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Effects of a 3-Month Physical Training on Cortisol and Testosterone Responses in Women After Bariatric Surgery. Obes Surg 2022; 32:3351-3358. [PMID: 35922611 DOI: 10.1007/s11695-022-06225-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE Although it is well established that physical activity (PA) may partially correct the metabolic and hormonal alterations observed in patients with obesity, knowledge of its impact after bariatric surgery (BS) remains poor. The purpose of this study was to assess the repercussions of physical training on cortisol and testosterone responses in post-BS women. MATERIALS AND METHODS According to a randomized clinical trial, a PA group (11 women) started a 3-month physical training 6 weeks after BS, whereas no specific activity was proposed to a control group (9 women). Submaximal exercise (i.e., 30 min at 60% VO2peak) was performed by all subjects just before and after the 3-month period. Blood samples were taken at rest, after 10, 20, and 30 min of exercise and 10 min of passive recovery for cortisol and testosterone analyses. Blood glucose, blood lactate, and heart rate were assessed at the same time. RESULTS Before the program, a significant increase in cortisol, blood lactate, and heart rate was observed in all subjects during the submaximal exercise vs. rest, with no change in blood glucose and testosterone. After vs. before the 3-month period, no modification in any parameter was noted at rest in either group. However, during exercise, lack of cortisol increase and lower heart rate were found in the PA group only, with disappearance of the increase in blood lactate in both groups. CONCLUSION Our results show some beneficial effects of physical training on hormonal and physical parameters. Further studies are needed to determine the biological and clinical significance of these adaptations induced by physical training in women after BS.
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Zhang H, Chen Y, Zheng T, Zhang M, Li X, Shi L. Factors Affecting the Exercise Capacity in Pediatric Primary Hypertension. Front Pediatr 2022; 10:882223. [PMID: 35692974 PMCID: PMC9174901 DOI: 10.3389/fped.2022.882223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Exercise training is crucial to the early intervention of pediatric primary hypertension (PHT). However, much less is known about exercise capacity in this disease. This work investigated the exercise capacity in pediatric PHT and analyzed the factors affecting exercise capacity. METHODS The study enrolled children with PHT at the Children's Hospital Capital Institute of Pediatrics between July 2017 and July 2020. The Bruce protocol of the treadmill exercise test (TET) was used to assess exercise capacity. Multivariate ordinal logistic regression and generalized linear models were used to analyze factors affecting exercise capacity. RESULTS Of 190 patients, 146 (76.8%) were male, and the median age was 13 (11, 14). Most children accomplished TET and achieved the submaximal heart rates (189 [99.5%]). Children with lower resting diastolic blood pressure (DBP) and 24 h average diastolic blood pressure (ADBP) could achieve a TET stage of 6 or more, whereas children with higher DBP and ADBP could only achieve a TET stage of 3 (P all < 0.05). Children with lower DBP and 24 h ADBP were also associated with greater metabolic equivalents (METs; r = -0.237, r = -0.179, P all < 0.05). The completion of TET stages was negatively associated with female (OR = 0.163), younger age (OR = 1.198), greater body mass index (BMI, OR = 0.921), and higher 24 h ADBP (OR = 0.952, P all < 0.05). In addition, METs were negatively associated with female (β = -1.909), younger age (β = 0.282), greater BMI (β = -0.134), and higher 24 h ADBP (β = -0.063, P all < 0.05). CONCLUSIONS Exercise capacity was impaired among pediatric PHT patients. Female gender, younger age, greater BMI, and higher 24 h ADBP are independently associated with the exercise capacity in pediatric PHT. These findings may help developing scientific exercise prescriptions for pediatric PHT.
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Affiliation(s)
- Hui Zhang
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Peking Union Medical College Graduate School, Beijing, China
| | - Yeshi Chen
- Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Tong Zheng
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Mingming Zhang
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Xiaohui Li
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Peking Union Medical College Graduate School, Beijing, China.,Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China.,Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Lin Shi
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
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Salvadori A, Fanari P, Marzullo P, Codecasa F, Tovaglieri I, Cornacchia M, Terruzzi I, Ferrulli A, Palmulli P, Brunani A, Lanzi S, Luzi L. Playing around the anaerobic threshold during COVID-19 pandemic: advantages and disadvantages of adding bouts of anaerobic work to aerobic activity in physical treatment of individuals with obesity. Acta Diabetol 2021; 58:1329-1341. [PMID: 34047810 PMCID: PMC8159723 DOI: 10.1007/s00592-021-01747-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/15/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Obesity is a condition that generally limits work capacity and predisposes to a number of comorbidities and related diseases, the last being COVID-19 and its complications and sequelae. Physical exercise, together with diet, is a milestone in its management and rehabilitation, although there is still a debate on intensity and duration of training. Anaerobic threshold (AT) is a broad term often used either as ventilatory threshold or as lactate threshold, respectively, detected by respiratory ventilation and/or respiratory gases (VCO2 and VO2), and by blood lactic acid. AIMS AND METHODOLOGY This review outlines the role of AT and of the different variations of growth hormone and catecholamine, in subjects with obesity vs normal weight individuals below and beyond AT, during a progressive increase in exercise training. We present a re-evaluation of the effects of physical activity on body mass and metabolism of individuals with obesity in light of potential benefits and pitfalls during COVID-19 pandemic. Comparison of a training program at moderate-intensity exercise (< AT) with training performed at moderate intensity (< AT) plus a final bout of high-intensity (> AT) exercise at the end of the aerobic session will be discussed. RESULTS Based on our data and considerations, a tailored strategy for individuals with obesity concerning the most appropriate intensity of training in the context of rehabilitation is proposed, with special regard to potential benefits of work program above AT. CONCLUSION Adding bouts of exercise above AT may improve lactic acid and H+ disposal and improve growth hormone. Long-term aerobic exercise may improve leptin reduction. In this way, the propensity of subjects with obesity to encounter a serious prognosis of COVID-19 may be counteracted and the systemic and cardiorespiratory sequelae that may ensue after COVID-19, can be overcome. Individuals with serious comorbidities associated with obesity should avoid excessive exercise intensity.
