Zoekresultaten

Sustained changes in body composition during 6 months follow-up after combined lifestyle intervention in older adults with obesity and type 2 diabetes

Kinetics of Physiological Responses as a Measure of Intensity and Hydration Status During Experimental Physical Stress in Human Volunteers

Introduction: Strenuous physical stress induces a range of physiological responses, the extent depending, among others, on the nature and severity of the exercise, a person’s training level and overall physical resilience. This principle can also be used in an experimental set-up by measuring time-dependent changes in biomarkers for physiological processes. In a previous report, we described the effects of workload delivered on a bicycle ergometer on intestinal functionality. As a follow-up, we here describe an analysis of the kinetics of various other biomarkers. Aim: To analyse the time-dependent changes of 34 markers for different metabolic and immunological processes, comparing four different exercise protocols and a rest protocol. Methods: After determining individual maximum workloads, 15 healthy male participants (20–35 years) started with a rest protocol and subsequently performed (in a cross-over design with 1-week wash-out) four exercise protocols of 1-h duration at different intensities: 70% Wmax in a hydrated and a mildly dehydrated state, 50% Wmax and intermittent 85/55% Wmax in blocks of 2 min. Perceived exertion was monitored using the Borg’ Rating of Perceived Exertion scale. Blood samples were collected both before and during exercise, and at various timepoints up to 24 h afterward. Data was analyzed using a multilevel mixed linear model with multiple test correction. Results: Kinetic changes of various biomarkers were exercise-intensity-dependent. Biomarkers included parameters indicative of metabolic activity (e.g., creatinine, bicarbonate), immunological and hematological functionality (e.g., leukocytes, hemoglobin) and intestinal physiology (citrulline, intestinal fatty acid-binding protein, and zonulin). In general, responses to high intensity exercise of 70% Wmax and intermittent exercise i.e., 55/85% Wmax were more pronounced compared to exercise at 50% Wmax. Conclusion: High (70 and 55/85% Wmax) and moderate (50% Wmax) intensity exercise in a bicycle ergometer test produce different time-dependent changes in a broad range of parameters indicative of metabolic activity, immunological and hematological functionality and intestinal physiology. These parameters may be considered biomarkers of homeostatic resilience. Mild dehydration intensifies these time-related changes. Moderate intensity exercise of 50% Wmax shows sufficient physiological and immunological responses and can be employed to test the health condition of less fit individuals.

Alternatives to animals

International Innovation is the leading global dissemination resource for the wider scientific, technology and research communities, dedicated to disseminating the latest science, research and technological innovations on a global level. More information and a complimentary subscription offer to the publication can be found at: www.researchmedia.eu

Salivary concentrations of secretory leukocyte protease inhibitor and matrix metallopeptidase-9 following a single bout of exercise are associated with intensity and hydration status

Aim: To investigate the effects of exercise on salivary concentrations of inflammatory markers by analyzing a panel of 25 inflammatory markers in subjects who had participated in bicycle ergometer tests varying in workload and hydration status. Methods: Fifteen healthy young men (20-35 years) had performed 4 different exercise protocols of 1 hour duration in a randomly assigned cross-over design, preceded by a rest protocol. Individual workloads depended on participant's pre-assessed individual maximum workload (Wmax): rest (protocol 1), 70% Wmax in hydrated (protocol 2) and dehydrated (protocol 3) state, 50% Wmax (protocol 4) and intermittent 85%/55% Wmax in 2 min blocks (protocol 5). Saliva samples were collected before (T0) and immediately after exercise (T1), and at several time points after exercise (2 hours (T3), 3 hours (T4), 6 hours (T5) and 24 hours (T6)). Secretory Leukocyte Protease Inhibitor (SLPI), Matrix Metallopeptidase-9 (MMP-9) and lactoferrin was analyzed using a commercial ELISA kit, a panel of 22 cytokines and chemokines were analyzed using a commercial multiplex immunoassay. Data was analyzed using a multilevel mixed linear model, with multiple test correction. Results: Among a panel of 25 inflammatory markers, SLPI concentrations were significantly elevated immediately after exercise in all protocols compared to rest and higher concentrations reflected the intensity of exercise and hydration status. MMP-9 showed a significant increase in the 70% Wmax dehydrated, 50% Wmax and intermittent protocols. Conclusions: Salivary concentrations of SLPI and MMP-9 seem associated with exercise intensity and hydration status and may offer non-invasive biomarkers to study (local) inflammatory responses to different exercise intensities in human studies. sa

Effect of a multidisciplinary lifestyle intervention on body composition in people with osteoarthritis

