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Mallardo M, Daniele A, Musumeci G, Nigro E. A Narrative Review on Adipose Tissue and Overtraining: Shedding Light on the Interplay among Adipokines, Exercise and Overtraining. Int J Mol Sci 2024; 25:4089. [PMID: 38612899 PMCID: PMC11012884 DOI: 10.3390/ijms25074089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Lifestyle factors, particularly physical inactivity, are closely linked to the onset of numerous metabolic diseases. Adipose tissue (AT) has been extensively studied for various metabolic diseases such as obesity, type 2 diabetes, and immune system dysregulation due to its role in energy metabolism and regulation of inflammation. Physical activity is increasingly recognized as a powerful non-pharmacological tool for the treatment of various disorders, as it helps to improve metabolic, immune, and inflammatory functions. However, chronic excessive training has been associated with increased inflammatory markers and oxidative stress, so much so that excessive training overload, combined with inadequate recovery, can lead to the development of overtraining syndrome (OTS). OTS negatively impacts an athlete's performance capabilities and significantly affects both physical health and mental well-being. However, diagnosing OTS remains challenging as the contributing factors, signs/symptoms, and underlying maladaptive mechanisms are individualized, sport-specific, and unclear. Therefore, identifying potential biomarkers that could assist in preventing and/or diagnosing OTS is an important objective. In this review, we focus on the possibility that the endocrine functions of AT may have significant implications in the etiopathogenesis of OTS. During physical exercise, AT responds dynamically, undergoing remodeling of endocrine functions that influence the production of adipokines involved in regulating major energy and inflammatory processes. In this scenario, we will discuss exercise about its effects on AT activity and metabolism and its relevance to the prevention and/or development of OTS. Furthermore, we will highlight adipokines as potential markers for diagnosing OTS.
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Affiliation(s)
- Marta Mallardo
- Department of Molecular and Biotechnological Medicine, University of Naples “Federico II”, 80131 Naples, Italy;
- CEINGE-Biotechnologies Advances S.c.a r.l., Via G. Salvatore 486, 80145 Naples, Italy;
| | - Aurora Daniele
- Department of Molecular and Biotechnological Medicine, University of Naples “Federico II”, 80131 Naples, Italy;
- CEINGE-Biotechnologies Advances S.c.a r.l., Via G. Salvatore 486, 80145 Naples, Italy;
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Sciences Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, 95123 Catania, Italy
| | - Ersilia Nigro
- CEINGE-Biotechnologies Advances S.c.a r.l., Via G. Salvatore 486, 80145 Naples, Italy;
- Department of Pharmaceutical, Biological, Environmental Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via G. Vivaldi 42, 81100 Caserta, Italy
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Alves MDDJ, Silva DDS, Pereira EVM, Pereira DD, de Sousa Fernandes MS, Santos DFC, Oliveira DPM, Vieira-Souza LM, Aidar FJ, de Souza RF. Changes in Cytokines Concentration Following Long-Distance Running: A Systematic Review and Meta-Analysis. Front Physiol 2022; 13:838069. [PMID: 35250639 PMCID: PMC8893166 DOI: 10.3389/fphys.2022.838069] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/25/2022] [Indexed: 12/15/2022] Open
Abstract
Long-distance running is an exhausting effort for the whole organism. Prolonged aerobic exercise induces changes in inflammatory markers. However, predicting muscle damage in response has limitations in terms of selecting biomarkers used to measure inflammatory status. The present study conducts a systematic review and meta-analysis of articles focusing in ultra-marathon, marathon, and half-marathon and levels of cytokines. The search was conducted in PubMed, Web of Science, and Scopus databases, resulting in the inclusion of 76 articles. IL-6 was highlighted, evaluated in 62 studies and show increase in the standard mean difference (SMD): half-marathon (SMD −1.36; IC 95%: −1.82, −0.89, Ch2:0.58; tau2:0.00; p < 0.0001), marathon (SMD −6.81; IC 95%: −9.26, −4.37; Ch2:481.37 tau2:11.88; p < 0.0001) and ultra-marathon (SMD −8.00 IC 95%: −10.47, −5.53; Ch2:328.40; tau2:14.19; p < 0.0001). In contrast meta-regression analysis did not show relationship to the running distance (p = 0.864). The meta-analysis evidenced increase in the concentration of IL-1ra (p < 0.0001), IL-1B (p < 0.0001), IL-8 (p < 0.0001), IL-10 (p < 0.0001) and TNF-α (p < 0.0001). Reduction in IL-2 (p < 0.0001) and INF-y (p < 0.03) and no change in the IL-4 (p < 0.56). The number of studies evaluating the effect of adipokines was limited, however Leptin and Resistin were recurrent. The effects of an acute bout of prolonged aerobic exercise will protect against chronic systemic inflammation. The time to return to baseline values showed a substantial and dose-dependent relationship with run volume. The concentration of IL-6 was robustly studied and the marathon running was the most explored. Network of endocrine interactions in which circulating factors, released in extreme exercises, interplay through inter-organ crosstalk and physiologic changes were expressed. The running volume variability was able to modulate compounds that play a fundamental role in the maintenance of homeostasis and cell signaling.