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Affiliation(s)
- Alberto Salvadori
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Paolo Fanari
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Paolo Marzullo
- Division of General Medicine, Ospedale S. Giuseppe, Istituto Auxologico Italiano, via Cadorna 90, 28824, Piancavallo Di Oggebbio (VB), Italy
- Department of Translational Medicine, University of Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - Franco Codecasa
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Ilaria Tovaglieri
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Mauro Cornacchia
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Ileana Terruzzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Anna Ferrulli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Patrizia Palmulli
- Department of Pulmonary Rehabilitation, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Amelia Brunani
- Department of Rehabilitation Medicine, Istituto Auxologico Italiano IRCCS, Verbania (VB), Italy
| | - Stefano Lanzi
- Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Livio Luzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, Italy.
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
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Verboven K, Hansen D. Critical Reappraisal of the Role and Importance of Exercise Intervention in the Treatment of Obesity in Adults. Sports Med 2021; 51:379-389. [PMID: 33332014 DOI: 10.1007/s40279-020-01392-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the treatment of obesity in adults, exercise intervention is recommended and some people with obesity even prefer exercise above dietary intervention as a single weight-loss strategy. However, evidence is accumulating that the long-term body weight and adipose tissue mass loss as a result of exercise intervention in these individuals is disappointingly small. Although this could be related to various clinical reasons, more recent evidence reveals that also (patho)physiological abnormalities are involved which cannot be remediated by exercise intervention, especially in metabolically compromised patients. As a result, the role and importance of exercise intervention in the treatment of obesity deserve significant reconsideration to avoid confusion and disappointment amongst clinicians, patients and society. Hence, to reduce adipose tissue mass and body weight, dietary intervention is much more effective than exercise intervention, and is, therefore, of key importance in this endeavour. However, dietary interventions must be supplemented by exercise training to induce clinically relevant changes in specific cardiovascular or metabolic risk factors like blood pressure, blood triglycerides and high-density lipoprotein cholesterol concentrations, as well as visceral adipose tissue mass, physical fitness, muscle mass and strength, quality of life and life expectancy. This allows individuals with obesity to preserve their cardiometabolic health or to shift from a metabolically unhealthy phenotype to a metabolically healthy phenotype. Signifying the true clinical value of exercise interventions might lead to a better understanding and appreciation of the goals and associated effects when implemented in the multidisciplinary treatment of obesity, for which a proper tailoring of exercise prescription is required.
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Affiliation(s)
- Kenneth Verboven
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Building A, 3590, AgoralaanDiepenbeek, Belgium. .,BIOMED-Biomedical Research Center, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Dominique Hansen
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Building A, 3590, AgoralaanDiepenbeek, Belgium.,BIOMED-Biomedical Research Center, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
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Tsofliou F, Pitsiladis YP, Lara J, Hadjicharalambous M, Macdonald IA, Wallace MA, Lean MEJ. The effects of moderate alterations in adrenergic activity on acute appetite regulation in obese women: A randomised crossover trial. Nutr Health 2020; 26:311-322. [PMID: 32729763 PMCID: PMC7534026 DOI: 10.1177/0260106020942117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous evidence has demonstrated that serum leptin is correlated with appetite in combination with, but not without, modest exercise. AIM The present experiments investigated the effects of exogenous adrenaline and α/β adrenoceptor blockade in combination with moderate exercise on serum leptin concentrations, appetite/satiety sensations and subsequent food intake in obese women. METHODS A total of 10 obese women ((mean ± SEM), age: 50 (1.9) years, body mass index 36 (4.1) kg/m2, waist 104.8 (4.1) cm) participated in two separate, double-blind randomised experimental trials. Experiment 1: moderate exercise after α/β adrenergic blocker (labetalol, 100 mg orally) versus moderate exercise plus placebo; experiment 2: adrenaline infusion for 20 minutes versus saline infusion. Appetite/satiety and biochemistry were measured at baseline, pre- and immediately post-intervention, then 1 hour post-intervention (i.e., before dinner). Food intake was assessed via ad libitum buffet-style dinner. RESULTS No differences were found in appetite/satiety, subsequent food intake or serum leptin in any of the studies (experiment 1 or experiment 2). In experiment 1, blood glucose was higher (p < 0.01) and plasma free fatty acids lower (p = 0.04) versus placebo. In experiment 2, plasma free fatty acids (p < 0.05) increased after adrenaline versus saline infusion. CONCLUSIONS Neither inhibition of exercise-induced adrenergic activity by combined α/β adrenergic blockade nor moderate increases in adrenergic activity induced by intravenous adrenaline infusion affected acute appetite regulation.
