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Delfan M, Behzadi NJ, Amadeh Juybari R, Daneshyar S, Saeidi A, Willems ME, Hackney AC, Laher I, Zouhal H. Adipokine modulation in obesity: Evaluating the integrative impact of chlorella vulgaris supplementation and interval resistance training in obese males. J Funct Foods 2024; 119:106315. [PMID: 39036605 PMCID: PMC11257098 DOI: 10.1016/j.jff.2024.106315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
Aims To evaluate the effects of 12-week chlorella vulgaris (CV) combined with interval resistance training (IRT) on plasma levels of leptin, adiponectin and neuregulin-4 (Nrg-4) in obese men. Methods Obese men (n = 44, BMI of 32.1 ± 1.5 kg/m2) were randomly allocated to the following groups of 11 participants per group: Control Placebo group (CP), CV supplement group (CV), Interval Resistance Training group plus Placebo (IRT + P), and Interval Resistance Training plus CV supplement group (IRT + CV). IRT was performed three times a week for 12 weeks using three sets of 10 repetitions at 60 % 1RM, and integrating an active rest interval with 15 repetitions at 20 % 1RM. Participants consumed either CV (1800 mg daily) or a placebo. Pre- and post-intervention blood samples were obtained to assess adipokines which were measured by ELISA. Results While CV or IRT separately did not alter plasma levels of leptin (p > 0.05), their combination reduced leptin levels (p = 0.007). IRT and IRT plus CV increased the plasma levels of adiponectin and Nrg-4 (p < 0.01). An intergroup comparison indicated significant elevations of adiponectin and Nrg-4 in the CV compared to the CP group (p < 0.05). Conclusion The combination of IRT and CV modulates plasma levels of leptin, adiponectin and NRG4 more effectively than either IRT or CV separately in obese men.
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Affiliation(s)
- Maryam Delfan
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - Nastaran Javadi Behzadi
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - Raheleh Amadeh Juybari
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - Saeed Daneshyar
- Department of Physical Education, Hamedan University of Technology, Hamedan, Iran
| | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran
| | - Mark E.T. Willems
- Institute of Applied Sciences, University of Chichester, Chichester PO19 6PE, UK
| | - Anthony C. Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Santé) - EA 1274, F-35000 Rennes, France
- Institut International des Sciences du Sport (2I2S), 35850, Irodouer, France
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Corona G, Rastrelli G, Sparano C, Vignozzi L, Sforza A, Maggi M. Advances in the treatment of functional male hypogonadism. Expert Rev Endocrinol Metab 2024; 19:163-177. [PMID: 38117229 DOI: 10.1080/17446651.2023.2296022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Functional hypogonadism is frequently found in obese men, particularly those with metabolic complications. Several possible therapeutic approaches could be considered. AREAS COVERED An extensive search on Medline, Embase, and Cochrane databases was performed to retrieve the available studies assessing the change of testosterone (T) and sexual function upon dieting or physical activity programs, as well as glucagon-like peptide 1 analogues. The role of lifestyle interventions associated with T replacement therapy (TRT) was also evaluated. The expert opinion provided here has been corroborated by meta-analyzing the results of the retrieved studies. EXPERT OPINION Current evidence supports the beneficial role of lifestyle modifications in increasing T and improving sexual function as a function of weight loss. While dieting programs are associated with greater effects in younger populations, physical exercise has major effects in older ones. Among the dieting programs, a very low-calorie ketogenic diet shows the best results; aerobic or endurance physical exercise perform similarly. The advantages of functional hypogonadism in lifestyle modifications are empowered by the association with TRT. Therefore, TRT may be a valuable complementary strategy to increase muscle mass and facilitate physical exercise while improving sexual symptoms, thus favoring the motivation and compliance for lifestyle interventions.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence, Italy
| | - Clotilde Sparano
- Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Endocrinology Unit, Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence, Italy
| | - Alessandra Sforza
- Endocrinology Unit, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Mario Maggi
- Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Endocrinology Unit, Florence, Italy
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Khairy EY, Salama OA. Effect of exercise on the hypothalamic-pituitary-gonadal axis in a rat model of Alzheimer's disease. Sci Rep 2023; 13:14300. [PMID: 37653057 PMCID: PMC10471618 DOI: 10.1038/s41598-023-41415-8] [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: 06/12/2023] [Accepted: 08/25/2023] [Indexed: 09/02/2023] Open
Abstract
Hypothalamic-pituitary-gonadal (HPG) axis dysregulation was suggested to play a crucial role in Alzheimer's disease (AD). This study investigated the effects of exercise on HPG hormones in an AD rat model, as a possible mechanism underlying the favorable effect of exercise on AD. Forty male Wistar albino rats 2-3 months old were subdivided randomly into two groups (n = 20 each): AD group (injected intraperitoneally with aluminum chloride (70 mg/kg/day) for 6 weeks) and Control group. Each group was subdivided into exercised or non-exercised group (n = 10 each). Exercised groups were subjected to a swimming protocol (60 min/day, 5 days/week, 4 weeks). Serum HPG hormones, hippocampal β-amyloid levels and Morris water-maze cognition were assessed. Results demonstrated higher levels of β-amyloid, gonadotropin releasing hormone (GnRH), luteinizing hormone (LH) and follicle stimulating hormone (FSH) together with lower testosterone levels and cognitive impairment in the AD rats compared to controls. Β-amyloid levels negatively correlated with testosterone levels and positively correlated with GnRH, LH and FSH among the AD rats. Higher testosterone and lower GnRH, LH, FSH and β-amyloid levels, as well as cognitive improvement, were observed in the exercised compared to non-exercised AD rats, suggesting a modulatory role of exercise training on AD-associated HPG axis dysregulation.
