with complete SCI at or below T5 volunteered for this study. Participants were randomly allocated to the intervention (n=9) or control group (n=8) using a concealed method. INTERVENTION: A 12-week arm cranking exercise program of 3 sessions per week consisted of warm-up (10-15min), arm crank (20-30min; increasing 2min and 30s every 3wk) at a moderate work intensity of 50% to 65% of heart rate reserve (starting at 50% and increasing 5% every 3wk), and cool-down (5-10min). MAIN OUTCOME MEASURES: Plasma levels of leptin, adiponectin, plasminogen activator inhibitor-1, tumor necrosis factor-alpha, and interleukin-6 were determined. Furthermore, physical fitness (maximum oxygen consumption [V˙O2max]) and body composition (anthropometric index, waist circumference, and body mass index) were also assessed. RESULTS: Plasma levels of leptin, tumor necrosis factor-alpha, and interleukin-6 were significantly decreased after the completion of the training program. Similarly, the anthropometric index and waist circumference were diminished too. A moderate correlation was found between leptin and the anthropometric index. Finally, V˙O2max was significantly increased, suggesting an improvement of physical fitness in the intervention group. No changes were found in the control group. CONCLUSIONS: Arm cranking exercise improved low-grade systemic inflammation by decreasing plasma levels of inflammatory cytokines. Furthermore, it also reduced plasma leptin levels. Long-term, well-conducted studies are still required to determine whether these changes may improve clinical outcomes of adults with chronic SCI.

A short-term training program reduced oxidative damage in elderly diabetic rats.

INTRODUCTION: Recent studies concluded long-term training programs have improved antioxidant system in young and adults diabetic rats. However, to our knowledge, little attention has been paid to elderly individuals. OBJECTIVE: To assess the influence of a shorter training program in reducing oxidative damage in elderly diabetic rats. MATERIAL AND METHODS: Twenty-four male homozygous Zucker diabetic fatty rats (Gmi, fa/fa) aged 18-weeks with an average weight of 370- 450 g were purchased. After a 2-week period of environmental adaptation, animals were randomly distributed into exercised group (n = 12) that performed a 6-week swimming training protocol and sedentary group (n = 12). Animals were sacrificed 24-h after the last exercise session under anesthesia. Serum metabolic profile was determined. Lipid oxidation, expressed as malondialdehyde and protein oxidation, expressed as carbonyl groups, were assessed in plasma samples. This protocol was approved by an Institutional Ethics Committee. RESULTS: Exercised rats improved significantly their metabolic profile in comparison to controls. Plasma malondialdehyde (1.58 ± 0.39 vs. 2.06 ± 0.41 nmol/mL; p = 0.016) and carbonyl group levels (1.37 ± 0.33 vs. 1.62 ± 0.58 UA; p = 0.011) were also significantly lowered in exercised rats when compared to sedentary counterparts. CONCLUSIONS: A 6-week swimming training program reduced lipid and protein oxidation in elderly fatty diabetic rats. Further studies on this topic are required.

Central obesity measurements predict metabolic syndrome in a retrospective cohort study of postmenopausal women / Obesidad abdominal determinada por DEXA como predictor de síndrome metabólico en mujeres postmenopáusicas

Introduction: The various diagnostic classifications in the literature concur as regards the important role of abdominal obesity in the onset and progression of metabolic syndrome. Accordingly, this study was aimed at clarifying whether central obesity measurements assessed by dual X-ray absorptiometry (DXA) may predict metabolic syndrome in Spanish postmenopausal women. Material and methods: This historical cohort study included a total of 1326 postmenopausal women aged > 45 years old who had routinely undergone DXA to measure their bone mineral density between January 2006 and January 2011. The regions of interest (ROI) envisaged in our study by using DXA were the lumbar regions L1-L4 and L4-L5. At the same time, they underwent a complete medical examination including personal medical history assessment, biochemical blood analysis, blood pressure measurement and anthropometrical evaluation. Metabolic syndrome was diagnosed attending to the criteria established by National Cholesterol Education Program Adult Treatment Panel III (NECP-ATP-III). Results: During the observation period, 537 women, representing 40.5% of the total studied, met the diagnostic criteria for metabolic syndrome. L1-L4 and L4-L5 abdominal fat mass determinations were associated with the development of metabolic syndrome in all regression models tested, showing an increasing gradient from the lowest to highest quintile. Conclusion: Central adiposity measurements assessed by DXA, especially L1-L4 region of interest, could be considered a powerful predictor of metabolic syndrome in postmenopausal women (AU)