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Affiliation(s)
- Fotini Tsofliou
- Human Nutrition, School of Medicine, University of Glasgow, United Kingdom
- Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, Bournemouth University, United Kingdom
| | - Yannis P Pitsiladis
- College of Medical Veterinary and Life Science, Institute of Cardiovascular & Medical Sciences, University of Glasgow, United Kingdom
- Centre for Sport and Exercise Science and Medicine, University of Brighton, United Kingdom
| | - Jose Lara
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, United Kingdom
| | - Marios Hadjicharalambous
- College of Medical Veterinary and Life Science, Institute of Cardiovascular & Medical Sciences, University of Glasgow, United Kingdom
- Human Performance Laboratory, Department of Life & Health Sciences, School of Sciences and Engineering, University of Nicosia, Cyprus
| | - Ian A Macdonald
- School of Life Sciences, University of Nottingham Medical School, Queen’s Medical Centre, United Kingdom
| | - Mike A Wallace
- University Department of Pathological Biochemistry, Glasgow Royal Infirmary, United Kingdom
| | - Mike E J Lean
- Human Nutrition, School of Medicine, University of Glasgow, United Kingdom
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Gar C, Rottenkolber M, Haenelt M, Potzel AL, Kern-Matschilles S, Then C, Seissler J, Bidlingmaier M, Lechner A. Altered metabolic and hormonal responses to moderate exercise in overweight/obesity. Metabolism 2020; 107:154219. [PMID: 32240726 DOI: 10.1016/j.metabol.2020.154219] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND An adequate metabolic and hormonal response to the switch from rest to exercise is critical for the health benefits of exercise interventions. Previous work suggests that this response is impaired with overweight/obesity but the specific differences between overweight/obese and lean individuals remain unclear. METHODS We compared glucose and non-esterified fatty acid (NEFA) regulation and the changes of key homeostatic hormones during 45 min of moderate exercise between 17 overweight/obese and 28 lean premenopausal women. For this comparison, we implemented an exercise protocol at 60% of individual peak oxygen uptake, with frequent blood sampling and under fasting conditions. RESULTS We found that at the same exercise intensity in the overweight/obese and the lean group of women, the metabolic and hormonal response differed. In contrast to the lean group, the overweight/obese group portrayed an activation in the stress axis (adrenocorticotropic hormone (ACTH)/cortisol) and a lower growth hormone (hGH) response and exercise-increase of plasma NEFA. Both groups, however, displayed increased insulin sensitivity during exercise that was accompanied by a normalization of the elevated fasting glucose in the overweight/obese group after 15-20 min. CONCLUSION We conclude that the response to exercise in overweight/obese subjects indeed differs from that in lean individuals. Additionally, we demonstrate that exercise can elicit beneficial (improved glucose regulation) and unwanted effects (stress axis activation) in overweight/obese subjects at the same time. This second finding suggests that exercise interventions for overweight/obese subjects need careful consideration of intensity and dose in order to achieve the intended results and avoid acute, undesired reactions.
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Affiliation(s)
- Christina Gar
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Marietta Rottenkolber
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Michael Haenelt
- Endocrine Laboratory, Endocrine Research Unit, Department of Medicine IV, University Hospital, LMU Munich, Germany
| | - Anne L Potzel
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Stefanie Kern-Matschilles
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Cornelia Then
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Jochen Seissler
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Martin Bidlingmaier
- Endocrine Laboratory, Endocrine Research Unit, Department of Medicine IV, University Hospital, LMU Munich, Germany
| | - Andreas Lechner
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
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7
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Arad AD, Basile AJ, Albu J, DiMenna FJ. No Influence of Overweight/Obesity on Exercise Lipid Oxidation: A Systematic Review. Int J Mol Sci 2020; 21:ijms21051614. [PMID: 32120832 PMCID: PMC7084725 DOI: 10.3390/ijms21051614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 12/16/2022] Open
Abstract
Compared to lean counterparts, overweight/obese individuals rely less on lipid during fasting. This deficiency has been implicated in the association between overweight/obesity and blunted insulin signaling via elevated intramuscular triglycerides. However, the capacity for overweight/obese individuals to use lipid during exercise is unclear. This review was conducted to formulate a consensus regarding the influence of overweight/obesity on exercise lipid use. PubMed, ProQuest, ISI Web of Science, and Cochrane Library databases were searched. Articles were included if they presented original research on the influence of overweight/obesity on exercise fuel use in generally healthy sedentary adults. Articles were excluded if they assessed older adults, individuals with chronic disease, and/or exercise limitations or physically-active individuals. The search identified 1205 articles with 729 considered for inclusion after duplicate removal. Once titles, abstracts, and/or manuscripts were assessed, 24 articles were included. The preponderance of evidence from these articles indicates that overweight/obese individuals rely on lipid to a similar extent during exercise. However, conflicting findings were found in eight articles due to the outcome measure cited, participant characteristics other than overweight/obesity and characteristics of the exercise bout(s). We also identified factors other than body fatness which can influence exercise lipid oxidation that should be controlled in future research.