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Affiliation(s)
- Eman Y Khairy
- Department of Physiology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt.
| | - Ola A Salama
- Department of Physiology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
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Boyer W, Toth L, Brenton M, Augé R, Churilla J, Fitzhugh E. The role of resistance training in influencing insulin resistance among adults living with obesity/overweight without diabetes: A systematic review and meta-analysis. Obes Res Clin Pract 2023; 17:279-287. [PMID: 37331899 DOI: 10.1016/j.orcp.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 05/24/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023]
Abstract
The purpose of this study was to systematically examine the independent effect of resistance training (RT) on markers of insulin resistance (IR) (fasting insulin and HOMA-IR) among individuals with overweight/obesity without diabetes. PubMed, SPORTdiscus, SCOPUS, Prospero, and clinicaltrials.gov were searched through December 19, 2022. Article screening was conducted in three phases: title screen (n = 5020), abstract screen (n = 202), and full text screen (n = 73). A total of 27 studies with 402 individual data points were used for the meta-analysis. Comprehensive Meta-Analysis software version 3.0 was used to interpret pre- and post-IR measurements with a random-effects model. Exploratory sub-analyses were conducted on studies for only females, only males, and age (< 40 and ≥ 40 years). RT had a significant effect on fasting insulin (- 1.03, 95 % CI - 1.03, - 0.75 p < 0.001) and HOMA-IR (- 1.05, 95 % CI - 1.33, - 0.76, p < 0.001). Sub-analyses revealed that males had a more pronounced effect compared to females and those < 40 years of age had a more pronounced effect compared to those ≥ 40 years. The results of this meta-analysis illustrate that RT plays an independent role in improving IR among adults with overweight/obesity. RT should continue to be recommended as part of preventive measures among these populations. Future studies examining the effect of RT on IR should consider dose centered on the current U.S. physical activity guidelines.
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Affiliation(s)
- William Boyer
- California Baptist University, Department of Kinesiology, 8432 Magnolia Ave., Riverside, CA 92504, United States of America.
| | - Lindsay Toth
- University of North Florida, Department of Clinical and Applied Movement Sciences, 1 UNF Dr., Jacksonville, FL 32224, United States of America
| | - Madison Brenton
- California Baptist University, Department of Kinesiology, 8432 Magnolia Ave., Riverside, CA 92504, United States of America
| | - Robert Augé
- University of Tennessee, Department of Plant Sciences, 2505 E J. Chapman Dr., Knoxville, TN 37919, United States of America
| | - James Churilla
- University of North Florida, Department of Clinical and Applied Movement Sciences, 1 UNF Dr., Jacksonville, FL 32224, United States of America
| | - Eugene Fitzhugh
- University of Tennessee, Department of Kinesiology, Recreation and Sports Studies, 1914 Andy Holt Ave, Knoxville, TN 37996, United States of America
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Rejeki PS, Pranoto A, Rahmanto I, Izzatunnisa N, Yosika GF, Hernaningsih Y, Wungu CDK, Halim S. The Positive Effect of Four-Week Combined Aerobic-Resistance Training on Body Composition and Adipokine Levels in Obese Females. Sports (Basel) 2023; 11:sports11040090. [PMID: 37104164 PMCID: PMC10145427 DOI: 10.3390/sports11040090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/07/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023] Open
Abstract
Obesity is a metabolic disease that is caused by a lack of physical activity and is associated with an increased risk of chronic inflammation. A total of 40 obese adolescent females with an average age of 21.93 ± 1.35 years and average body mass index (BMI) of 30.81 ± 3.54 kg/m2 were enrolled in this study, randomized, and divided into four groups, i.e., control (CTL; n = 10), moderate intensity aerobic training (MAT; n = 10), moderate intensity resistance training (MRT; n = 10), and moderate intensity combined aerobic-resistance training (MCT; n = 10). The enzyme-linked immunosorbent assay (ELISA) kits method was used to analyze the adiponectin and leptin levels between pre-intervention and post-intervention. Statistical analysis was conducted using a paired sample t-test, while correlation analysis between variables used the Pearson product-moment correlation test. Research data showed that MAT, MRT, and MCT significantly increased adiponectin levels and decreased leptin levels compared to the CTL (p ≤ 0.05). The results of the correlation analysis of delta (∆) data showed that an increase in adiponectin levels was significantly negatively correlated with a decrease in body weight (BW) (r = -0.671, p ≤ 0.001), BMI (r = -0.665, p ≤ 0.001), and fat mass (FM) (r = -0.694, p ≤ 0.001) and positively correlated with an increase in skeletal muscle mass (SMM) (r = 0.693, p ≤ 0.001). Whereas, a decrease in leptin levels was significantly positively correlated with a decrease in BW (r = 0.744, p ≤ 0.001), BMI (r = 0.744, p ≤ 0.001), and FM (r = 0.718, p ≤ 0.001) and negatively correlated with an increase in SMM (r = -0.743, p ≤ 0.001). In summary, it can be concluded that our data show that adiponectin levels increased and leptin levels decreased after the intervention of aerobic, resistance, and combined aerobic-resistance training.