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Affiliation(s)
- Micael Deivison de Jesus Alves
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Graduate Program in Physical Education, Postgraduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports—GEPEPS, Federal University of Sergipe (UFS), São Cristovão, Brazil
| | - Devisson dos Santos Silva
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Graduate Program in Physical Education, Postgraduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports—GEPEPS, Federal University of Sergipe (UFS), São Cristovão, Brazil
| | - Erika Vitoria Moura Pereira
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports—GEPEPS, Federal University of Sergipe (UFS), São Cristovão, Brazil
| | - Danielle Dutra Pereira
- Department of Physiology and Pharmacology, Biological Sciences Course, Federal University of Piauí, Teresina, Brazil
| | - Matheus Santos de Sousa Fernandes
- Graduate Program, Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Recife, Brazil
| | | | | | - Lucio Marques Vieira-Souza
- Graduate Program in Physical Education, Postgraduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Physical Education Course, State University of Minas Gerais-UEMG, Passos, Brazil
| | - Felipe J. Aidar
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Graduate Program in Physical Education, Postgraduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports—GEPEPS, Federal University of Sergipe (UFS), São Cristovão, Brazil
| | - Raphael Fabricio de Souza
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Graduate Program in Physical Education, Postgraduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristóvão, Brazil
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports—GEPEPS, Federal University of Sergipe (UFS), São Cristovão, Brazil
- *Correspondence: Raphael Fabricio de Souza
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Efficacy of Whole-Body Vibration Training on Brain-Derived Neurotrophic Factor, Clinical and Functional Outcomes, and Quality of Life in Women with Fibromyalgia Syndrome: A Randomized Controlled Trial. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7593802. [PMID: 34900203 PMCID: PMC8654532 DOI: 10.1155/2021/7593802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/08/2021] [Accepted: 10/16/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the efficacy of whole-body vibration training (WBVT) on blood brain-derived neurotrophic factor (BDNF) levels and determine the clinical and functional outcomes in patients with fibromyalgia syndrome (FMS). Thirty-two women with FMS were randomized into an intervention group (IG), receiving 6 weeks of WBVT, or a control group (CG) with no intervention. The outcomes at the baseline and follow-up in both groups included blood BDNF levels, sit-to-stand test (STS), 6-minute walk test (6MWT), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and visual analogue scale (VAS). WBVT resulted in a group-by-time interaction effect. Thus, after the intervention time, the IG had increased blood BDNF levels (p=0.045), a higher number of repetitions on the STS test (p=0.011), and increased walking distance on the 6MWT (p=0.010), compared to CG. Moreover, there was a reduction in the scores of the FIQ (p=0.001), the PSQI (p=0.001), the BDI (p=0.017), and pain assessed using VAS (p=0.008) in IG. The results demonstrate that WBVT promotes an increase in blood BDNF levels, with concomitant improvement in lower limb muscle strength, aerobic capacity, clinical symptoms, and quality of life in women with FMS. This trial is registered with Brazilian Clinical Trials Registry (REBEC; RBR-38nbbx) (https://ensaiosclinicos.gov.br/rg/RBR-38nbbx).
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Atzeni F, Alciati A, Salaffi F, Di Carlo M, Bazzichi L, Govoni M, Biasi G, Di Franco M, Mozzani F, Gremese E, Dagna L, Batticciotto A, Fischetti F, Giacomelli R, Guiducci S, Guggino G, Bentivegna M, Gerli R, Salvarani C, Bajocchi G, Ghini M, Iannone F, Giorgi V, Farah S, Bonazza S, Barbagli S, Gioia C, Marino NG, Capacci A, Cavalli G, Cappelli A, Carubbi F, Nacci F, Riccucci I, Cutolo M, Sinigaglia L, Sarzi-Puttini P. The association between body mass index and fibromyalgia severity: data from a cross-sectional survey of 2339 patients. Rheumatol Adv Pract 2021; 5:rkab015. [PMID: 34345760 PMCID: PMC8324026 DOI: 10.1093/rap/rkab015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/11/2021] [Indexed: 12/19/2022] Open
Abstract
Objective Various studies have shown that overweight and obesity are central features of FM, but the real impact of a high BMI on clinical severity in patients with FM is still controversial. The aim of this study was to analyse the relationships between BMI categories and measures of symptom severity and functional impairment using data from a Web-based registry of patients with FM. Methods Adult patients with an ACR 2010/2011 diagnosis of FM underwent a complete physical examination and laboratory tests and were asked to complete a package of questionnaires covering their sociodemographic and treatment details, in addition to the following disease-specific questionnaires: the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status questionnaire (ModFAS) and the Polysymptomatic Distress Scale (PDS). Results A total of 2339 patients were recruited and divided into two weight categories, underweight/normal (U/N, n = 1127, 48.2%) and overweight/obese (O/O, n = 1212, 51.8%). The total and subscales of FIQR, ModFAS and PSD scores were significantly higher in the O/O patients, as were all the mean scores of the individual FIQR items (P < 0.001 for all). Conclusion Our findings demonstrate that O/O patients with FM are significantly more impaired than U/N patients in all the symptomatological and functional domains as measured using the FIQR, ModFAS and PDS, thus suggesting that being O/O has an additional effect on symptoms and function.
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Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, Department of Internal Medicine, University of Messina, Messina
| | - Alessandra Alciati
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Albese con Cassano, Humanitas Clinical and Research Center, Como, Milan, Rozzano
| | - Fausto Salaffi
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | - Marco Di Carlo
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | | | - Marcello Govoni
- Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara
| | - Giovanni Biasi
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena
| | - Manuela Di Franco
- Rheumatology Unit, Department of Internal Medicine, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome
| | - Flavio Mozzani
- Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma
| | - Elisa Gremese
- Rheumatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | | | - Fabio Fischetti
- Unit of Rheumatology, Department of Medical, Surgery and Health Sciences, ASUGI and Clinical University, University of Trieste
| | - Roberto Giacomelli
- Clinical Unit of Rheumatology, School of Medicine, University of L'Aquila
| | - Serena Guiducci
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Giuliana Guggino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo
| | - Mario Bentivegna
- Integrated Reference Center of Rheumatology, Scicli Hospital, Ragusa
| | - Roberto Gerli
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia
| | - Carlo Salvarani
- University of Modena and Reggio Emilia, Azienda USL-IRCCS di Reggio Emilia
| | - Gianluigi Bajocchi
- Rheumatology Unit, S. Maria Hospital-USL, IRCCS Institute, Reggio Emilia
| | | | - Florenzo Iannone
- Rheumatology Unit, Department of Emergency Surgery and Organ Transplantations, University of Bari, Bari
| | - Valeria Giorgi
- Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli-Sacco, Milan University School of Medicine, Milan
| | - Sonia Farah
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | - Sara Bonazza
- Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara
| | - Stefano Barbagli
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena
| | - Chiara Gioia
- Rheumatology Unit, Department of Internal Medicine, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome
| | - Noemi Giuliana Marino
- Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma
| | - Annunziata Capacci
- Rheumatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | - Antonella Cappelli
- Rheumatology Unit, Internal Medicine Department, ASST Settelaghi, Varese
| | - Francesco Carubbi
- Clinical Unit of Rheumatology, School of Medicine, University of L'Aquila
| | - Francesca Nacci
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Ilenia Riccucci
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia
| | - Maurizio Cutolo
- Research Laboratory and Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, IRCCS San Martino, Genova
| | | | - Piercarlo Sarzi-Puttini
- Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli-Sacco, Milan University School of Medicine, Milan
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Relationship of leptin, growth hormone, and insulin-like growth factor levels with body mass index and disease severity in patients with fibromyalgia syndrome. Acta Neurol Belg 2020; 120:595-599. [PMID: 30547374 DOI: 10.1007/s13760-018-01063-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 12/08/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE A high prevalence of obesity in fibromyalgia syndrome (FMS) predisposes patients to metabolic changes. It is not clear how the clinical manifestations of the disease affect metabolism. This study aimed to investigate leptin, growth hormone (GH), and insulin-like growth factor (IGF-1) levels in FMS, and their relationship with body mass index (BMI) and disease severity. METHOD This case-control study included 60 patients with FMS and 42 age- and sex-matched healthy controls. BMIs were recorded for all participants. The disease severity was assessed using the Fibromyalgia Impact Questionnaire (FIQ) and a visual analog scale (VAS). The serum levels of leptin, GH, and IGF-1 of all participants were measured using specific enzyme-linked immunosorbent assays. RESULTS Both groups had similar age (p = 0.058), sex (p = 0.25), and BMI (p = 0.29) distribution. The mean age of the FMS and the control groups was 40.7 ± 10.8 years and 36.2 ± 13.6 years, respectively. The mean BMI was 26.7 kg/m2 in the FMS group. The GH (p = 0.037) and IGF-1 (p = 0.002) levels were statistically lower, and leptin (p = 0.002) levels were considerably higher in the FMS group than in the control group. The leptin values were positively correlated with age (p = 0.001; r = 0.386) and BMI (p < 0.001; r = 445). Insulin-like growth factor levels were negatively correlated with age (p < 0.001; r = - 0.605) and BMI (p < 0.001; r = - 0.564). Similarly, GH levels were negatively correlated with age (p = 0.040; r = - 0.243) and BMI (p < 0.001; p = - 0.420). None of the three hormones were associated with FIQ and VAS. CONCLUSION We found that leptin (high), GH (low), and IGF-1 (low) levels were statistically different, together with being independent of disease severity (FIQ, VAS), and correlated with BMI in the FMS group. These findings may be related with hypothalamo-pituitary axis dysfunction, BMI, and energy metabolism.