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Affiliation(s)
- Avigdor D. Arad
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.D.A.); (A.J.B.); (J.A.)
| | - Anthony J. Basile
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.D.A.); (A.J.B.); (J.A.)
| | - Jeanine Albu
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.D.A.); (A.J.B.); (J.A.)
| | - Fred J. DiMenna
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.D.A.); (A.J.B.); (J.A.)
- Department of Biobehavioral Sciences, Columbia University Teachers College, New York, NY 10027, USA
- Correspondence:
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Jabbour G, Iancu HD, Paulin A, Lavoie JM, Lemoine-Morel S, Zouhal H. Effects of Acute Supramaximal Cycle Exercise on Plasma FFA Concentration in Obese Adolescent Boys. PLoS One 2015; 10:e0129654. [PMID: 26076464 PMCID: PMC4468086 DOI: 10.1371/journal.pone.0129654] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 05/12/2015] [Indexed: 10/31/2022] Open
Abstract
AIMS The aims of the present study are 1) to evaluate the free fatty acid (FFA) profile and 2) to determine the relative anaerobic and aerobic contributions to total energy consumption during repeated supramaximal cycling bouts (SCE) in adolescent boys with different body weight statuses. MATERIALS AND METHODS Normal-weight (NW), overweight (OW), and obese (OB) adolescent boys (n =15 per group) completed a SCE sessions consisted of 6 x 6s maximal sprints with 2 min of passive rest between each repetition. Plasma FFA levels were determined at rest, immediately after a 10 min warm-up, and immediately at the end of SCE. The anaerobic and aerobic contributions (%) were measured via repeated SCE bouts. Insulin resistance was calculated using the homoeostatic model assessment (HOMA-IR) index. RESULTS The FFA concentrations measured immediately after SCE were higher in the OB group than in the OW and NW (p<0.01 and p<0.01, respectively) groups. Moreover, the anaerobic contributions to SCE were significantly lower in obese adolescents (p<0.01) and decreased significantly during the 2nd, 3rd and 4th repetitions. The FFA levels were significantly associated with the HOMA-IR index and aerobic contribution among adolescent boys (r=0.83 and r=0.91, respectively, p<0.01). CONCLUSION In contrast to the NW and OW groups, there is an increase in lipid mobilization and sift to aerobic energy metabolism during SCE in the OB group.
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Affiliation(s)
- Georges Jabbour
- School of Kinesiology and Leisure, Faculty of Health Sciences and Community Services, Université de Moncton, Moncton, New-Brunswick, Canada
- * E-mail:
| | - Horia-Daniel Iancu
- School of Kinesiology and Leisure, Faculty of Health Sciences and Community Services, Université de Moncton, Moncton, New-Brunswick, Canada
| | - Anne Paulin
- School of Kinesiology and Leisure, Faculty of Health Sciences and Community Services, Université de Moncton, Moncton, New-Brunswick, Canada
| | - Jean-Marc Lavoie
- Department of Kinesiology, University of Montreal, Montreal, QC, H3C 3J7, Canada
| | - Sophie Lemoine-Morel
- Movement Sport and Health Sciences Laboratory, University of Rennes 2-ENS Cachan, Rennes, France
| | - Hassane Zouhal
- Movement Sport and Health Sciences Laboratory, University of Rennes 2-ENS Cachan, Rennes, France
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9
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Clemmer JS, Xiang L, Lu S, Mittwede PN, Hester RL. β2-adrenergic regulation of stress hyperglycemia following hemorrhage in the obese Zucker rat. Physiol Rep 2014; 2:2/12/e12215. [PMID: 25472607 PMCID: PMC4332203 DOI: 10.14814/phy2.12215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Stress hyperglycemia following trauma has been shown to potentiate morbidity and mortality. Glucose control in obese patients can be challenging due to insulin resistance. Thus, understanding the mechanisms for glucose generation following hemorrhage may provide important insights into alternative options for glycemic control in obesity. Obesity is characterized by elevated glycogen and increased hepatic β2‐adrenergic activity, which play major roles in glucose production after hemorrhage. We hypothesized that, in obesity, hepatic glycogenolysis is enhanced during stress hyperglycemia due to increased hepatic β2‐adrenoceptor activation. Hemorrhage was performed in conscious lean Zucker (LZ) and obese Zucker rats (OZ) by withdrawing 35% total blood volume over 10 min. Liver glycogen content and plasma levels of glucose, insulin, and glucagon were measured before and 1 h after hemorrhage. The hyperglycemic response was greater in OZ as compared to LZ, but glycogen content was similarly reduced in both groups. Subsequently, OZ had a greater fall in insulin compared to LZ. Glucagon levels were significantly increased 1 h after hemorrhage in LZ but not in OZ. To test the direct adrenergic effects on the liver after hemorrhage, we treated animals before hemorrhage with a selective β2‐adrenoceptor antagonist, ICI‐118,551 (ICI; 2 mg/kg/h, i.v.). After hemorrhage, ICI significantly reduced hyperglycemia in both LZ and OZ, independent of hormonal changes, but there was a significantly decreased hepatic glycogenolysis in OZ. These results suggest that the hemorrhage‐induced hepatic glycogenolysis is likely glucagon‐dependent in LZ, whereas the β2‐adrenoceptor plays a greater role in OZ. This figure demonstrates that hemorrhage does not result in an increase in glucagon levels in the obese Zucker rat, but does increase in the lean Zucker rat. These results suggest that the hemorrhage‐induced hepatic glycogenolysis is likely glucagon‐dependent in LZ and not in obese Zucker.