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Affiliation(s)
- Purwo Sri Rejeki
- Physiology Division, Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, East Java, Indonesia
| | - Adi Pranoto
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, East Java, Indonesia
| | - Ilham Rahmanto
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, East Java, Indonesia
| | - Nabilah Izzatunnisa
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, East Java, Indonesia
| | - Ghana Firsta Yosika
- Study Program of Sports Coaching Education, Faculty of Teacher Training and Education Universitas Tanjungpura, Pontianak 78124, West Kalimantan, Indonesia
| | - Yetti Hernaningsih
- Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, East Java, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Biochemistry Division, Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, East Java, Indonesia
| | - Shariff Halim
- Clinical Research Centre, Management and Science University, Shah Alam 40100, Selangor, Malaysia
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Hejazi K, Wong A. Effects of exercise training on inflammatory and cardiometabolic health markers in overweight and obese adults: a systematic review and meta-analysis of randomized controlled trials. J Sports Med Phys Fitness 2023; 63:345-359. [PMID: 35816146 DOI: 10.23736/s0022-4707.22.14103-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The improvements in inflammation and cardiometabolic health play an important role in the prevention and treatment of obesity. However, the interactions between different exercise training (ET) modalities with inflammatory and cardiometabolic biomarkers are not completely understood. This systematic review and meta-analysis investigated the effects of ET on inflammatory and cardiometabolic health markers in overweight and obese adults. EVIDENCE ACQUISITION A systematic search was conducted in PubMed, CINAHL, MEDLINE, Cochrane, Google Scholar, Scopus and Web of Science up to December 15, 2021. Thirty-five studies including 2752 participants were included and analyzed using a random-effects model to estimate weighted mean differences (MD) with 95% confidence intervals (CI). EVIDENCE SYNTHESIS The meta-analysis found that ET significantly (P<0.05) increased adiponectin (WMD: 0.72 µg/mL; 95% CI: 0.60 to 0.84; SMD=0.65) and maximal oxygen consumption levels (WMD: 5.26 mL.kg.min; 95% CI: 3.84, 6.69; SMD=1.21). Moreover, ET significantly (P<0.05) reduced fasting insulin (WMD: -2.40 μIU/mL; 95% CI: -3.43 to -1.37; SMD=-0.87), fasting blood glucose (WMD: -5.41 mg/dL; 95% CI: -7.91, -2.91; SMD=-0.66), insulin resistance (WMD: -0.66; 95% CI: -1.08, -0.24; SMD=-0.66) and triglyceride levels (WMD: -10.88 mg/dL; 95% CI: -17.61, -4.15; SMD=-0.91). No significant changes were observed in interleukin-6, tumor necrosis factor-α, leptin, C-reactive protein and cholesterol concentrations. Subgroup analysis by type of training indicated that aerobic and resistance exercise had the most consistent beneficial effects as compared to other modalities. CONCLUSIONS Our findings suggest that ET may improve inflammation and cardiometabolic health in overweight and obese adults. Aerobic and resistance training appear to be more beneficial for improving adiponectin, fasting insulin, fasting blood glucose, insulin resistance index and triglyceride levels as compared to other exercise modalities. Further long-term studies are required to confirm and expand on these findings.
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Affiliation(s)
- Keyvan Hejazi
- Department of Physical Education and Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran -
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
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Lopez P, Taaffe DR, Galvão DA, Newton RU, Nonemacher ER, Wendt VM, Bassanesi RN, Turella DJP, Rech A. Resistance training effectiveness on body composition and body weight outcomes in individuals with overweight and obesity across the lifespan: A systematic review and meta-analysis. Obes Rev 2022; 23:e13428. [PMID: 35191588 PMCID: PMC9285060 DOI: 10.1111/obr.13428] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/09/2022] [Accepted: 01/09/2022] [Indexed: 12/23/2022]
Abstract
To systematically review and analyze the effects of resistance-based exercise programs on body composition, regional adiposity, and body weight in individuals with overweight/obesity across the lifespan. Using PRISMA guidelines, randomized controlled trials were searched in nine electronic databases up to December 2020. Meta-analyses were performed using random-effects model. One-hundred sixteen articles describing 114 trials (n = 4184 participants) were included. Interventions involving resistance training and caloric restriction were the most effective for reducing body fat percentage (ES = -3.8%, 95% CI: -4.7 to -2.9%, p < 0.001) and whole-body fat mass (ES = -5.3 kg, 95% CI: -7.2 to -3.5 kg, p < 0.001) compared with groups without intervention. Significant results were also observed following combined resistance and aerobic exercise (ES = -2.3% and -1.4 kg, p < 0.001) and resistance training alone (ES = -1.6% and -1.0 kg, p < 0.001) compared with no training controls. Resistance training alone was the most effective for increasing lean mass compared with no training controls (ES = 0.8 kg, 95% CI: 0.6 to 1.0 kg, p < 0.001), whereas lean mass was maintained following interventions involving resistance training and caloric restriction (ES = ~ - 0.3 kg, p = 0.550-0.727). Results were consistently observed across age and sex groups (p = 0.001-0.011). Reductions in regional adiposity and body weight measures were also observed following combined resistance and aerobic exercise and programs including caloric restriction (p < 0.001). In conclusion, this study provides evidence that resistance-based exercise programs are effective and should be considered within any multicomponent therapy program when caloric restriction is utilized in individuals with overweight or obesity.