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Erlandsson MC, Lyngfelt L, Åberg ND, Wasén C, Espino RA, Silfverswärd ST, Nadali M, Jood K, Andersson KME, Pullerits R, Bokarewa MI. Low serum IGF1 is associated with hypertension and predicts early cardiovascular events in women with rheumatoid arthritis. BMC Med 2019; 17:141. [PMID: 31327319 PMCID: PMC6643304 DOI: 10.1186/s12916-019-1374-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 06/25/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Since low insulin-like growth factor (IGF) 1 is often linked to inflammation, we analyze whether serum levels of IGF1 are associated with cardiovascular disease (CVD) in rheumatoid arthritis (RA) in a longitudinal observational study. METHODS A CVD risk was estimated (eCVR) in 184 female RA patients (mean age 52 years) and in 132 female patients after ischemic stroke (mean age 56 years) with no rheumatic disease, using the Framingham algorithm. The median level of IGF1 divided the cohorts in IGF1high and IGF1low groups. A 5-year prospective follow-up for new CVD events was completed in all RA patients. The Mantel-Cox analysis and event-free survival curves were prepared. Unsupervised clustering of proteins within the IGF1 signaling pathway was employed to identify their association with eCVR. RESULTS Low IGF1 resulted in a higher eCVR in RA patients (7.2% and 3.3%, p = 0.0063) and in stroke (9.3% and 7.1%, p = 0.033). RA had higher rate for new CVD events at prospective follow-up (OR 4.96, p = 0.028). Hypertension was the major risk factor associated with low IGF1 in RA and stroke. In hypertension, IGF1 was no longer responsible for intracellular activation and lost its correlation to IRS1/2 adaptor proteins. The clustering analysis confirmed that combination of low IGF1 and IRS1/2 with high IL6, insulin, and glucose predisposed to high eCVR and emphasized the functional role of serum IGF1. CONCLUSIONS Low serum IGF1 precedes and predicts development of early CVD events in female RA patients. Hypertension and aberrant IGF1 receptor signaling are highlighted as the important contributors to IGF1-related CVD events.
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Affiliation(s)
- Malin C Erlandsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden. .,Rheumatology Clinic, the Sahlgrenska University Hospital, Gothenburg, Region of West Götaland, Sweden.
| | - Lovisa Lyngfelt
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden
| | - N David Åberg
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Caroline Wasén
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden
| | - Rachelle A Espino
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden.,Keele University, Keele, UK
| | - Sofia Töyrä Silfverswärd
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden
| | - Mitra Nadali
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden.,Rheumatology Clinic, the Sahlgrenska University Hospital, Gothenburg, Region of West Götaland, Sweden
| | - Katharina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, the Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karin M E Andersson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden
| | - Rille Pullerits
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden.,Rheumatology Clinic, the Sahlgrenska University Hospital, Gothenburg, Region of West Götaland, Sweden.,Department of Clinical Immunology and Transfusion Medicine, the Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria I Bokarewa
- Department of Rheumatology and Inflammation Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Guldhedsgatan 10A, SE-41345, Gothenburg, Sweden. .,Rheumatology Clinic, the Sahlgrenska University Hospital, Gothenburg, Region of West Götaland, Sweden.
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7
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Gavilán-Carrera B, Segura-Jiménez V, Mekary RA, Borges-Cosic M, Acosta-Manzano P, Estévez-López F, Álvarez-Gallardo IC, Geenen R, Delgado-Fernández M. Substituting Sedentary Time With Physical Activity in Fibromyalgia and the Association With Quality of Life and Impact of the Disease: The al-Ándalus Project. Arthritis Care Res (Hoboken) 2019; 71:281-289. [PMID: 30055083 DOI: 10.1002/acr.23717] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 07/24/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE There is an overall awareness of the detrimental health effects of sedentary time (ST) in fibromyalgia; however, data are limited on how replacement of ST with physical activity (PA) of different intensity may be related to health in this condition. The aim of this study was to examine how a substitution of ST with light PA (LPA) or moderate-to-vigorous PA (MVPA) is associated with quality of life and disease impact. METHODS This study comprised 407 women with fibromyalgia, mean ± SD age 51.4 ± 7.6 years. The time spent in ST and PA was measured with triaxial accelerometry. Quality of life and disease impact were assessed using the Short Form 36 (SF-36) health survey and the Revised Fibromyalgia Impact Questionnaire (FIQR), respectively. The substitution of ST with an equivalent time of LPA or MVPA and the associated outcomes were examined using isotemporal substitution analyses. RESULTS Substituting 30 minutes of ST with LPA in the isotemporal model was associated with better scores in bodily pain (B = 0.55), vitality (B = 0.74), and social functioning (B = 1.45) according to the SF-36, and better scores at all of the domains (function, overall impact, symptoms, and total impact) of the FIQR (B ranging from -0.95 to -0.27; all P < 0.05). When ST was replaced with MVPA, better physical role (B = 2.30) and social functioning (B = 4.11) of the SF-36 and function of the FIQR (B = -0.73) were observed (all P < 0.05). CONCLUSION In regression models, allocation of time of sedentary behavior to either LPA or MVPA was associated with better quality of life and lower disease impact in women with fibromyalgia.