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Affiliation(s)
- John S Clemmer
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lusha Xiang
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Silu Lu
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Peter N Mittwede
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Robert L Hester
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
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11
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Hansen D, Meeusen R, Mullens A, Dendale P. Effect of Acute Endurance and Resistance Exercise on Endocrine Hormones Directly Related to Lipolysis and Skeletal Muscle Protein Synthesis in Adult Individuals with Obesity. Sports Med 2012; 42:415-31. [DOI: 10.2165/11599590-000000000-00000] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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12
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Ben Ounis O, Elloumi M, Zouhal H, Makni E, Lac G, Tabka Z, Amri M. Effect of an individualized physical training program on resting cortisol and growth hormone levels and fat oxidation during exercise in obese children. ANNALES D'ENDOCRINOLOGIE 2011; 72:34-41. [DOI: 10.1016/j.ando.2010.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 04/19/2010] [Accepted: 04/22/2010] [Indexed: 10/19/2022]
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13
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Mendonca GV, Heffernan KS, Rossow L, Guerra M, Pereira FD, Fernhall B. Sex differences in linear and nonlinear heart rate variability during early recovery from supramaximal exercise. Appl Physiol Nutr Metab 2010; 35:439-46. [PMID: 20725109 DOI: 10.1139/h10-028] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Women demonstrate greater RR interval variability than men of similar age. Enhanced parasympathetic input into cardiac regulation appears to be not only greater in women, but also protective during periods of cardiac stress. Even though women may have a more favorable autonomic profile after exercise, little research has been conducted on this issue. This study was designed to examine the cardiac autonomic response, in both male and female participants, during the early recovery from supramaximal exercise. Twenty-five individuals, aged 20 to 33 years (13 males and 12 females), performed a 30-s Wingate test. Beat-to-beat RR series were recorded before and 5 min after exercise, with the participants in the supine position and under paced breathing. Linear (spectral analysis) and nonlinear analyses (detrended fluctuation analysis (DFA)) were performed on the same RR series. At rest, women presented lower raw low frequency (LF) power and higher normalized high frequency (HF) power. Under these conditions, the LF/HF ratio of women was also lower than that of men (p<0.05), but there were no differences in the short-term scaling exponent (α1). Even though both sexes showed a significant modification in linear and nonlinear measures of heart rate variability (HRV) (p<0.05), women had a greater change in LF/HF ratio and α1 than men from rest to recovery. This study demonstrates that the cardiac autonomic function of women is more affected by supramaximal exercise than that of men. Additionally, DFA did not provide additional information about sexual dimorphisms, compared with conventional spectral HRV techniques.
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Affiliation(s)
- Goncalo V Mendonca
- Department of Human Kinetics, Faculty of Human Kinetics, Technical University of Lisbon, Lisbon 1495-688, Portugal.
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Making physical activity programs work for american indian/alaska native youth at risk for obesity and type 2 diabetes mellitus. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2010; 16:426-31. [PMID: 20689392 DOI: 10.1097/phh.0b013e3181c60ec2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Obesity and catecholamine responses to maximal exercise in adolescent girls. Eur J Appl Physiol 2010; 110:247-54. [DOI: 10.1007/s00421-010-1492-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2010] [Indexed: 11/27/2022]
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16
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Magkos F, Mittendorfer B. Gender differences in lipid metabolism and the effect of obesity. Obstet Gynecol Clin North Am 2009; 36:245-65, vii. [PMID: 19501312 DOI: 10.1016/j.ogc.2009.03.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
There are many differences between men and women, and between lean and obese subjects, in fatty acid and very low-density lipoprotein triglyceride and apolipoprotein B-100 metabolism. Currently, observations in this area are predominantly descriptive. The mechanisms responsible for sexual dimorphism in lipid metabolism are largely unknown.