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Affiliation(s)
- Pedro Lopez
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Dennis R. Taaffe
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Daniel A. Galvão
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Robert U. Newton
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | | | | | | | - Douglas J. P. Turella
- Centro Clínico UCSUniversidade de Caxias do SulCaxias do SulBrazil
- Curso de Educação FísicaUniversidade de Caxias do SulCaxias do SulBrazil
| | - Anderson Rech
- Curso de Educação FísicaUniversidade de Caxias do SulCaxias do SulBrazil
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Potter NJ, Tomkinson GR, Dufner TJ, Walch TJ, Roemmich JN, Wilson PB, Fitzgerald JS. Effects of Exercise Training on Resting Testosterone Concentrations in Insufficiently Active Men: A Systematic Review and Meta-Analysis. J Strength Cond Res 2021; 35:3521-3528. [PMID: 35134000 DOI: 10.1519/jsc.0000000000004146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Potter, NJ, Tomkinson, GR, Dufner, TJ, Walch, TJ, Roemmich, JN, Wilson, PB, and Fitzgerald, JS. Effects of exercise training on resting testosterone concentrations in insufficiently active men: a systematic review and meta-analysis. J Strength Cond Res 35(12): 3521-3528, 2021-The anabolic hormone testosterone plays a pivotal role in the healthy aging of men and tends to decline with age. The aims of this systematic review and meta-analysis were 2-fold: (a) to evaluate the effect of exercise training on resting total testosterone concentration in insufficiently active, apparently healthy men and (b) to determine whether the effects of exercise training differed by training mode, age, body mass status, or testosterone measure. Electronic databases (MEDLINE, Scopus, CINAHL, and SPORTDiscus) were systematically searched (up to and including October 22, 2020) for peer-reviewed randomized controlled trials (RCTs) meeting the following criteria: population (insufficiently active, apparently healthy men aged ≥18 years), intervention (exercise training [any modality at intensity of ≥4 metabolic equivalents] lasting a minimum of 4 weeks), control (insufficiently active men), and outcome (resting total testosterone concentration). Intervention effects, weighted by the inverse of the pooled variance, were calculated relative to the control group as standardized mean differences (SMDs). Eleven RCTs, representing 421 insufficiently active, apparently healthy men aged 19-75 years across 16 intervention groups who participated in aerobic, resistance, or combined training lasting a median of 12 weeks, were included in the analysis. Overall, exercise training had a negligible effect on resting total testosterone concentration (mean SMD [95% CI]: 0.00 [-0.20 to 0.20]). Subgroup analyses indicated that the effect of exercise training was not significantly affected by training mode, age, body mass status, or testosterone measure. Exercise training does not seem to affect resting total or free testosterone concentration in insufficiently active, eugonadal men.
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Affiliation(s)
- Nolan J Potter
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
| | - Grant R Tomkinson
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Trevor J Dufner
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
| | - Tanis J Walch
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
| | - James N Roemmich
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, North Dakota; and
| | - Patrick B Wilson
- Human Performance Laboratory, Human Movement Sciences Department, Old Dominion University, Norfolk, Virginia
| | - John S Fitzgerald
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
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The Impact of Body Resistance Training Exercise on Biomedical Profile at High Altitude: A Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6684167. [PMID: 34159199 PMCID: PMC8187057 DOI: 10.1155/2021/6684167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/16/2021] [Indexed: 11/18/2022]
Abstract
Background Obesity causes different diseases, eventually. In our study, the results of resistance exercises were examined on selected biochemical markers in Abha City, Saudi Arabia, which is at the height of 2,270 meters above sea level. Methods A randomized controlled research was conducted with 60 participants equally divided into three groups, 20 subjects in each group: group 1 was composed of obese people who received resistance training exercise, group 2 was composed of the obese control group who did not receive resistance training exercise, and group 3 was composed of normal individuals who received resistance exercise training. The resistance exercises were done in the 6th and 12th weeks. Biochemical blood tests were done. Results Comparing to the control group, glucose decreased very little with insulin also showing little difference. It has been seen that TC, TG, and LDL reduced to a reasonable extent after resistance exercise, while HDL was increased (p ≤ 0.01). Plasma urea and creatinine showed no differences. Interleukin-6 and leptin decreased significantly (p ≤ 0.01), while there was a significant elevation in adiponectin and testosterone (p ≤ 0.01) once comparing group 1 with group 2 and group 3. Conclusion We have seen that resistance exercise helps in reducing lipid profile which will result in a decrease of the cardiac and related risk factors when conducted in obese patients in high-altitude regions. Also, alterations of the levels of interleukin-6, leptin, adiponectin, and testosterone showed that resistance exercise is of benefit and favourable in obese persons in high-altitude regions, which can also pave the way for added development of drugs related to the above parameters.