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Affiliation(s)
| | | | - Rania A Mekary
- Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Fernando Estévez-López
- University of Granada, Granada, Spain, Ulster University, Northern Ireland, United Kingdom, and Utrecht University, Utrecht, The Netherlands
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Honda Y, Sakamoto J, Hamaue Y, Kataoka H, Kondo Y, Sasabe R, Goto K, Fukushima T, Oga S, Sasaki R, Tanaka N, Nakano J, Okita M. Effects of Physical-Agent Pain Relief Modalities for Fibromyalgia Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Res Manag 2018; 2018:2930632. [PMID: 30402199 PMCID: PMC6191958 DOI: 10.1155/2018/2930632] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/27/2018] [Indexed: 11/21/2022]
Abstract
Purpose We conducted a systematic review and meta-analysis to investigate the effects of the following physical-agent modalities for pain relief in fibromyalgia (FM) patients. Methods We identified randomized controlled studies of adults with FM in the MEDLINE, CINAHL, and PEDro databases. The primary outcome measure was pain relief measured by a visual analogue scale (VAS), and the secondary outcome measures of interest were subjective improvements in the number of tender points, Fibromyalgia Impact Questionnaire (FIQ), and quality of life (QOL) scores. Results Eleven studies were included in our review. The studies' physical-agent modalities were low-level laser therapy (LLLT), thermal therapy, electromagnetic field therapy, and transcutaneous electrical nerve stimulation (TENS). LLLT did not reduce VAS scores, but it significantly reduced both the number of tender points and FIQ score. Thermal therapy was associated with significantly reduced VAS scores, tender points, and FIQ scores. Electromagnetic field therapy was associated with significantly reduced VAS score and FIQ score. TENS significantly reduced VAS scores. Conclusion Our analyses revealed that thermal therapy and LLLT had a partial effect on pain relief in FM patients, and this beneficial effect may have a positive influence on FM patients' health status.
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Affiliation(s)
- Yuichiro Honda
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
- Department of Rehabilitation, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
| | - Junya Sakamoto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
| | - Yohei Hamaue
- Department of Physical Therapy, Niigata University of Health and Welfare, Shimami-cho 1398, Kitaku, Niigata 950-3198, Japan
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kitaku, Niigata 950-3198, Japan
| | - Hideki Kataoka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Fukahori 1-11-5, Nagasaki 851-0301, Japan
| | - Yasutaka Kondo
- Department of Rehabilitation, Japanese Red Cross Nagasaki Atomic Bomb Hospital, Mori 3-15, Nagasaki 852-8104, Japan
| | - Ryo Sasabe
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
- Department of Rehabilitation, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
| | - Kyo Goto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Fukahori 1-11-5, Nagasaki 851-0301, Japan
| | - Takuya Fukushima
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
- Department of Rehabilitation, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
| | - Satoshi Oga
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
- Department of Rehabilitation, Saiseikai Nagasaki Hospital, Kitafuchi 2-5-1, Nagasaki 850-0003, Japan
| | - Ryo Sasaki
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
- Department of Rehabilitation, Juzenkai Hospital, Kago 7-18, Nagasaki 850-0905, Japan
| | - Natsumi Tanaka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Shimami-cho 1398, Kitaku, Niigata 950-3198, Japan
| | - Jiro Nakano
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
| | - Minoru Okita
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8520, Japan
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9
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Nageeb RS, Hashim NA, Fawzy A. Serum insulin-like growth factor 1 (IGF-1) in multiple sclerosis: relation to cognitive impairment and fatigue. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2018; 54:25. [PMID: 30294204 PMCID: PMC6153711 DOI: 10.1186/s41983-018-0026-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 08/26/2018] [Indexed: 12/14/2022] Open
Abstract
Background Multiple sclerosis (MS) is a chronic demyelinating central nervous system (CNS) disease. Changes in insulin growth factor 1 (IGF-1) input to the brain can affect survival of myelin and CNS cells. The study aims to investigate the relation of serum IGF-1 levels with cognitive impairment and fatigue in MS patients. Methods This study was conducted on 46 MS patients and 46 healthy controls. All participants were subjected to clinical assessment, serum IGF-1 levels, expanded disability status scale (EDSS), modified fatigue impact scale (MFIS), and Montreal cognitive assessment (MoCA) scale. Results There was no significant difference between patients and controls regarding serum IGF-1 levels (P = 0.19). However, low serum levels of IGF-1 have significantly greater odds for fatigue (P = 0.002) and cognitive impairment (P < 0.001). Also, serum IGF-1 levels have a significant negative correlation with MFIS (r = - 0.701 and P < 0.001) and a significant positive correlation with MoCA scale (r = + 0.84 and P < 0.001). Conclusions The results, specifically that low levels of serum IGF-1 was associated with cognitive impairment and fatigue in MS, suggest that IGF-I may be involved in the pathogenesis of cognitive deficits and fatigue in MS disease.
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Affiliation(s)
- Rania S Nageeb
- 1Department of Neurology, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Noha A Hashim
- 1Department of Neurology, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Amal Fawzy
- 2Department of Biochemistry, Faculty of Medicine, Zagazig University, Sharkia, Egypt
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10
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Ribeiro VGC, Mendonça VA, Souza ALC, Fonseca SF, Camargos ACR, Lage VKS, Neves CDC, Santos JM, Teixeira LAC, Vieira ELM, Teixeira Junior AL, Mezêncio B, Fernandes JSC, Leite HR, Poortmans JR, Lacerda ACR. Inflammatory biomarkers responses after acute whole body vibration in fibromyalgia. ACTA ACUST UNITED AC 2018. [PMID: 29513791 PMCID: PMC5856441 DOI: 10.1590/1414-431x20176775] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aims of this study were 1) to characterize the intensity of the vibration stimulation in women diagnosed with fibromyalgia (FM) compared to a control group of healthy women (HW) matched by age and anthropometric parameters, and 2) to investigate the effect of a single session of whole body vibration (WBV) on inflammatory responses. Levels of adipokines, soluble tumor necrosis factor receptors (sTNFr1, sTNFr2), and brain-derived neurotrophic factor (BDNF) were determined by enzyme-linked immunosorbent assay. Oxygen consumption (VO2) was estimated by a portable gas analysis system, heart rate (HR) was measured using a HR monitor, and perceived exertion (RPE) was evaluated using the Borg scale of perceived exertion. Acutely mild WBV increased VO2 and HR similarly in both groups. There was an interaction (disease vs vibration) in RPE (P=0.0078), showing a higher RPE in FM compared to HW at rest, which further increased in FM after acute WBV, whereas it remained unchanged in HW. In addition, there was an interaction (disease vs vibration) in plasma levels of adiponectin (P=0.0001), sTNFR1 (P=0.000001), sTNFR2 (P=0.0052), leptin (P=0.0007), resistin (P=0.0166), and BDNF (P=0.0179). In conclusion, a single acute session of mild and short WBV can improve the inflammatory status in patients with FM, reaching values close to those of matched HW at their basal status. The neuroendocrine mechanism seems to be an exercise-induced modulation towards greater adaptation to stress response in these patients.