Introducción: En la actualidad se acepta la importancia de la masa grasa abdominal en la fisiopatología del síndrome metabólico tal y como reconocen las diferentes clasificaciones diagnósticas disponibles. Nuestro objetivo fue analizar la utilidad como predictores de síndrome metabólico de marcadores de grasa abdominal obtenidos por DEXA en mujeres postmenopausicas aprovechando su participación en screening rutinarios para el estudio de la densidad mineral ósea. Material y método: El presente estudio de cohortes histórico incluyó a un total de 1326 mujeres post-menopausicas con edad > 45 años que se habían sometido rutinariamente a DEXA para conocer su densidad mineral ósea entre Enero de 2006 y Enero de 2011. Además del DEXA, se obtuvo de cada participante la correspondiente anamnesis, bioquímica, tensión arterial e índices de distribución de masa grasa mediante técnicas antropométricas convencionales. Se utilizó la clasificación NCEP-ATP-III para el diagnóstico de síndrome metabólico. Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: Durante el periodo de observación, 537 mujeres, el 40.5% del total de las estudiadas, cumplió los criterios diagnósticos de síndrome metabólico. Los parámetros de masa grasa abdominal obtenidos mediante DEXA fueron significativamente mayores en mujeres postmenopáusicas con síndrome metabólico. Finalmente, la masa grasa abdominal de regiones de interés L1-L4 y L3-L4 obtenidas por DEXA se relacionaron con el desarrollo de síndrome metabólico en los modelos de regresión ensayados. Conclusión: La masa grasa abdominal determinada por DEXA, especialmente la región L1-L4, podría recomendarse como predictor de síndrome metabólico en este grupo (AU)

Maternal fat mass may predict overweight/obesity in non-instituzionalized women with intellectual disability / La masa grasa materna como predictor de sobrepeso/obesidad en mujeres con discapacidad intelectual no institucionalizadas

Introduction: Previous studies have found a significant correlation between parents and offspring regarding overweight and obesity in general population at early life stages. However this issue has received no attention in people with intellectual disability (ID). Therefore, the present study was designed to find out potential correlations in overweight/obesity between young adult women with ID living in the family and their parents. Material and methods: In the present observational cross-sectional study, a total of thirty-four women with Down syndrome (n = 34; 22.6 ± 2.1 years; 29.6 ± 3.3 km/m2) were recruited through different community support groups for people with intellectual disabilities. Furthermore, biological mothers (n = 34; 59.6 ± 4.9 years; 28.5 ± 3.2 km/m2) and fathers (n = 34; 61.5 ± 5.3 years; 26.2 ± 2.7 km/m2) volunteered for this study. They all underwent an anthropometric assessment to determine body mass index (BMI). This protocol was approved by an Institutional Ethics Committee. Results: In the studied population, a total of 26 (76.5%) women with ID were overweight/obese. Furthermore, there were 22 (66.6%) overweight/obese mothers and 16(53.3%) fathers. Results also showed significant correlations between participants BMI and their father (r = 0.327; p = 0.0116) and mother BMI (r = 0.412; p < 0.001). Lastly, overweight/obese women presented a stronger correlation with overweight/obese mothers (odds ratio 4.3; 95%CI 2.9-7.3) than fathers (odds ratio 3.1; 95%CI 1.6-4.4). Conclusion: Parental overweight/obesity, especially maternal one, was strongly associated to overweight/obesity in young adult women with DS. Accordingly, there is an urgent necessity of incorporating parents in the intervention programs designed to the prevention and treatment of overweight and obesity in people with ID (AU)

Fundamento y objetivo: Recientes estudios han encontrado en la población general una correlación entre la incidencia de sobrepeso/obesidad de padres e hijos, especialmente a edades tempranas. Sin embargo, este asunto no ha recibido atención en el caso de hijos adultos con discapacidad intelectual no institucionalizados. El presente estudio pretende determinar una posible correlación entre el sobrepeso/obesidad de padres respecto a sus hijas adultas con discapacidad intelectual que viven en el domicilio. Material y método: Se diseñó un estudio de tipo transversal observacional en el que participaron 34 mujeres adultas con síndrome de Down (22,6 ± 2,1 años; 29,6 ± 3,3 km/m2). Asimismo 34 madres (59,6 ± 4,9 años; 28,5 ± 3,2 km/m2) y 34 padres (61,5 ± 5,3 años; 26,2 ± 2,7 km/m2) biológicos participaron voluntariamente. Todos los participante se sometieron a un estudio cinenatropométrico en el que se obtuvo el índice de masa corporal (IMC). Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: El 76,5% de las mujeres con discapacidad intelectual estudiadas presentaba sobrepeso/obesidad. En cuanto a los progenitores, el 66,6% de las madres y el 53.3 de los padres también presentó sobrepeso/obesidad. El IMC de las participantes se correlacionó significativamente con el de sus madres (r = 0,412; p < 0,001) y padres (r = 0,327; p = 0,0116). Por último, las participantes con sobrepeso/obesidad presentaron una fuerte correlación con sus progenitores con sobrepeso/obesidad, especialmente las madres (odds ratio 4,3; 95%CI 2,9-7,3) y en menor medida sus padres (odds ratio 3,1;95%CI 1,6-4,4). Conclusión: La masa grasa de los padres, especialmente la materna, podría recomendarse como predictor de sobrepeso/obesidad de hijas adultas con discapacidad intelectual no institucionalizadas (AU)