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Various Factors May Modulate the Effect of Exercise on Testosterone Levels in Men. J Funct Morphol Kinesiol 2020; 5:jfmk5040081. [PMID: 33467296 PMCID: PMC7739287 DOI: 10.3390/jfmk5040081] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 11/21/2022] Open
Abstract
Exercise has been proposed to increase serum testosterone concentrations. The analysis of existing literature demonstrates a large degree of variability in hormonal changes during exercise. In our manuscript, we summarized and reviewed the literature, and concluded that this variability can be explained by the effect of numerous factors, such as (a) the use of different types of exercise (e.g., endurance vs. resistance); (b) training intensity and/or duration of resting periods; (c) study populations (e.g., young vs. elderly; lean vs. obese; sedentary vs. athletes); and (d) the time point when serum testosterone was measured (e.g., during or immediately after vs. several minutes or hours after the exercise). Although exercise increases plasma testosterone concentrations, this effect depends on many factors, including the aforementioned ones. Future studies should focus on clarifying the metabolic and molecular mechanisms whereby exercise may affect serum testosterone concentrations in the short and long-terms, and furthermore, how this affects downstream mechanisms.
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Kenk M, Grégoire JC, Coté MA, Connelly KA, Davis MK, Dresser G, Ghosh N, Goodman S, Johnson C, Fleshner N. Optimizing screening and management of cardiovascular health in prostate cancer: A review. Can Urol Assoc J 2020; 14:E458-E464. [PMID: 32569573 DOI: 10.5489/cuaj.6685] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In clinical practice, cancer management does not consistently encompass screening and identification of cardiovascular (CV) risk. The use of androgen deprivation therapy (ADT) in prostate cancer has been associated with increased CV risk and development of metabolic syndrome, necessitating identification of patients at risk in this population (e.g., those with pre-existing CV disease). A multidisciplinary team of Canadian physicians was assembled to develop a series of recommendations intended to identify patients who may benefit from optimal management of their CV disease and/or modification of cardiac risk factors. A key goal was the development of a simple screening tool for identification of patients with pre-existing CV disease. This simple and inclusive set of recommendations are intended for use within urology clinics to facilitate holistic approaches and simplify the management of patients.
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Affiliation(s)
- Miran Kenk
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Marc-Andre Coté
- Centre hospitalier universitaire de Quebec, Québec City, QC, Canada
| | - Kim A Connelly
- St. Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Margot K Davis
- University of British Columbia Diamond Health Care Center, Vancouver, BC, Canada
| | - George Dresser
- Division of Clinical Pharmacology, Department of Medicine, Western University, London, ON, Canada
| | - Nina Ghosh
- Queensway Carleton Hospital, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Shaun Goodman
- Division of Cardiology, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Neil Fleshner
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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Polito R, Monda V, Nigro E, Messina A, Di Maio G, Giuliano MT, Orrù S, Imperlini E, Calcagno G, Mosca L, Mollica MP, Trinchese G, Scarinci A, Sessa F, Salerno M, Marsala G, Buono P, Mancini A, Monda M, Daniele A, Messina G. The Important Role of Adiponectin and Orexin-A, Two Key Proteins Improving Healthy Status: Focus on Physical Activity. Front Physiol 2020; 11:356. [PMID: 32390865 PMCID: PMC7188914 DOI: 10.3389/fphys.2020.00356] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 03/27/2020] [Indexed: 12/15/2022] Open
Abstract
Exercise represents the most important integrative therapy in metabolic, immunologic and chronic diseases; it represents a valid strategy in the non-pharmacological intervention of lifestyle linked diseases. A large body of evidence indicates physical exercise as an effective measure against chronic non-communicable diseases. The worldwide general evidence for health benefits are both for all ages and skill levels. In a dysregulated lifestyle such as in the obesity, there is an imbalance in the production of different cytokines. In particular, we focused on Adiponectin, an adipokine producted by adipose tissue, and on Orexin-A, a neuropeptide synthesized in the lateral hypothalamus. The production of both Adiponectin and Orexin-A increases following regular and structured physical activity and both these hormones have similar actions. Indeed, they improve energy and glucose metabolism, and also modulate energy expenditure and thermogenesis. In addition, a relevant biological role of Adiponectin and Orexin A has been recently highlighted in the immune system, where they function as immune-suppressor factors. The strong connection between these two cytokines and healthy status is mediated by physical activity and candidates these hormones as potential biomarkers of the beneficial effects induced by physical activity. For these reasons, this review aims to underly the interconnections among Adiponectin, Orexin-A, physical activity and healthy status. Furthermore, it is analyzed the involvement of Adiponectin and Orexin-A in physical activity as physiological factors improving healthy status through physical exercise.