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Affiliation(s)
- Faidon Magkos
- Center for Human Nutrition, Division of Geriatrics & Nutritional Science, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA
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17
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Fornitano LD, Godoy MF. Exercise Testing in Individuals with Morbid Obesity. Obes Surg 2008; 20:583-8. [DOI: 10.1007/s11695-008-9692-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2008] [Accepted: 09/02/2008] [Indexed: 01/19/2023]
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18
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Pinet BM, Prud'homme D, Gallant CA, Boulay P. Exercise intensity prescription in obese individuals. Obesity (Silver Spring) 2008; 16:2088-95. [PMID: 18483474 DOI: 10.1038/oby.2008.272] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The main purpose of this study was to evaluate the relationship between different methods proposed by the American College of Sports Medicine (ACSM) to prescribe exercise intensity using heart rate (HR) and oxygen uptake (VO2) in obese individuals. Sixty-eight overweight to severely obese adults were divided into three groups (tertile) based on their BMI. The groups were T1 group (BMI = 30.5 +/- 1.5, n = 23), T2 group (BMI = 34.3 +/- 1.0, n = 23), and T3 group (BMI = 40.2 +/- 3.7, n = 22). All subjects performed a graded exercise test using a ramp protocol on a treadmill. Individual linear regressions between %HR reserve (%HRR) and %VO2 reserve (%VO2R), %HRR and %VO2 peak (%VO2peak), %maximal HR (%HRmax) and %VO2R, and %HRmax and %VO2peak were calculated. When all the subjects were grouped together, the %HRR-%VO2R mean regression was partially related to the line of identity, while the %HRR-%VO2peak, %HRmax-%VO2R, and %HRmax-%VO2peak mean regressions were all significantly different than the line of identity (P < 0.001). The degree of obesity accounted for approximately 15% of the variation for both %HRR-%VO2R and %HRR-%VO2peak mean regressions. The %HRmax-%VO2R and %HRmax-%VO2peak mean regressions were not affected by the degree of obesity but resting HR accounted for 28-37% of the variation. The relationship between the exercise intensity determined by the %HRR-%VO2R and the %HRR-%VO2peak mean regression seems to be influenced by the degree of obesity. The degree of obesity does not affect the relationship between exercise intensity generated by the %HRmax-%VO2R or %HRmax-%VO2peak equations but the resting HR does.
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Affiliation(s)
- Bernard M Pinet
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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19
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Tilbrook AJ, Rivalland EAT, Turner AI, Lambert GW, Clarke IJ. Responses of the hypothalamopituitary adrenal axis and the sympathoadrenal system to isolation/restraint stress in sheep of different adiposity. Neuroendocrinology 2008; 87:193-205. [PMID: 18285679 DOI: 10.1159/000117576] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 11/11/2007] [Indexed: 11/19/2022]
Abstract
There is evidence that levels of adipose tissue can influence responses of the hypothalamopituitary-adrenal (HPA) axis to stress in humans and rats but this has not been explored in sheep. Also, little is known about the sympathoadrenal responses to stress in individuals with relatively different levels of adipose tissue. We tested the hypothesis that the stress-induced activation of the HPA axis and sympathoadrenal system is lower in ovariectomized ewes with low levels of body fat (lean) than ovariectomized ewes with high levels of body fat (fat). Ewes underwent dietary manipulation for 3 months to yield a group of lean ewes (n = 7) with a mean (+/-SEM) live weight of 39.1 +/- 0.9 kg and body fat of 8.9 +/- 0.6% and fat ewes (n = 7) with a mean (+/-SEM) live weight of 69.0 +/- 1.8 kg and body fat of 31.7 +/- 3.4%. Fat ewes also had higher circulating concentrations of leptin than lean ewes. Blood samples were collected every 15 min over 8 h when no stress was imposed (control day) and on a separate day when 4 h of isolation/restraint was imposed after 4 h of pretreatment sampling (stress day). Plasma concentrations of adrenocorticotropic hormone (ACTH), cortisol, epinephrine and norepinephrine did not change significantly over the control day and did not differ between lean and fat ewes. Stress did not affect plasma leptin levels. All stress hormones increased significantly during isolation/restraint stress. The ACTH, cortisol and epinephrine responses were greater in fat ewes than lean ewes but norepinephrine responses were similar. Our results suggest that relative levels of adipose tissue influence the stress-induced activity of the hypothalamopituitary-adrenal axis and some aspects of the sympathoadrenal system with fat animals having higher responses than lean animals.
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Affiliation(s)
- Alan J Tilbrook
- Department of Physiology, Monash University, Monash, Vic., Australia.