Motivación de los docentes clínicos en las Escuelas de Medicina Deportiva: ¿participar es lo que en realidad importa? / Motivation of clinical teachers at Schools of Sports Medicine: Taking part is what really counts?

Introducción: Este estudio fue el primero en abordar los factores que pueden motivar a los docentes clínicos en las Escuelas de Medicina Deportiva. Estos hallazgos podrían ser de interés particular en un momento en el que van disminuyendo los recursos para recompensar la enseñanza en las escuelas deportivas. Material y métodos: Se incluyó a un total de 32 docentes clínicos voluntarios (13 mujeres [40%],19 varones [60%]) en este estudio observacional y transversal. Se utilizó la metodología Q convencional para que los participantes clasificaran en orden 69 aseveraciones, en función del modo en que éstas reflejaran su motivación para impartir la docencia en una Escuela de Medicina Deportiva. Las aseveraciones clasificadas fueron analizadas utilizando factores, para obtener así grupos de experiencias similares. Resultados: De acuerdo a la práctica recomendada, surgieron dos factores: el factor 1 ‘‘Yo enseño para ayudar a los demás’’ incluyó a 23 (72%) tipos de participantes (13 varones y 10 mujeres), mientras que el factor 2 ‘‘Yo enseño para mejorarme a mí mismo’’ incluyó únicamente a 9 (28%) participantes (6 varones y 3 mujeres). La aseveración que recibió una mayor puntuación media para el factor 1 fue: ‘‘Quiero ayudar a mis estudiantes a convertirse en buenos doctores’’. En cuanto al factor 2, la afirmación que recibió la mayor puntuación media fue: ‘‘Yo enseño movido por la estimulación intelectual’’. Conclusión: Se ha propuesto un pool de factores clasificados que motivan a los facultativos ala enseñanza en las Escuelas de Medicina Deportiva. Al identificarlos, estos factores pueden reforzarse mediante estrategias de motivación en las Escuelas de Medicina Deportiva, a fin de realzar la cooperación y el cumplimiento de los profesores, reduciendo así los porcentajes de abandono (AU)

Introduction: This was the first study to focus on what factors may motivate clinical teachers in Sports Medicine Schools. These findings would be of particular interest at a time of decreasing resources for Schools of Sports Medicine to reward teaching. Material and methods: A total of 32 clinical teachers (13 females [40%]; 19 males [60%]) volunteered for this observational, cross-sectional study. Conventional Q-methodology so that participants rank-ordered 69 numbered statements according to the extent to which these reflected their motivation to teach at School of Sports Medicine. The sorted statements were factor-analyzed to provide clusters of similar experiences. Results: In accordance with recommended practice, two factors emerged: factor 1 ‘‘I teach for helping others’’ included 23 (72%) participant’s sorts (13 males; 10 females) whereas factor 2 ‘‘I teach for improving myslef’’ included just 9 (28%) participants (6 males; 3 females). The statement that received the highest average score for factor 1 was ‘‘I want to help my students become good doctors’’. Regarding factor 2, the statement that received the highest average score was ‘‘I teach because of the intellectual stimulation’’. Conclusion: A ranked-pool of factors that motivate clinicians to teach in Schools of Sports Schools has been proposed. By identifying them, these factors can be reinforced by motivational strategies at Schools of Sports Medicine in order to enhance teacher cooperation and compliance, thereby reducing drop-out rates (AU)

Resistance circuit training reduced inflammatory cytokines in a cohort of male adults with Down syndrome.