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Affiliation(s)
- V G C Ribeiro
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Diamantina, MG, Brasil
| | - V A Mendonça
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Diamantina, MG, Brasil.,Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil.,Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - A L C Souza
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - S F Fonseca
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Diamantina, MG, Brasil
| | - A C R Camargos
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil.,Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - V K S Lage
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Diamantina, MG, Brasil
| | - C D C Neves
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Diamantina, MG, Brasil
| | - J M Santos
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - L A C Teixeira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - E L M Vieira
- Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - A L Teixeira Junior
- Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - B Mezêncio
- Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo, SP, Brasil
| | - J S C Fernandes
- Departamento de Agronomia, Faculdade de Ciências Agrárias, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - H R Leite
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Diamantina, MG, Brasil.,Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil.,Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - J R Poortmans
- Faculty of Motor Sciences, Université of Libre de Bruxelles, Brussels, Belgium
| | - A C R Lacerda
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Sociedade Brasileira de Fisiologia, Diamantina, MG, Brasil.,Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil.,Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
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11
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Mahieu MA, Ahn GE, Chmiel JS, Dunlop DD, Helenowski IB, Semanik P, Song J, Yount S, Chang RW, Ramsey-Goldman R. Serum adipokine levels and associations with patient-reported fatigue in systemic lupus erythematosus. Rheumatol Int 2018; 38:1053-1061. [PMID: 29302804 DOI: 10.1007/s00296-017-3924-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 12/29/2017] [Indexed: 01/03/2023]
Abstract
Physical activity ameliorates fatigue in systemic lupus erythematosus (SLE) patients by an unknown mechanism. Adipokines, which are influenced by adiposity and physical activity, may be associated with patient-reported fatigue. We describe cross-sectional associations between adipokines and fatigue, physical activity, and SLE disease activity. We measured adipokines, self-reported fatigue, and objective physical activity in 129 SLE patients. Fatigue was assessed with the Fatigue Severity Scale (FSS) and Patient Reported Outcomes Measurement Information System® (PROMIS®) Fatigue score. Disease activity was measured with the Safety of Estrogens in Systemic Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI). Participants wore an accelerometer for 7 days to measure physical activity. Leptin, adiponectin, and resistin were measured in stored serum with a Luminex bead-based assay. Multivariable regression models assessed relationships between fatigue and adipokines, and Spearman correlation coefficients summarized associations between adipokines, physical activity, and SELENA-SLEDAI. Median adipokine levels were: leptin 30.5 ng/ml (Interquartile Range 14.0, 56.6), adiponectin 11.6 μg/ml (7.2, 16.8) and resistin 1.4 ng/ml (1.0, 2.2). Associations between adipokines and FSS or PROMIS fatigue were not significant. Body mass index (BMI) ≥ 30 kg/m2 was associated with FSS and PROMIS fatigue in regression analyses (p < 0.05). Weak correlations between leptin, adiponectin, leptin/adiponectin (L/A) ratio, and physical activity and between adiponectin and SELENA-SLEDAI score were not significant after adjusting for BMI. Adipokines were not associated with fatigue in SLE. Adipokines were correlated with physical activity (leptin, adiponectin, L/A ratio) and SLE disease activity (adiponectin), but most of these associations were explained by BMI.
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Affiliation(s)
- Mary A Mahieu
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, 240 East Huron Street M-300, Chicago, IL, 60611, USA.
| | - Grace E Ahn
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, 240 East Huron Street M-300, Chicago, IL, 60611, USA.,Arthritis and Rheumatism Associates, Wheaton, MD, USA
| | - Joan S Chmiel
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dorothy D Dunlop
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, 240 East Huron Street M-300, Chicago, IL, 60611, USA.,Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Irene B Helenowski
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pamela Semanik
- Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, IL, USA
| | - Jing Song
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Susan Yount
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rowland W Chang
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, 240 East Huron Street M-300, Chicago, IL, 60611, USA.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rosalind Ramsey-Goldman
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, 240 East Huron Street M-300, Chicago, IL, 60611, USA
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12
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Bjersing JL, Larsson A, Palstam A, Ernberg M, Bileviciute-Ljungar I, Löfgren M, Gerdle B, Kosek E, Mannerkorpi K. Benefits of resistance exercise in lean women with fibromyalgia: involvement of IGF-1 and leptin. BMC Musculoskelet Disord 2017; 18:106. [PMID: 28288611 PMCID: PMC5348801 DOI: 10.1186/s12891-017-1477-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 03/06/2017] [Indexed: 12/02/2022] Open
Abstract
Background Chronic pain and fatigue improves by exercise in fibromyalgia (FM) but underlying mechanisms are not known. Obesity is increased among FM patients and associates with higher levels of pain. Symptom improvement after aerobic exercise is affected by body mass index (BMI) in FM. Metabolic factors such as insulin-like growth factor 1 (IGF-1) and leptin may be involved. In this study, the aim was to evaluate the role of metabolic factors in lean, overweight and obese women during resistance exercise, in relation to symptom severity and muscle strength in women with FM. Methods Forty-three women participated in supervised progressive resistance exercise, twice weekly for 15-weeks. Serum free and total IGF-1, IGF-binding protein 3 (IGFBP3), adiponectin, leptin and resistin were determined at baseline and after 15-weeks. Level of current pain was rated on a visual analogue scale (0–100 mm). Level of fatigue was rated by multidimensional fatigue inventory (MFI-20) subscale general fatigue (MFIGF). Knee extension force, elbow flexion force and handgrip force were assessed by dynamometers. Results Free IGF-1 (p = 0.047), IGFBP3 (p = 0.025) and leptin (p = 0.008) were significantly decreased in lean women (n = 18), but not in the overweight (n = 17) and the obese (n = 8). Lean women with FM benefited from resistance exercise with improvements in current pain (p= 0.039, n = 18), general fatigue (MFIGF, p = 0.022, n = 18) and improved elbow-flexion force (p = 0.017, n = 18). In overweight and obese women with FM there was no significant improvement in pain or fatigue but an improvement in elbow flexion (p = 0.049; p = 0.012) after 15 weeks of resistance exercise. Conclusion The clearest clinical response to resistance exercise was found in lean patients with FM. In these individuals, individualized resistance exercise was followed by changes in IGF-1 and leptin, reduced pain, fatigue and improved muscular strength. In overweight and obese women FM markers of metabolic signaling and clinical symptoms were unchanged, but strength was improved in the upper limb. Resistance exercise combined with dietary interventions might benefit patients with FM and overweight. Trial registration The trial was registered 21 of October 2010 with ClinicalTrials.gov identification number: NCT01226784.