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Norman AC, Drinkard B, McDuffie JR, Ghorbani S, Yanoff LB, Yanovski JA. Influence of excess adiposity on exercise fitness and performance in overweight children and adolescents. Pediatrics 2005; 115:e690-6. [PMID: 15930197 PMCID: PMC1350764 DOI: 10.1542/peds.2004-1543] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Relatively little is known about how excess body mass affects adolescents' capacity to perform sustained exercise. We hypothesized that most of the difficulty that severely overweight adolescents have with sustained exercise occurs because the metabolic costs of moving excess mass result in use of a high proportion of their total oxygen reserve. METHODS We compared results from a maximal cycle ergometry fitness test in 129 severely overweight adolescents who had BMIs of 41.5 +/- 9.7 kg/m2 and ages of 14.5 +/- 1.8 years (range: 12.1-17.8 years) and 34 nonoverweight adolescents who had BMIs of 20.1 +/- 2.9 kg/m2 and ages of 14.5 +/- 1.5 years (range: 12.0-18.1 years). Oxygen uptake (Vo2) was compared at 3 times: during a 4-minute period of unloaded cycling (ULVo2), at the lactate threshold estimated by gas exchange (LTVo2), and at maximal exertion (Vo2 max). Heart rate was obtained at rest and at Vo2 max. Participants also completed a 12-minute walk/run performance test to obtain distance traveled (D12) and heart rate. RESULTS Absolute LTVo2 and Vo2 max and LTVo2 as a percentage of Vo2 max were not different in overweight and nonoverweight adolescents during the cycle test. However, absolute ULVo2 was significantly greater in overweight adolescents: ULVo2 accounted for 35 +/- 8% of Vo2 max (and 63 +/- 15% of LTVo2) in overweight adolescents but only 20 +/- 5% of Vo2 max (and 39 +/- 12% of LTVo2) in nonoverweight adolescents. Resting heart rate before initiating the cycle test was significantly greater in overweight than nonoverweight adolescents (94 +/- 14 vs 82 +/- 15 beats per minute). However, maximal heart rate during the cycle test was significantly lower in overweight adolescents (186 +/- 13 vs 196 +/- 11 beats per minute). During the walk/run test, mean D12 was significantly shorter for overweight than for nonoverweight adolescents (1983 +/- 323 vs 1159 +/- 194 m). D12 was negatively related to BMI SDS (r = -0.81) and to ULVo2 (r = -0.98). DISCUSSION Overweight and nonoverweight adolescents had similar absolute Vo2 at the lactate threshold and at maximal exertion, suggesting that overweight adolescents are more limited by the increased cardiorespiratory effort required to move their larger body mass through space than by cardiorespiratory deconditioning. The higher percentage of oxygen consumed during submaximal exercise indicates that overweight adolescents are burdened by the metabolic cost of their excess mass. Their greater oxygen demand during an unloaded task predicted poorer performance during sustained exercise. Exercise prescriptions for overweight adolescents should account for the limited exercise tolerance imposed by excess body mass, focusing on activities that keep demands below lactate threshold so that exercise can be sustained.
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Key Words
- v̇o2 max, maximum oxygen uptake
- sds, sd score
- ulv̇o2, unloaded oxygen uptake;
- ltv̇o2, oxygen uptake at the lactate threshold
- v̇o2 max, oxygen uptake at maximal exertion
- hrr, heart rate reserve
- rpe, rating of perceived exertion
- bpm, beats per minute
- d12, distance achieved at 12 minutes during walk/run test
- ancova, analysis of covariance
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Affiliation(s)
- Anne-Caroline Norman
- Developmental Endocrinology Branch, National Institute on Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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Loftin M, Sothern M, VanVrancken C, O'Hanlon A, Udall J. Effect of obesity status on heart rate peak in female youth. Clin Pediatr (Phila) 2003; 42:505-10. [PMID: 12921451 DOI: 10.1177/000992280304200604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to compare heart rate peak in obese (n = 43) and normal weight (n = 45) female youth. Heart rate (HR) peak was significantly lower (p < or = 0.05) in the obese group as compared to the normal weight group (192.3 +/- 9.3, 203.4 +/- 7.6), and VO2 (L x min(-1)) peak similar between groups (1.77 +/- 0.53, 1.97 +/- 0.60). Bivariate correlations for heart rate peak with body weight, percent fat, and body mass index yielded the following: -0.53, -0.54, and -0.57. These findings agree with the adult data indicating low HR peak in obese individuals. Further research is needed to explore physiologic factors that may lead to reduced HR peak in obese female youth.
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Affiliation(s)
- Mark Loftin
- Department of Human Performance and Health Promotion, University of New Orleans, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana 70148, USA
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Del Rio G, Velardo A, Zizzo G, Galetti S, Marrama P, Della Casa L. Daily variations in catecholamine excretion are not influenced by very low calorie diet in obese women. J Endocrinol Invest 1993; 16:527-32. [PMID: 8227982 DOI: 10.1007/bf03348899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The increase in metabolic efficiency during energy restriction seems to be an established phenomenon in obese patients. The sympathoadrenal system is involved in the control of energy expenditure and the catecholamine responses to stimuli vary during the day. We therefore studied the circadian pattern of urinary catecholamine excretion during 4-h collections for two consecutive days in a group of 20 obese female patients during and after a very low calorie diet (500 kcal/die). The diet period induced a significant weight loss in all the patients studied (99.1 +/- 3.7 vs 92.5 +/- 4.1 Kg; p < 0.01). The mean daily excretion of epinephrine did not change after 24 days of diet restriction when compared with the value obtained at the 4th day (12.0 +/- 2.5 vs 10.3 +/- 2.2 nmol/4 h respectively; p = NS) while a slight decrease was observed in the mean daily excretion of norepinephrine (52.5 +/- 8.7 vs 66.6 +/- 9.3 nmol/4 h respectively; p = NS). A circadian rhythm was detected for epinephrine and norepinephrine excretion both during and after very low calorie diet. No significant changes were found in the chronobiological characteristics of epinephrine and norepinephrine with the peak of excretion in the afternoon both during (epinephrine: 16:30 h; norepinephrine: 16:45 h) and after the diet (epinephrine: 17:35 h; norepinephrine: 18:00 h). It seems doubtful that alterations in the chronobiological pattern of catecholamines play a role in the metabolic adaptation occurring during very low calorie diet in obese females.