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Affiliation(s)
- Rita Polito
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche e Farmaceutiche, University of Campania "Luigi Vanvitelli", Caserta, Italy.,Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vincenzo Monda
- Dipartimento di Medicina Sperimentale, Sezione di Fisiologia Umana e Unità di Dietetica e Medicina dello Sport, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Ersilia Nigro
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche e Farmaceutiche, University of Campania "Luigi Vanvitelli", Caserta, Italy.,Ceinge Biotecnologie Avanzate S. C. a R. L., Naples, Italy
| | - Antonietta Messina
- Dipartimento di Medicina Sperimentale, Sezione di Fisiologia Umana e Unità di Dietetica e Medicina dello Sport, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Girolamo Di Maio
- Dipartimento di Medicina Sperimentale, Sezione di Fisiologia Umana e Unità di Dietetica e Medicina dello Sport, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Teresa Giuliano
- Dipartimento di Medicina Sperimentale, Sezione di Fisiologia Umana e Unità di Dietetica e Medicina dello Sport, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefania Orrù
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli "Parthenope", Naples, Italy.,IRCCS SDN, Naples, Italy
| | | | - Giuseppe Calcagno
- Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy
| | - Laura Mosca
- Dipartimento di Biologia, Universitá degli studi di Napoli Federico II, Naples, Italy
| | - Maria Pina Mollica
- Dipartimento di Biologia, Universitá degli studi di Napoli Federico II, Naples, Italy
| | - Giovanna Trinchese
- Dipartimento di Biologia, Universitá degli studi di Napoli Federico II, Naples, Italy
| | - Alessia Scarinci
- Dipartimento di Scienze della Formazione, Psicologia, Comunicazione, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Monica Salerno
- Department of Medical, Surgery Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Gabriella Marsala
- Struttura Complessa di Farmacia, Azienda Ospedaliero Universitaria - Ospedali Riuniti, Foggia, Italy
| | - Pasqualina Buono
- Ceinge Biotecnologie Avanzate S. C. a R. L., Naples, Italy.,Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli "Parthenope", Naples, Italy.,IRCCS SDN, Naples, Italy
| | - Annamaria Mancini
- Ceinge Biotecnologie Avanzate S. C. a R. L., Naples, Italy.,Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli "Parthenope", Naples, Italy
| | - Marcellino Monda
- Dipartimento di Medicina Sperimentale, Sezione di Fisiologia Umana e Unità di Dietetica e Medicina dello Sport, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Aurora Daniele
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche e Farmaceutiche, University of Campania "Luigi Vanvitelli", Caserta, Italy.,Ceinge Biotecnologie Avanzate S. C. a R. L., Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Lam T, Birzniece V, McLean M, Gurney H, Hayden A, Cheema BS. The Adverse Effects of Androgen Deprivation Therapy in Prostate Cancer and the Benefits and Potential Anti-oncogenic Mechanisms of Progressive Resistance Training. SPORTS MEDICINE-OPEN 2020; 6:13. [PMID: 32056047 PMCID: PMC7018888 DOI: 10.1186/s40798-020-0242-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/05/2020] [Indexed: 12/25/2022]
Abstract
Prostate cancer has the second highest incidence of all cancers amongst men worldwide. Androgen deprivation therapy (ADT) remains a common form of treatment. However, in reducing serum testosterone to castrate levels and rendering men hypogonadal, ADT contributes to a myriad of adverse effects which can affect prostate cancer prognosis. Physical activity is currently recommended as synergistic medicine in prostate cancer patients to alleviate the adverse effects of treatment. Progressive resistance training (PRT) is an anabolic exercise modality which may be of benefit in prostate cancer patients given its potency in maintaining and positively adapting skeletal muscle. However, currently, there is a scarcity of RCTs which have evaluated the use of isolated PRT in counteracting the adverse effects of prostate cancer treatment. Moreover, although physical activity in general has been found to reduce relapse rates and improve survival in prostate cancer, the precise anti-oncogenic effects of specific exercise modalities, including PRT, have not been fully established. Thus, the overall objective of this article is to provide a rationale for the in-depth investigation of PRT and its biological effects in men with prostate cancer on ADT. This will be achieved by (1) summarising the metabolic effects of ADT in patients with prostate cancer and its effect on prostate cancer progression and prognosis, (2) reviewing the existing evidence regarding the metabolic benefits of PRT in this cohort, (3) exploring the possible oncological pathways by which PRT can affect prostate cancer prognosis and progression and (4) outlining avenues for future research.