BACKGROUND: It is widely accepted that muscle strength plays a key role on functional tasks of daily living and employability in individuals with Down syndrome (DS). Recent studies have also reported resistance training may improve chronic inflammation in other clinical situations. This is the first study conducted to determine the effect of resistance circuit training on low-grade systemic inflammation in adults with DS. MATERIAL/METHODS: A total of 40 young male adults with DS were recruited for the trial through different community support groups for people with intellectual disabilities and their families. They had medical approval for physical activity participation. Twenty-four were randomly assigned to perform resistance circuit training with 6 stations, 3 days per week for 12 weeks. Exercise intensity was based on function of the 8RM assessments. The control group included 16 age-, sex-, and BMI-matched adults with Down syndrome. Plasma levels of leptin, adiponectin, and TNF-a were assessed by commercial ELISA kits. C-reactive protein (CRP) was assessed by nephelometry. Body composition was also determined, measuring fat-free mass percentage and waist circumference (WC). This protocol was approved by our Institutional Ethics Committee. RESULTS: Plasma levels of leptin, TNF-a, and IL-6 were significantly decreased after the completion of the training program, as were fat-free mass and WC. No sports-related injuries or withdrawals from the program were reported during the entire study period. No changes were observed in the control group. CONCLUSIONS: Resistance circuit training improved low-grade systemic inflammation in male sedentary adults with DS.

[A short-term training program reduced acute phase proteins in premenopausal women with metabolic syndrome]. / Reducción de reactantes de fase aguda en mujeres con síndrome metabólico tras 12 semanas de entrenamiento.

INTRODUCTION: It is accepted low grade systemic inflammation plays a key role in metabolic syndrome. Further, several studies have reported it may be considered a therapeutic target. Accordingly, this study was conducted to ascertain the impact of a short-term aerobic training program on acute phase proteins in women with metabolic syndrome. MATERIAL AND METHODS: A total of 135 adult women (38.4 ± 3.3 years) with metabolic syndrome volunteered for this study. Participants assigned to the intervention group underwent a 12-week aerobic training program, 3 sessions/week. The main part of each exercise sessions was performed in a treadmill at moderate intensity (60- 75%HRmax; increasing 5% each 3 weeks) for 25-40 minutes (increasing 5 minutes each 3 weeks). Physical fitness was determined by a continuous maximal incremental test. Further, fat mass percentage and indices of obesity were assessed. Plasmatic levels of C reactive protein (CRP-us) and fibrinogen were determined by nephelometry and HPLC respectively. This protocol was approved by an Institutional Ethics Committee. RESULTS: Aerobic training improved physical fitness and reduced both fat mass percentage and indices of obesity. Compared with baseline, it also reduced significantly plasmatic levels of CRP-us (4.90 ± 0.7 vs. 3.77 ± 0.4 mg/l; p = 0.017) and fibrinogen (3.88 ± 0.4 vs. 3.36 ± 0.2 g/l; p = 0.025). Further, a moderate correlation was found between CRP-us and waist circumference (r = 0.66; p = 0.008). No significant changes were found in controls. CONCLUSION: A short-term, aerobic training program reduced acute phase proteins in young women with metabolic syndrome. Further, long-term, well-conducted studies are still required to determine whether correction of this low-grade inflammation improves clinical outcomes of women with metabolic syndrome.

Fundamento y objetivo: Actualmente se acepta la importancia del estatus proinflamatorio en la fisiopatología del síndrome metabólico. De hecho, ha sido propuesto como diana terapéutica en el manejo clínico de estos pacientes. Por consiguiente este estudio pretende reducir los niveles plasmáticos de reactantes de fase aguda en mujeres con síndrome metabólico mediante un corto programa de entrenamiento. Material y método: Un total de 135 mujeres jóvenes adultas (38,4 ± 3,3 años) con diagnóstico de síndrome metabólico participaron voluntariamente en este estudio. El grupo de intervención se sometió a un programa de entrenamiento aeróbico de 12 semanas, con 3 sesiones/ semana en el que duración e intensidad de la parte principal se incrementaron progresivamente. Los niveles plasmáticos de proteína C-reactiva (PCR) y fibrinógeno se determinaron mediante nefelometría y HPLC respectivamente. También se evaluaron el fitness cardiovascular mediante prueba de esfuerzo máxima e índices de distribución de masa grasa. Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: Tras completar el programa, se observo una mejora significativa del fitness cardiovascular además de una reducción también significativa de los niveles de fibrinógeno y PCR. Asimismo, se encontraron correlaciones entre niveles de reactantes e índices de distribución de masa grasa, siendo la de mayor fuerza de asociación la establecida entre PCR y perímetro cintura. Conclusión: Un programa de 12 semanas consiguió reducir los niveles de reactantes de fase aguda en mujeres con síndrome metabólico. Futuros estudios longitudinales son necesarios para conocer el impacto del efecto anti-inflamatorio del ejercicio en el manejo de estos pacientes a medio/largo plazo.