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Affiliation(s)
- G Del Rio
- Cattedra di Malattie del Metabolismo e Cattedra di Endocrinologia, Università di Modena, Italy
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Sothmann MS, Hart BA, Horn TS. Sympathetic nervous system and behavioral responses to stress following exercise training. Physiol Behav 1992; 51:1097-103. [PMID: 1641410 DOI: 10.1016/0031-9384(92)90293-b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study tests the hypothesis that a short-term (16 weeks) exercise program modifies sympathetic nervous system (SNS) and selected behavioral responses to acute psychological stress. Twenty-four previously sedentary middle-aged men with maximal aerobic capacity (VmaxO2) values less than 40 ml.kg-1.min-1 were assigned to experimental (n = 12) and control (n = 12) groups. All subjects performed a modified Stroop test (18 min) at pre- and postexercise training during which intravenous blood samples were drawn at three time intervals for plasma catecholamine (CA) determination. Motor performance was continuously recorded for assessment of premotor (PMT) and motor (MOT) components of reactions time. A set of anagrams were administered immediately following the modified Stroop to determine the level of cognitive fatigue induced. At both pre- and postexercise intervention, the total group (n = 24) manifested significant (p less than or equal to 0.05) elevations in state anxiety, heart rate, and plasma norepinephrine. No significant changes occurred over time on PMT or MOT. There were significantly (p less than or equal to 0.01) lengthened anagram performance scores poststress compared to nonstress values. The experimental group exercise trained 3 days/week for 16 weeks, resulting in a 20% increase in VO2max. However, there were no group differences on the CA or behavioral responses to the modified Stroop at pre- or postintervention. These findings do not support the hypothesis that short-term aerobic training significantly alters SNS activity or behavioral measures of central processing in middle-aged men exposed to an acute psychological challenge.
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Affiliation(s)
- M S Sothmann
- Department of Human Kinetics, School of Allied Health Professions, University of Wisconsin-Milwaukee 53201
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Weaver JU, Noonan K, Kopelman PG. An association between hypothalamic-pituitary dysfunction and peripheral endocrine function in extreme obesity. Clin Endocrinol (Oxf) 1991; 35:97-102. [PMID: 1889145 DOI: 10.1111/j.1365-2265.1991.tb03503.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim was to investigate a possible relationship between measures of insulin secretion and glucose disposal and hypothalamic-pituitary function in extreme obesity. DESIGN A cross-sectional analysis of obese subjects attending the Obesity Clinic at the Royal London Hospital and normal weight volunteers was undertaken. Investigations were performed on separate occasions and in random order. PATIENTS The subjects were 34 extremely obese women, menstruating and with normal glucose tolerance (mean Body Mass Index, BMI = 42) and 15 normal weight female controls (mean BMI = 22). MEASUREMENTS The following were measured: fasting insulin, relative insulin resistance calculated using fasting insulin and plasma glucose by the homeostatic model of assessment, insulin release during a 75-g oral glucose tolerance test (insulin area under the curve), steady-state plasma glucose level achieved during a simultaneous intravenous infusion of dextrose, insulin and somatostatin, and the prolactin and growth hormone (GH) responses to insulin-induced hypoglycaemia. RESULTS In the obese group an impaired prolactin response to hypoglycaemia (mean area under the curve obese 54 U/l min, controls 155 U/l min; P = 0.0001) was inversely correlated to fasting insulin, r2 = 0.142, P = 0.03; relative insulin resistance, r2 = 0.134, P = 0.03 and steady-state plasma glucose level, r2 = 0.345, P = 0.0004 whereas the impaired GH response (mean GH area under the curve obese 1.9 U/l min, controls 65.7 U/l min; P = 0.0001) was inversely correlated to steady-state plasma glucose level, r2 = 0.196, P = 0.01. Backward procedure for stepwise regression analysis confirmed the steady-state plasma glucose level to be the most important variable associated with the prolactin and growth hormone response among the remaining indices of insulin secretion/resistance. CONCLUSION We conclude from these findings that hyperinsulinaemia in obesity is an important association with altered hypothalamic-pituitary function indicated by impaired prolactin and growth hormone secretion to insulin-induced hypoglycaemia.
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