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Affiliation(s)
- Jan L Bjersing
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530, Gothenburg, Sweden. .,Sahlgrenska University Hospital, Rheumatology, Gothenburg, Sweden.
| | - Anette Larsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530, Gothenburg, Sweden.,University of Gothenburg Centre for Person Centered Care (GPCC), Gothenburg, Sweden
| | - Annie Palstam
- University of Gothenburg Centre for Person Centered Care (GPCC), Gothenburg, Sweden.,Institute of Neuroscience and Physiology/Physiotherapy, Section of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Ernberg
- Department of Dental Medicine and Scandinavian Center for Orofacial Neurosciences (SCON) Karolinska Institutet, Stockholm, Sweden
| | | | - Monika Löfgren
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Björn Gerdle
- Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Pain and Rehabilitation Center, Anaesthetics, Operations and Specialty Surgery Center, Region Östergotland, Linköping, Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Spine Center, Stockholm, Sweden
| | - Kaisa Mannerkorpi
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530, Gothenburg, Sweden.,Institute of Neuroscience and Physiology/Physiotherapy, Section of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Physiotherapy and Occupational therapy, Gothenburg, Sweden
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13
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Mannerkorpi K, Landin-Wilhelmsen K, Larsson A, Cider Å, Arodell O, Bjersing JL. Acute effects of physical exercise on the serum insulin-like growth factor system in women with fibromyalgia. BMC Musculoskelet Disord 2017; 18:37. [PMID: 28122522 PMCID: PMC5264319 DOI: 10.1186/s12891-017-1402-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 01/14/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Increased Serum insulin-like growth factor-1 (S-IGF-1) has been noted after physical activity in healthy subjects, while the acute release of S-IGF-1 in relation to exercise has not previously been studied in women with fibromyalgia (FM). S-IGF-1 and its binding protein (S-IGFBP-3) are mediated by growth hormone and have anabolic effects on the skeletal muscle. Aim of the study was to investigate acute release of IGF-1 after aerobic exercise in women with FM. METHODS The acute effect of physical exercise on S-IGF-1 and S-IGFBP-3 were studied in 22 women with FM and in 27 healthy controls during moderate and high-intensity cycling (i.e. ratings 12-13 and 15-17, on Borg's perceived exertion scale (RPE), respectively). Self-reported pain and fatigue were recorded. Differences within and between the two groups were analyzed. RESULTS After 15 min of bicycling, S-IGF-1 and S-IGFBP-3 increased both within the group with FM and in the healthy controls (p < 0.01). The increases in S-IGF-1 did not significantly differ between the women with FM and the healthy control group (mean increase 11 ± 10 vs. 11 ± 15 ng/ml and 13 ± 10 vs. 19 ± 22 ng/ml) when bicycling at moderate or high intensity, respectively. Self-reported pain and fatigue during exercise, irrespective of intensity, were higher in women with FM compared with healthy controls (p < 0.001). CONCLUSIONS Fifteen minutes bicycling at moderate intensity was sufficient to acutely mobilise S-IGF-1 in women with FM similarly to healthy controls in spite of higher score of fatigue and pain in women with FM. Hence, patients with FM were able to activate their skeletal muscle metabolism during a short, moderate bout of exercise and were not resistant to training effects. The result is important for encouraging clinical rehabilitation of patients with FM who commonly exercise at a moderate, rather than at a high-intensity level. TRIAL REGISTRATION ClinicalTrials.govNCT01592916 , May 4, 2012.
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Affiliation(s)
- Kaisa Mannerkorpi
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Sahlgrenska University Hospital, Physiotherapy and Occupational therapy, Göteborg, Sweden. .,Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530, Göteborg, Sweden.
| | - Kerstin Landin-Wilhelmsen
- Section of Endocrinology, Sahlgrenska Academy, Sahlgrenska University Hospital, Institution of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Anette Larsson
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Åsa Cider
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Olivia Arodell
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530, Göteborg, Sweden
| | - Jan L Bjersing
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530, Göteborg, Sweden.,Sahlgrenska University Hospital, Rheumatology, Göteborg, Sweden
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14
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Ericsson A, Palstam A, Larsson A, Löfgren M, Bileviciute-Ljungar I, Bjersing J, Gerdle B, Kosek E, Mannerkorpi K. Resistance exercise improves physical fatigue in women with fibromyalgia: a randomized controlled trial. Arthritis Res Ther 2016; 18:176. [PMID: 27473164 PMCID: PMC4967304 DOI: 10.1186/s13075-016-1073-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/06/2016] [Indexed: 01/03/2023] Open
Abstract
Background Fibromyalgia (FM) affects approximately 1–3 % of the general population. Fatigue limits the work ability and social life of patients with FM. A few studies of physical exercise have included measures of fatigue in FM, indicating that exercise can decrease fatigue levels. There is limited knowledge about the effects of resistance exercise on multiple dimensions of fatigue in FM. The present study is a sub-study of a multicenter randomized controlled trial in women with FM. The purpose of the present sub-study was to examine the effects of a person-centered progressive resistance exercise program on multiple dimensions of fatigue in women with FM, and to investigate predictors of the potential change in fatigue. Methods A total of 130 women with FM (age 22–64 years) were included in this assessor-blinded randomized controlled multicenter trial examining the effects of person-centered progressive resistance exercise compared with an active control group. The intervention was performed twice a week for 15 weeks. Outcomes were five dimensions of fatigue measured with the Multidimensional Fatigue Inventory (MFI-20). Information about background was collected and the women also completed several health-related questionnaires. Multiple linear stepwise regression was used to analyze predictors of change in fatigue in the total population. Results A higher improvement was found at the post-treatment examination for change in the resistance exercise group, as compared to change in the active control group in the MFI-20 subscale of physical fatigue (resistance group Δ –1.7, SD 4.3, controls Δ 0.0, SD 2.7, p = 0.013), with an effect size of 0.33. Sleep efficiency was the strongest predictor of change in the MFI-20 subscale general fatigue (beta = −0.54, p = 0.031, R2 = 0.05). Participating in resistance exercise (beta = 1.90, p = 0.010) and working fewer hours per week (beta = 0.84, p = 0.005) were independent significant predictors of change in physical fatigue (R2 = 0.14). Conclusions Person-centered progressive resistance exercise improved physical fatigue in women with FM when compared to an active control group. Trial registration ClinicalTrials.gov NCT01226784. Registered 21 October 2010.