Reducción de reactantes de fase aguda en mujeres con síndrome metabólico tras 12 semanas de entrenamiento / A short-term training program reduced acute phase proteins in premenopausal women with metabolic syndrome

Fundamento y objetivo: Actualmente se acepta la importancia del estatus proinflamatorio en la fisiopatología del síndrome metabólico. De hecho, ha sido propuesto como diana terapéutica en el manejo clínico de estos pacientes. Por consiguiente este estudio pretende reducir los niveles plasmáticos de reactantes de fase aguda en mujeres con síndrome metabólico mediante un corto programa de entrenamiento. Material y método: Un total de 135 mujeres jóvenes adultas (38,4 ± 3,3 años) con diagnóstico de síndrome metabólico participaron voluntariamente en este estudio. El grupo de intervención se sometió a un programa de entrenamiento aeróbico de 12 semanas, con 3 sesiones/ semana en el que duración e intensidad de la parte principal se incrementaron progresivamente. Los niveles plasmáticos de proteína C-reactiva (PCR) y fibrinógeno se determinaron mediante nefelometría y HPLC respectivamente. También se evaluaron el fitness cardiovascular mediante prueba de esfuerzo máxima e índices de distribución de masa grasa. Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: Tras completar el programa, se observo una mejora significativa del fitness cardiovascular además de una reducción también significativa de los niveles de fibrinógeno y PCR. Asimismo, se encontraron correlaciones entre niveles de reactantes e índices de distribución de masa grasa, siendo la de mayor fuerza de asociación la establecida entre PCR y perímetro cintura. Conclusión: Un programa de 12 semanas consiguió reducir los niveles de reactantes de fase aguda en mujeres con síndrome metabólico. Futuros estudios longitudinales son necesarios para conocer el impacto del efecto anti-inflamatorio del ejercicio en el manejo de estos pacientes a medio/largo plazo (AU)

INTRODUCTION: It is accepted low grade systemic inflammation plays a key role in metabolic syndrome. Further, several studies have reported it may be considered a therapeutic target. Accordingly, this study was conducted to ascertain the impact of a short-term aerobic training program on acute phase proteins in women with metabolic syndrome. MATERIAL AND METHODS: A total of 135 adult women (38.4 ± 3.3 years) with metabolic syndrome volunteered for this study. Participants assigned to the intervention group underwent a 12-week aerobic training program, 3 sessions/week. The main part of each exercise sessions was performed in a treadmill at moderate intensity (60- 75%HRmax; increasing 5% each 3 weeks) for 25-40 minutes (increasing 5 minutes each 3 weeks). Physical fitness was determined by a continuous maximal incremental test. Further, fat mass percentage and indices of obesity were assessed. Plasmatic levels of C reactive protein (CRP-us) and fibrinogen were determined by nephelometry and HPLC respectively. This protocol was approved by an Institutional Ethics Committee. RESULTS: Aerobic training improved physical fitness and reduced both fat mass percentage and indices of obesity. Compared with baseline, it also reduced significantly plasmatic levels of CRP-us (4.90 ± 0.7 vs. 3.77 ± 0.4 mg/l; p = 0.017) and fibrinogen (3.88 ± 0.4 vs. 3.36 ± 0.2 g/l; p = 0.025). Further, a moderate correlation was found between CRP-us and waist circumference (r = 0.66; p = 0.008). No significant changes were found in controls. CONCLUSION: A short-term, aerobic training program reduced acute phase proteins in young women with metabolic syndrome. Further, long-term, well-conducted studies are still required to determine whether correction of this low-grade inflammation improves clinical outcomes of women with metabolic syndrome (AU)

Mejora del perfil lipídico y lipoperoxidación mediante entrenamiento de fuerza en adultos con discapacidad intelectual / Resistance training improved lipid profile and lipoperoxidation in adults with intellectual disability