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Affiliation(s)
- Teresa Lam
- School of Medicine, Western Sydney University, Penrith, NSW, Australia. .,Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia. .,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia.
| | - Vita Birzniece
- School of Medicine, Western Sydney University, Penrith, NSW, Australia.,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia.,School of Medicine, UNSW Sydney, Sydney, NSW, Australia.,Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,Translational Health Research Institute, Penrith, NSW, Australia
| | - Mark McLean
- School of Medicine, Western Sydney University, Penrith, NSW, Australia.,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia
| | - Howard Gurney
- Crown Princess Mary Cancer Centre, Westmead, NSW, Australia
| | - Amy Hayden
- Crown Princess Mary Cancer Centre, Westmead, NSW, Australia.,Department of Radiation Oncology, Blacktown Hospital, Blacktown, NSW, Australia
| | - Birinder S Cheema
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
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14
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Effect of Strength Training on Lipid and Inflammatory Outcomes: Systematic Review With Meta-Analysis and Meta-Regression. J Phys Act Health 2019; 16:477-491. [PMID: 31023184 DOI: 10.1123/jpah.2018-0317] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The aim of this study was to perform a systematic review with meta-analysis and meta-regressions evaluating the effects of isolated strength training (ST), compared with a control group, on total cholesterol (TC), triglycerides (TG), low-density (LDL), high-density lipoprotein (HDL), C-reactive protein (CRP), and adiponectin of adults. Methods: Embase, PubMed, Cochrane, and Scopus data sources were searched up to May 2017. Clinical trials that compared ST with a control group of adults older than 18 years, which evaluated blood TC, TG, LDL, HDL, CRP, or adiponectin as an outcome were included. Random effect was used and the effect size (ES) was calculated by using the standardized mean difference with a 95% confidence interval. Results: ST promotes a reduction in TC (ES: -0.399; P < .001), TG (ES: -0.204; P = .002), LDL (ES: -0.451; P < .001), and CRP (ES: -0.542; P = .01) levels. In addition, ST is associated to an increase in HDL (ES: 0.363; P < .001) and adiponectin concentrations (ES: 1.105; P = .01). Conclusion: ST promotes decreases in TC, TG, LDL, and CRP levels and increases HDL and adiponectin concentrations. Thus, progressive ST could be a potential therapeutic option for improving abnormalities in lipid and inflammatory outcomes in adults.
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Ribeiro HQT, Coqueiro AY, Lima VBDS, Martins CEC, Tirapegui J. Leucine and resistance training improve hyperglycemia, white adipose tissue loss, and inflammatory parameters in an experimental model of type 1 diabetes. Nutr Health 2017; 24:19-27. [PMID: 29019279 DOI: 10.1177/0260106017733908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Loss of white adipose tissue (WAT), associated with type 1 diabetes (DM1), contributes to increased chronic systemic inflammation. AIM The aim of this study was to investigate the effects of leucine supplementation and resistance training (RT) in attenuating WAT loss and improving inflammatory parameters and glucose metabolism in DM1 rats. METHODS Thirty-two male Wistar rats were distributed into four groups: DA (sedentary and supplemented with non-essential amino acids (NEAA)), DL (sedentary and supplemented with leucine), DTA (submitted to RT and supplemented with NEAA) and DTL (submitted to RT and supplemented with leucine). DM1 was induced by streptozotocin (STZ). An 8-week period of RT consisted of climbing a ladder with a progressively increased load, and supplementation was offered in the feed. RESULTS Glycemia, polyphagia and polydipsia were lower in DL, DTA and DTL groups compared with the DA group by approximately 20% ( p<.0001), 28% ( p=.004) and 64% ( p<.0001), respectively. Weight of total WAT and retroperitoneal adipose tissue (RPAT) were higher by approximately 21% ( p=.01) and 54% ( p=.0004), respectively, in DL, DTA and DTL groups compared with DA. However, gene expression of adiponectin and leptin in RPAT was only increased by RT (DTA and DTL) compared with DA and DL by approximately 93% ( p<.0001) and 78% ( p=.0002), respectively. Similarly, the levels of adiponectin in the serum, tissue IL-10 (RPAT) and serum IL-10 were only increased in DTA and DTL compared with DA and DL by approximately 31% ( p=.03), 45% ( p=.0009) and 35% ( p=.003), respectively. CONCLUSIONS Both interventions, isolated or together, reduced hyperglycemia and excessive loss of WAT, but RT was the main factor responsible for attenuating inflammation.