ObjectiveThe Plants for Joints (PFJ) intervention significantly improved pain, stiffness, and physical function, and metabolic outcomes, in people with metabolic syndrome-associated osteoarthritis (MSOA). This secondary analysis investigated its effects on body composition.MethodIn the randomized PFJ study, people with MSOA followed a 16-week intervention based on a whole-food plant-based diet, physical activity, and stress management, or usual care. For this secondary analysis, fat mass, muscle mass, and bone mineral density were measured using dual-energy X-ray absorptiometry (DEXA) for all participants. Additionally, in a subgroup (n ​= ​32), hepatocellular lipid (HCL) content and composition of visceral adipose tissue (VAT) were measured using magnetic resonance spectroscopy (MRS). An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyse between-group differences.ResultsOf 66 people randomized, 64 (97%) completed the study. The PFJ group experienced significant weight loss (−5.2 ​kg; 95% CI –6.9, −3.6) compared to controls, primarily from fat mass reduction (−3.9 ​kg; 95% CI –5.3 to −2.5). No significant differences were found in lean mass, muscle strength, or bone mineral density between groups. In the subgroup who underwent MRI scans, the PFJ group had a greater reduction in HCL (−6.5%; 95% CI –9.9, 3.0) compared to controls, with no observed differences in VAT composition.ConclusionThe PFJ multidisciplinary intervention positively impacted clinical and metabolic outcomes, and appears to significantly reduce body fat, including liver fat, while preserving muscle mass and strength.

Validity of the Dutch modified painDETECT questionnaire (MPDQ-NL) for patients with hip or knee osteoarthritis

Purpose: The etiology of pain in osteoarthritis (OA) is complex andmultifactorial. A growing number of studies suggest that modificationof pain-transmission in the peripheral and central nervous system,leading to sensitization, plays a role in OA pain. Sensitization seems tobe associated with neuropathic pain-like symptoms and assessment ofthese symptoms can help to identify patients who could benefit fromadditional treatment options. Several questionnaires are available todistinguish neuropathic from nociceptive pain symptoms. The modifiedpainDETECT questionnaire (mPDQ) is a self-reported questionnairedeveloped to discriminate between nociceptive- and possible/likelyneuropathic pain in knee OA patients. Recently the mPDQ was translatedinto Dutch and adjusted to also fit hip OA patients. The aim of thisstudy was to assess the validity of the mPDQ-NL in patients with hip orknee OA.Methods: Primary hip and knee OA patients were recruited from threeDutch hospitals. Based on previous research, confirmatory factor analysisfor two principal components was performed to assess structuralvalidity. Construct validity (both convergent and divergent) wasassessed using hypothesis testing. Predefined hypotheses were formulatedconcerning the correlation between the mPDQ-NL and theSelf-reported Leeds Assessment of Neuropathic Symptoms and Signs (SLANSS),subscales of the Knee injury and Osteoarthritis Outcome score/Hip disability and Osteoarthritis Outcome Score (KOOS/HOOS), VisualAnalogue Scale for pain (VAS pain), and subscales of the RAND-36health survey (RAND-36). According to the COSMIN criteria, constructvalidity of a questionnaire is sufficient if 75% of predefined hypothesesare met. Additionally, convergent validity was assessed with blunt PainPressure Thresholds (PPTs) in a subsample of participants. A reducedPPT is a somatosensory abnormality that is considered an indication ofsensitization in OA. Therefore it was expected that reduction of PPTswas associated with higher mPDQ scores.Results: 168 participants were included. PPT measurements wereperformed in a sample of 46 participants. Factor analysis confirmed twoprincipal components. The items that loaded on the first componentcould be described as “evoked neuropathic sensations”, the items thatloaded on the second component as “spontaneous neuropathic sensations”.However there were two items that substantially loaded on bothcomponents. The item regarding pain pattern did not load on anycomponent. Considering construct analysis, 80% of the predefinedhypotheses concerning the correlation between mPDQ and self-reportedquestionnaires were met. Considering the correlation with PPTmeasurements, 50% of the predefined hypotheses were met.Conclusions: The mPDQ-NL seems to adequately reflect neuropathicpain-like symptoms experienced by hip and knee OA patients. Concerningstructural validity, two determinative components seem to bepresent, in line with previous research. However, one particular itemregarding pain pattern might not reflect the construct of neuropathicpain-like symptoms in hip or knee OA. Therefore, when using the mPDQin hip or knee OA patients, it might be considered to skip this particularitem. Construct validity can be considered sufficient, with over 75% ofthe predefined hypotheses regarding correlation between the mPDQNLand other questionnaires were met. However, only 50% of the hypotheses concerning PPT measurements were met, probably due toheterogeneity and limited sample size of this subgroup. To ourknowledge, this study is the first to assess the structural validity of themPDQ knee and hip by using factor analysis and to assess constructvalidity using elaborate hypothesis testing as proposed by the COSMINguidelines.