Recientes estudios sugieren que el ejercicio de tipo aeróbico reduce el daño oxidativo en personas con síndrome de Down (SD). Sin embargo, los programas de entrenamiento de fuerza han recibido escasa atención en esta línea de trabajo a pesar de la importancia de ésta en el desarrollo de tareas cotidianas y profesionales en este grupo poblacional. Por consiguiente, se diseño el presente estudio para conocer el impacto de este tipo de programas en la lipoperoxidación de adultos sedentarios con síndrome de Down. Para tal fin, un total de 40 adultos jóvenes varones sedentarios con SD participaron voluntariamente en este estudio. Los participantes se distribuyeron aleatoriamente en un grupo intervención (n=24) que realizó un programa de entrenamiento de fuerza de 12 semanas, 3 sesiones semana. El grupo control (n=16) estaba formado por participantes con SD ajustados en sexo y edad. Los niveles plasmáticos de lipoproteína de baja densidad oxidada (oxLDL) se determinaron mediante ELISA. Además, se determinaron el porcentaje de masa grasa, mediante impedanciometría (BIA), así como el perfil lipídico por procedimientos estándar de laboratorio. Este protocolo fue aprobado por un Comité de Ética Institucional. Tras completar el programa de entrenamiento, se redujeron significativamente los niveles plasmáticos de ox-LDL. También se redujo el porcentaje de masa grasa así como los niveles de colesterol-LDL. Asimismo, se observó un aumento significativo de los niveles de colesterol-HDL. No se registraron lesiones ni abandonos a lo largo de la experiencia. Tampoco se observaron cambios en las variables ensayadas en el grupo control. Se concluye que el entrenamiento de fuerza reduce la lipoperoxidación, expresada como niveles de ox-LDL, en adultos sedentarios con SD. Futuros estudios longitudinales para conocer el impacto de esta mejora en el manejo clínico de personas con SD son aún necesarios (AU)

Resistance training has received less attention than endurance training in individuals with intellectual disability in general and Down syndrome in particular. It would be of great interest to compensate this imbalance given muscle strength is essential on functional tasks of daily living and employability in this group. To achieve this goal, this is the first study conducted to determine the effect of resistance circuit training on lipoperoxidation in sedentary adults with DS, given promising results reported in previous studies focused on aerobic training. A total of forty young male adults with DS were recruited for the trial through different community support groups for people with intellectual disabilities and their families. They all had medical approval for physical activity participation. Twenty-four were randomly assigned to perform a resistance circuit training with 6 stations, 3 days per week for 12 weeks. Exercise intensity was based on function of the 8RM assessments. Control group included 16 age, sex and BMI matched adults with Down syndrome. Plasma levels of oxidized low-density lipoprotein (oxLDL) were assessed by commercial ELISA-kits. Serum lipid profile and fat mass percentage were also determined. This protocol was approved by an Institutional Ethics Committee. When compared to baseline results, plasma levels of oxLDL were significantly decreased after the completion of the training program. Serum lipid profile and fat mass were significantly improved too. Neither sports-related injuries nor withdrawals from the program were reported during the entire study period. Finally, no changes were observed in the control group. It was concluded resistance circuit training improved lipoperoxidation in male sedentary adults with DS. Further, long-term, well-conducted studies are required to determine whether the increased antioxidant system may improve clinical outcomes of adults with DS (AU)

Arm-cranking exercise reduced oxidative damage in adults with chronic spinal cord injury.

OBJECTIVE: To assess the effect of a 12-week arm-cranking exercise program on reducing oxidative damage in untrained adults with chronic spinal cord injury (SCI). DESIGN: Randomized controlled trial. SETTING: Community-based supervised intervention. PARTICIPANTS: Male adults with complete SCI at or below the fifth thoracic level (T5) (N=17) volunteered for this study. Participants were randomly allocated to the intervention (n=9) or control (n=8) group using a concealed method. INTERVENTION: A 12-week arm-cranking exercise program, 3 sessions/wk, consisting of warming-up (10-15min) followed by a main part in arm-crank (20-30min [increasing 2min and 30s every 3wk]) at a moderate work intensity of 50% to 65% of the heart rate reserve (starting at 50% and increasing 5% every 3 weeks) and by a cooling-down period (5-10min). MAIN OUTCOME MEASURES: Plasmatic levels of total antioxidant status as well as erythrocyte glutathione peroxidase activity were measured. Lipid and protein oxidation were determined as malondialdehyde and carbonyl group levels, respectively. Furthermore, physical fitness and body composition were assessed. RESULTS: When compared with baseline results, maximum oxygen consumption was significantly increased (P=.031), suggesting an improvement in physical fitness in the intervention group. Regarding the antioxidant defense system, it was found that both total antioxidant status (P=.014) and erythrocyte glutathione peroxidase activity (P=.027) were significantly increased at the end of the training program. As a consequence, plasmatic levels of malondialdehyde (P=.008) and carbonyl groups (P=.022) were significantly reduced. CONCLUSION: A 12-week arm-cranking exercise program improved the antioxidant defense system in adults with chronic SCI, which may finally attenuate both lipid and protein oxidation in this population.