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Affiliation(s)
- Anna Ericsson
- Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. .,University of Gothenburg Centre for Person Centered Care (GPCC), Göteborg, Sweden.
| | - Annie Palstam
- Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Anette Larsson
- Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.,University of Gothenburg Centre for Person Centered Care (GPCC), Göteborg, Sweden
| | - Monika Löfgren
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital Stockholm, Stockholm, Sweden
| | - Indre Bileviciute-Ljungar
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital Stockholm, Stockholm, Sweden
| | - Jan Bjersing
- Institute of Medicine, Department of Rheumatology and Inflammation research, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Björn Gerdle
- Department of Medical and Health Sciences, Division of Community Medicine, Faculty of Medicine and Health Sciences, Linköping University, Pain and Rehabilitation Center, Anesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kaisa Mannerkorpi
- Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.,University of Gothenburg Centre for Person Centered Care (GPCC), Göteborg, Sweden
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15
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Berghoff M, Hochberg A, Schmid A, Schlegel J, Karrasch T, Kaps M, Schäffler A. Quantification and regulation of the adipokines resistin and progranulin in human cerebrospinal fluid. Eur J Clin Invest 2016; 46:15-26. [PMID: 26509463 DOI: 10.1111/eci.12558] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/24/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Adipokines bearing the potential to cross the blood-brain barrier (BBB) are promising candidates for the endocrine regulation of central nervous processes and of a postulated fat-brain axis. Resistin and progranulin concentrations in paired serum and cerebrospinal fluid (CSF) samples of patients undergoing neurological evaluation and spinal puncture were investigated. MATERIALS AND METHODS Samples of n = 270 consecutive patients with various neurological diseases were collected without prior selection. Adipokine serum and CSF concentrations were measured by enzyme-linked immunosorbent assay and serum and CSF routine parameters by standard procedures. Anthropometric data, medication and patient history were available. RESULTS Serum levels of resistin and progranulin were positively correlated among each other, with respective CSF levels, low-density lipoprotein cholesterol levels and markers of systemic inflammation. CSF resistin concentrations were generally low. Progranulin CSF concentrations and CSF/serum progranulin ratio were significantly higher in patients with infectious diseases, with disturbed BBB function and with elevated CSF cell count and presence of oligoclonal bands. Both adipokines are able to cross the BBB depending on a differing patency that increases with increasing grade of barrier dysfunction. Whereas resistin represents a systemic marker of inflammation, CSF progranulin levels strongly depend on the underlying disease and dysfunction of blood-CSF barrier. CONCLUSIONS Resistin and progranulin represent novel and putative regulators of the fat-brain axis by their ability to cross the BBB under physiological and pathophysiological conditions. The presented data provide insight into the characteristics of BBB function regarding progranulin and resistin and the basis for future establishment of normal values for CSF concentrations and CSF/serum ratios.
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Affiliation(s)
- Martin Berghoff
- Department of Neurology, Giessen University Hospital, Giessen, Germany
| | - Alexandra Hochberg
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Andreas Schmid
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Jutta Schlegel
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Thomas Karrasch
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
| | - Manfred Kaps
- Department of Neurology, Giessen University Hospital, Giessen, Germany
| | - Andreas Schäffler
- Department of Internal Medicine III, Giessen University Hospital, Giessen, Germany
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Effects of non-pharmacological interventions on inflammatory biomarker expression in patients with fibromyalgia: a systematic review. Arthritis Res Ther 2015; 17:272. [PMID: 26411586 PMCID: PMC4584481 DOI: 10.1186/s13075-015-0789-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/12/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction Fibromyalgia (FM) is a prevalent disorder. However, few studies have evaluated the effect of treatment interventions on biomarker expression. The aim of this review was to explore the efficacy of non-pharmacological interventions on inflammatory biomarker expression, specifically cytokines, neuropeptides and C-reactive protein (CRP), in FM patients. Method A literature search using PubMed, EMBASE, PsycINFO and the Cochrane library was performed from January 1990 to March 2015. Randomized controlled trials (RCTs) and non-RCTs published in English, French or Spanish were eligible. Results Twelve articles with a total of 536 participants were included. After exercise, multidisciplinary, or dietary interventions in FM patients, interleukin (IL) expression appeared reduced, specifically serum IL-8 and IL-6 (spontaneous, lipopolysaccharide (LPS)-induced, or serum). Furthermore, the changes to insulin-like growth factor 1 (IGF-1) levels might indicate a beneficial role for fatigue in obese FM patients. In contrast, evidence of changes in neuropeptide and CRP levels seemed inconsistent. Conclusion Despite minimal evidence, our findings indicate that exercise interventions might act as an anti-inflammatory treatment in FM patients and ameliorate inflammatory status, especially for pro-inflammatory cytokines. Additional RCTs focused on the changes to inflammatory biomarker expression after non-pharmacological interventions in FM patients are needed.
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Erkmen Uyar M, Sezer S, Bal Z, Guliyev O, Tutal E, Genctoy G, Kulah E, Ozdemir Acar N, Haberal M. Fibromyalgia and its clinical relevance in renal transplant recipients. Transplant Proc 2015; 47:1105-9. [PMID: 26036530 DOI: 10.1016/j.transproceed.2015.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/30/2014] [Accepted: 01/28/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Recent evidence suggests that fibromyalgia syndrome (FS) is associated with inflammation and endothelial dysfunction. Our aim was to determine the prevalence of FS in renal transplant recipients and to identify possible links between FS and clinical and laboratory parameters. METHODS Ninety-nine kidney transplant recipients with normal graft functions (37.15 ± 10.83 years old, 67 male) were enrolled in the study. All subjects completed the Fibromyalgia Impact Questionnaire (FIQ). The biochemical and clinical parameters in the 1st post-transplantation year were retrospectively recorded. Cardiovascular parameters, including body composition analyses (Tanita), ambulatory blood pressure monitoring data, and pulse-wave velocity, were cross-sectionally analyzed. RESULTS Mean FIQ score for the whole group was 21.4 ± 14.7. Eight patients had FIQ score >50, and these patients had significantly higher left ventricular mass index than patients with lower FIQ score (P = .048). Patients were divided according to their physical impairment score (PIS): PIS ≥5 (n = 50) and PIS <5 (n = 49). Patients with higher PIS had significantly higher serum creatinine (P = .047) and lower eGFR values (P = .008) than patients with lower PIS. Patients were also evaluated with the use of the stiffness score (SS): patients with (n = 41) and without (n = 58) stiffness. Patients with stiffness had significantly higher office systolic (P = .027) and diastolic (P = .044) blood pressure, body mass index (P = .033), and sagittal abdominal diameter (P = .05) than patients without stiffness. Decline in estimated glomerular filtration rate levels were significantly higher in patients with higher FIQ (7.6% vs 9.4%; P = .0001) than in other patients. CONCLUSIONS FS in renal transplant recipients was strongly associated with hypertension, arterial stiffness, obesity, and renal allograft dysfunction.