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Affiliation(s)
- Henrique Quintas Teixeira Ribeiro
- 1 Department of Physical Education, Anhanguera Faculty, Osasco, São Paulo, Brazil.,2 Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, Brazil
| | - Audrey Yule Coqueiro
- 2 Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, Brazil
| | - Vanessa Batista de Sousa Lima
- 2 Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, Brazil
| | | | - Julio Tirapegui
- 2 Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, Brazil
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Roelfsema F, Yang RJ, Olson TP, Joyner MJ, Takahashi PY, Veldhuis JD. Enhanced Coupling Within Gonadotropic and Adrenocorticotropic Axes by Moderate Exercise in Healthy Men. J Clin Endocrinol Metab 2017; 102:2482-2490. [PMID: 28453740 PMCID: PMC5505190 DOI: 10.1210/jc.2017-00036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 04/17/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT Exercise elicits incompletely defined adaptations of metabolic and endocrine milieu, including the gonadotropic and corticotropic axes. OBJECTIVE To quantify the impact of acute exercise on coordinate luteinizing hormone (LH) and testosterone (T) and adrenocorticotropic hormone (ACTH) and cortisol secretion in healthy men in relation to age. PARTICIPANTS AND DESIGN Prospectively randomized, within-subject crossover study in 23 men aged 19 to 77 years old. Subjects underwent rest and 30 minutes of mixed exercise at 65% of maximal aerobic capacity with 10-minute blood sampling between 7:00 am and 1:00 pm, 2 weeks apart. MAIN OUTCOME MEASURES Incremental changes in LH, T, ACTH, and cortisol concentrations, the feedforward and feedback strength between exercise and rest, quantified by approximate entropy (ApEn), and bihormonal synchrony, quantitated by cross-ApEn. RESULTS Mean hourly exercise-minus-rest LH and ACTH increments increased from -0.055 ± 0.187 to 0.755 ± 0.245 IU/L (P = 0.003) and from 2.9 ± 2.2 to 71.2 ± 16.1 ng/L (P < 0.0001), respectively, during exercise. T and cortisol increments increased concurrently from -9.6 ± 16.7 to 47.6 ± 17.1 ng/dL (P < 0.0001) and 0.45 ± 0.76 to 7.27 ± 0.64 µg/dL (P < 0.0001), respectively. During exercise, feedforward and feedback LH-T and ACTH-cortisol cross-ApEn decreased markedly quantifying enhanced hormonal coupling. CONCLUSIONS Acute moderate mixed exercise in healthy men rapidly enhances feedforward LH-T and ACTH-cortisol coordination and reciprocal feedback within the gonadotropic and corticotropic axes. In principle, enhancement of both LH-T and ACTH-cortisol secretory synchrony by exercise could reflect augmented coupling between brain-testicular and brain-adrenal neural outflow.
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Affiliation(s)
- Ferdinand Roelfsema
- Department of Endocrinology and Metabolism, Leiden University Medical Center, 2333ZA Leiden, The Netherlands
| | - Rebecca J. Yang
- Endocrine Research Unit, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota 55905
| | - Thomas P. Olson
- Department of Cardiovascular Research, Mayo Clinic, Rochester, Minnesota 55905
| | - Michael J. Joyner
- Department of Anesthesia Research, Department of Physiology and Biomedical Engineering, and Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota 55905
| | - Paul Y. Takahashi
- Department of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905
| | - Johannes D. Veldhuis
- Endocrine Research Unit, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota 55905
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Cobo G, Cordeiro AC, Amparo FC, Amodeo C, Lindholm B, Carrero JJ. Visceral Adipose Tissue and Leptin Hyperproduction Are Associated With Hypogonadism in Men With Chronic Kidney Disease. J Ren Nutr 2017; 27:243-248. [PMID: 28366446 DOI: 10.1053/j.jrn.2017.01.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/17/2017] [Accepted: 01/17/2017] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Hypogonadism is a common endocrine disorder in men with chronic kidney disease (CKD), but its pathophysiology is poorly understood. We here explore the plausible contribution of abdominal adiposity and leptin hyperproduction to testosterone deficiency in this patient population. DESIGN Cross-sectional analysis with all men included the Malnutrition, Inflammation and Vascular Calcification cohort, which enrolled consecutive nondialyzed patients with CKD stages 3-5. SUBJECTS A total of 172 men with CKD stages 3-5 nondialysis (median age 61 [45-75] years, median glomerular filtration rate 24 [9-45] mL/min/1.73 m2). In them, serum levels of total testosterone, estrogen, sex hormone binding globulin, and leptin were quantified, together with visceral adipose tissue (VAT) by thoracic and abdominal CT scan. INTERVENTION None, observational study. MAIN OUTCOME MEASURE Total testosterone, hypogonadism. RESULTS The median level of total testosterone was 11.7 (7.3-18.4) nmol/L, with hypogonadism (<10 nmol/L) present in 52 (30%) patients. Testosterone-deficient patients presented with significantly higher body mass index, waist circumference, and VAT. An inverse correlation between testosterone and VAT (rho = -0.25, P = .001) or waist circumference (rho = -0.20, P = .008) was found, also after multivariate adjustment including sex hormone binding globulin and estrogen. Total testosterone was inversely correlated with serum leptin (rho = -0.22, P = .003), and the ratio of leptin/VAT, an index of leptin hyperproduction, was strongly and independently associated with the prevalence of hypogonadism in multivariable regression analyses. CONCLUSION Visceral adiposity independently associated with lower testosterone levels among men with CKD stage 3-5 nondialysis. The observed link between hyperleptinemia and hypogonadism is in line with previous evidence on direct effects of leptin on testosterone production.
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Affiliation(s)
- Gabriela Cobo
- Divisions of Renal Medicine and Baxter Novum (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Antonio C Cordeiro
- Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | | | - Celso Amodeo
- Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - Bengt Lindholm
- Divisions of Renal Medicine and Baxter Novum (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Juan Jesús Carrero
- Divisions of Renal Medicine and Baxter Novum (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine (MMK), Karolinska Institutet, Stockholm, Sweden.
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