Mejoras del porcentaje y distribución abdominal de masa grasa en mujeres con discapacidad intelectual tras entrenamiento aeróbico de 10 semanas / A short training program reduced fat mass and abdominal distribution in obese women with intellectual disability

En la actualidad se acepta que la obesidad es un grave problema de salud pública. La situación es aún más preocupante entre las personas con discapacidad intelectual, especialmente entre las mujeres. Afortunadamente recientes estudios sugieren la utilidad del ejercicio como estrategia frente a la obesidad. Sin embargo, la mayoría de estos estudios utilizan grupos mixtos (hombres y mujeres) o varones, siendo escasa la información sobre un grupo homogéneo de mujeres. Por consiguiente nos planteamos como hipótesis que un programa de entrenamiento de 10 semanas podría reducir el porcentaje de masa grasa y la distribución abdominal en mujeres obesas con síndrome de Down. En nuestro estudio participaron 20 mujeres adultas (18-30 años) con un cociente intelectual de 50-69 según la escala Stanford-Binet y diagnóstico citogenético de trisomía 21. Todas presentaban obesidad definida como IMC>30 kg/m2. Once de las participantes se asignaron aleatoriamente al grupo experimental y desarrollaron un programa de entrenamiento de 10 semanas de tipo aeróbico con 3 sesiones/semana. El porcentaje de masa grasa se determinó mediante impedanciometría bioeléctrica (Tanita TBF521). Para obtener el índice cintura/cadera se midieron las circunferencias de la cintura y la cadera utilizando una cinta antropométrica. Nuestro protocolo fue aprobado por un Comité de Ética Institucional. Nuestros resultados confirman que el ejercicio aeróbico redujo significativamente el porcentaje de masa grasa, el índice cintura/cadera y el perímetro de la cintura (p<0,05). Por el contrario no se observaron cambios en el grupo control. Concluimos que un programa de entrenamiento de 10 semanas consiguió mejorar la composición corporal de mujeres obesas con síndrome de Down. Futuros estudios longitudinales bien conducidos y controlados son necesarios para conocer el impacto de esta mejora en el manejo clínico de este grupo.

Recent studies have reported obesity prevalence in people with intellectual disability is even higher than in the general population what may finally lead to impair their health status and increase healthcare costs. Fortunately several studies have reported regular exercise may improve body composition in obese people with and without intellectual disability. To the best of our knowledge this is the first study conducted exclusively in female participants with intellectual disability, in an attempt to keep our sample homogeneous. To date, many studies focused on the influence of regular exercise in people with intellectual disability have recruited mixed (males and females) groups in order to increase their sample size to strengthen research designs. Therefore, we assessed the influence of a 10-week aerobic training program on fat mass percentage and indices of obesity in women with Down syndrome. To get this goal, twenty obese young women with Down syndrome volunteered for this study. Eleven were randomly assigned to perform a 10-week aerobic training program, 3 sessions/week, consisting of warming-up followed by a main part in a treadmill (30-40 min) at a work intensity of 55-65% of peak heart rate and a cooling-down period. Control group included 9 age, sex and BMI matched women with Down syndrome. Fat mass percentage and fat distribution were measured. This protocol was approved by an Institutional Ethics Committee. When compared to baseline, fat mass percentage, waist circumference and waist to hip ratio were significantly reduced after training. Conversely, no changes were reported in controls. It was concluded a 10-week training program reduced fat mass in obese adult women with Down syndrome.

Central obesity measurements predict metabolic syndrome in a retrospective cohort study of postmenopausal women.

INTRODUCTION: The various diagnostic classifications in the literature concur as regards the important role of abdominal obesity in the onset and progression of metabolic syndrome. Accordingly, this study was aimed at clarifying whether central obesity measurements assessed by dual X-ray absorptiometry (DXA) may predict metabolic syndrome in Spanish postmenopausal women. MATERIAL AND METHODS: This historical cohort study included a total of 1326 postmenopausal women aged > 45 years old who had routinely undergone DXA to measure their bone mineral density between January 2006 and January 2011. The regions of interest (ROI) envisaged in our study by using DXA were the lumbar regions L1-L4 and L4-L5. At the same time, they underwent a complete medical examination including personal medical history assessment, biochemical blood analysis, blood pressure measurement and anthropometrical evaluation. Metabolic syndrome was diagnosed attending to the criteria established by National Cholesterol Education Program Adult Treatment Panel III (NECP-ATP-III). RESULTS: During the observation period, 537 women, representing 40.5% of the total studied, met the diagnostic criteria for metabolic syndrome. L1-L4 and L4-L5 abdominal fat mass determinations were associated with the development of metabolic syndrome in all regression models tested, showing an increasing gradient from the lowest to highest quintile. CONCLUSION: Central adiposity measurements assessed by DXA, especially L1-L4 region of interest, could be considered a powerful predictor of metabolic syndrome in postmenopausal women.