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Affiliation(s)
- M Erkmen Uyar
- Department of Nephrology, Baskent University, Ankara, Turkey.
| | - S Sezer
- Department of Nephrology, Baskent University, Ankara, Turkey
| | - Z Bal
- Department of Nephrology, Baskent University, Ankara, Turkey
| | - O Guliyev
- Department of Nephrology, Baskent University, Ankara, Turkey
| | - E Tutal
- Department of Nephrology, Baskent University, Ankara, Turkey
| | - G Genctoy
- Department of Nephrology, Baskent University, Antalya, Turkey
| | - E Kulah
- Department of Nephrology, Baskent University, Istanbul, Turkey
| | - N Ozdemir Acar
- Department of Nephrology, Baskent University, Istanbul, Turkey
| | - M Haberal
- Department of Nephrology, Baskent University, Istanbul, Turkey; Department of General Surgery, Baskent University, Ankara, Turkey
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Lourenço S, Costa L, Rodrigues AM, Carnide F, Lucas R. Gender and psychosocial context as determinants of fibromyalgia symptoms (fibromyalgia research criteria) in young adults from the general population. Rheumatology (Oxford) 2015; 54:1806-15. [DOI: 10.1093/rheumatology/kev110] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Indexed: 12/24/2022] Open
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Bjersing JL, Bokarewa MI, Mannerkorpi K. Profile of circulating microRNAs in fibromyalgia and their relation to symptom severity: an exploratory study. Rheumatol Int 2014; 35:635-42. [PMID: 25261961 DOI: 10.1007/s00296-014-3139-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/18/2014] [Indexed: 12/20/2022]
Abstract
Fibromyalgia (FM) is characterized by generalized chronic pain and reduced pain thresholds. Disturbed neuroendocrine function and impairment of growth hormone/insulin-like growth factor-1 is common. However, the pathophysiology of FM is not clear. MicroRNAs are important regulatory factors reflecting interface of genes and environment. Our aim was to identify characteristic microRNAs in FM and relations of specific microRNAs with characteristic symptoms. A total of 374 circulating microRNAs were measured in women with FM (n = 20; median 52.5 years) and healthy women (n = 20; 52.5 years) by quantitative PCR. Pain thresholds were examined by algometry. Pain [fibromyalgia impact questionnaire (FIQ) pain] levels were rated (0-100 mm) using FIQ. Fatigue (FIQ fatigue) was rated (0-100 mm) using FIQ and multidimensional fatigue inventory general fatigue. Sleep quantity and quality (1-4) rated from satisfactory to nonsatisfactory. Higher scores indicate more severe symptoms. Eight microRNAs differed significantly between FM and healthy women. Seven microRNAs, miR-103a-3p, miR-107, let-7a-5p, miR-30b-5p, miR-151a-5p, miR-142-3p and miR-374b-5p, were lower in FM. However, levels of miR-320a were higher in FM. MiR-103a-3p correlated with pain (r = 0.530, p = 0.016) and sleep quantity (r = 0.593, p = 0.006) in FM. MiR-320a correlated inversely with pain (r = -0.468, p = 0.037). MiR-374b-5p correlated inversely with pain threshold (r = -0.612, p = 0.004). MiR-30b-5p correlated with sleep quantity (r = 0.509, p = 0.022), and let-7a-5p was associated with sleep symptoms. When adjusted for body mass index, the correlation of sleep quantity with miR-103a and miR-30b was no longer significant. To our knowledge, this is the first study of circulating microRNAs in FM. Levels of several microRNAs differed significantly in FM compared to healthy women. Three microRNAs were associated with pain or pain threshold in FM.
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Affiliation(s)
- Jan L Bjersing
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530, Göteborg, Sweden,
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Aparicio VA, Segura-Jiménez V, Alvarez-Gallardo IC, Estévez-López F, Camiletti-Moirón D, Latorre PA, Delgado-Fernández M, Carbonell-Baeza A. Are there differences in quality of life, symptomatology and functional capacity among different obesity classes in women with fibromyalgia? The al-Ándalus project. Rheumatol Int 2013; 34:811-21. [PMID: 24322452 DOI: 10.1007/s00296-013-2908-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 11/15/2013] [Indexed: 11/26/2022]
Abstract
Obesity may influence fibromyalgia severity. The present study aimed to examine fibromyalgia (FM) symptomatology, quality of life (QoL), and functional capacity across obesity class categories. A total sample of 208 obese FM patients and 108 obese control women were included in the study. The sample was further categorized following the international criteria for obesity classes: obesity I (BMI 30.0-34.99 kg/m(2)), obesity II (BMI 35.0-39.99 kg/m(2)), and obesity III (BMI ≥40.0 kg/m(2)). QoL was assessed by means of the Short-Form-36 Health Survey (SF-36) and FM symptomatology with the Fibromyalgia Impact Questionnaire (FIQ). Standardized field-based fitness tests were used to assess cardiorespiratory fitness, muscular strength, flexibility, agility, and balance. All the dimensions of QoL, as measured by SF-36, were worse in obese FM patients compared to the obese control group (all p < 0.001). Obese FM patients also scored worse in the entire functional capacity tests studied (all p < 0.001). Except for the higher FIQ-depression across obesity status categories (p < 0.05), no differences between obesity status groups were found in QoL and FM impact. However, upper-body muscular strength and cardiorespiratory fitness were worse across obesity class categories and pairwise comparisons showed differences mainly between obesity I and II (p < 0.05, and p < 0.01, respectively). The absence of clear differences in QoL and FM symptomatology among obesity classes suggests that just avoiding any obese status may be a useful advice for a better management of the disease. Nevertheless, upper-body muscular strength and cardiorespiratory fitness, which are important health indicators highly related to the mortality risk, were worse across obesity categories.
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Affiliation(s)
- V A Aparicio
- Department of Physical Education and Sport, Faculty of Sports Sciences, University of Granada, Granada, Spain,
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