Introducción: En la actualidad se acepta la importancia de la masa grasa abdominal en la fisiopatología del síndrome metabólico tal y como reconocen las diferentes clasificaciones diagnósticas disponibles. Nuestro objetivo fue analizar la utilidad como predictores de síndrome metabólico de marcadores de grasa abdominal obtenidos por DEXA en mujeres postmenopausicas aprovechando su participación en screening rutinarios para el estudio de la densidad mineral ósea. Material y método: El presente estudio de cohortes histórico incluyó a un total de 1326 mujeres post-menopausicas con edad > 45 años que se habían sometido rutinariamente a DEXA para conocer su densidad mineral ósea entre Enero de 2006 y Enero de 2011. Además del DEXA, se obtuvo de cada participante la correspondiente anamnesis, bioquímica, tensión arterial e índices de distribución de masa grasa mediante técnicas antropométricas convencionales. Se utilizó la clasificación NCEP-ATP-III para el diagnóstico de síndrome metabólico. Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: Durante el periodo de observación, 537 mujeres, el 40.5% del total de las estudiadas, cumplió los criterios diagnósticos de síndrome metabólico. Los parámetros de masa grasa abdominal obtenidos mediante DEXA fueron significativamente mayores en mujeres postmenopáusicas con síndrome metabólico. Finalmente, la masa grasa abdominal de regiones de interés L1-L4 y L3-L4 obtenidas por DEXA se relacionaron con el desarrollo de síndrome metabólico en los modelos de regresión ensayados. Conclusión: La masa grasa abdominal determinada por DEXA, especialmente la región L1-L4, podría recomendarse como predictor de síndrome metabólico en este grupo.

Maternal fat mass may predict overweight/obesity in non-instituzionalized women with intellectual disability.

INTRODUCTION: Previous studies have found a significant correlation between parents and offspring regarding overweight and obesity in general population at early life stages. However this issue has received no attention in people with intellectual disability (ID). Therefore, the present study was designed to find out potential correlations in overweight/obesity between young adult women with ID living in the family and their parents. MATERIAL AND METHODS: In the present observational cross-sectional study, a total of thirty-four women with Down syndrome (n=34;22.6±2.1 years; 29.6±3.3 km/m2) were recruited through different community support groups for people with intellectual disabilities. Furthermore, biological mothers (n=34;59.6±4.9 years; 28.5±3.2 km/m2) and fathers (n=34; 61.5±5.3 years; 26.2±2.7 km/m2) volunteered for this study. They all underwent an anthropometric assessment to determine body mass index (BMI). This protocol was approved by an Institutional Ethics Committee. RESULTS: In the studied population, a total of 26 (76.5%) women with ID were overweight/obese. Furthermore, there were 22 (66.6%) overweight/obese mothers and 16(53.3%) fathers. Results also showed significant correlations between participants BMI and their father (r = 0.327; p = 0.0116) and mother BMI (r = 0.412; p < 0.001). Lastly, overweight/obese women presented a stronger correlation with overweight/obese mothers (odds ratio 4.3; 95%CI 2.9-7.3) than fathers (odds ratio 3.1; 95%CI 1.6-4.4). CONCLUSION: Parental overweight/obesity, especially maternal one, was strongly associated to overweight/obesity in young adult women with DS. Accordingly, there is an urgent necessity of incorporating parents in the intervention programs designed to the prevention and treatment of overweight and obesity in people with ID.

Fundamento y objetivo: Recientes estudios han encontrado en la población general una correlación entre la incidencia de sobrepeso/obesidad de padres e hijos, especialmente a edades tempranas. Sin embargo, este asunto no ha recibido atención en el caso de hijos adultos con discapacidad intelectual no institucionalizados. El presente estudio pretende determinar una posible correlación entre el sobrepeso/obesidad de padres respecto a sus hijas adultas con discapacidad intelectual que viven en el domicilio. Material y método: Se diseñó un estudio de tipo transversal observacional en el que participaron 34 mujeres adultas con síndrome de Down (22.6±2.1años; 29.6±3.3km/m2). Asimismo 34 madres (59.6±4.9años; 28.5±3.2km/m2) y 34 padres (61.5±5.3años; 26.2±2.7 km/m2) biológicos participaron voluntariamente. Todos los participante se sometieron a un estudio cinenatropométrico en el que se obtuvo el índice de masa corporal (IMC). Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: El 76.5% de las mujeres con discapacidad intelectual estudiadas presentaba sobrepeso/obesidad. En cuanto a los progenitores, el 66.6% de las madres y el 53.3 de los padres también presentó sobrepeso/obesidad. El IMC de las participantes se correlacionó significativamente con el de sus madres (r=0.412;p.