Doxorubicin caused severe hyperglycaemia and insulin resistance, mediated by inhibition in AMPk signalling in skeletal muscle

BACKGROUND

Cancer is considered the second leading cause of death in the world, and for the treatment of this disease, pharmacological intervention strategies are frequently based on chemotherapy. Doxorubicin (DOX) is one of the most widely used chemotherapeutic agents in clinical practice for treating a number of solid tumours. The treatment with DOX mimics some effects of cancer cachexia, such as anorexia, asthenia, decreases in fat and skeletal muscle mass and fatigue. We observed that treatment with DOX increased the systemic insulin resistance and caused a massive increase in glucose levels in serum. Skeletal muscle is a major tissue responsible for glucose uptake, and the positive role of AMPk protein (AMP-activated protein kinase) in GLUT-4 (Glucose Transporter type 4) translocation, is well established. With this, our aim was to assess the insulin sensitivity after treatment with DOX and involvement of AMPk signalling in skeletal muscle in this process.

METHODS

We used Wistar rats which received a single dose of doxorubicin (DOX group) or saline (CT group) intraperitoneally at a dose of 15 mg/kg b.w. The expression of proteins involved in insulin sensitivity, glucose uptake, inflammation, and activity of electron transport chain was assessed in extensor digitorum longus muscle, as well as the histological evaluation. In vitro assays were performed in L6 myocytes to assess glucose uptake after treatment with DOX. Agonist of AMPk [5-aminoimidazole-4-carboxamide (AICAR)] and the antioxidant n-acetyl cysteine were used in L6 cells to evaluate its effect on glucose uptake and cell viability.

RESULTS

The animals showed a significant insulin resistance, hyperglycaemia, and hyperinsulinemia. A decrease in the expression of AMKP and GLUT-4 was observed in the extensor digitorum longus muscle. Also in L6 cells, DOX leads to a decrease in glucose uptake, which is reversed with AICAR.

CONCLUSIONS

DOX leads to conditions similar to cachexia, with severe glucose intolerance both in vivo and in vitro. The decrease of AMPk activity of the protein is modulated negatively with DOX, and treatment with agonist of AMPk (AICAR) has proved to be a possible therapeutic target, which is able to recover glucose sensitivity in skeletal muscle.

Both adiponectin and interleukin-10 inhibit LPS-induced activation of the NF-κB pathway in 3T3-L1 adipocytes

Adiponectin and interleukin 10 (IL-10) are adipokines that are predominantly secreted by differentiated adipocytes and are involved in energy homeostasis, insulin sensitivity, and the anti-inflammatory response. These two adipokines are reduced in obese subjects, which favors increased activation of nuclear factor kappa B (NF-κB) and leads to elevation of pro-inflammatory adipokines. However, the effects of adiponectin and IL-10 on NF-κB DNA binding activity (NF-κBp50 and NF-κBp65) and proteins involved with the toll-like receptor (TLR-2 and TLR-4) pathway, such as MYD88 and TRAF6 expression, in lipopolysaccharide-treated 3T3-L1 adipocytes are unknown. Stimulation of lipopolysaccharide-treated 3T3-L1 adipocytes for 24h elevated IL-6 levels; activated the NF-κB pathway cascade; increased protein expression of IL-6R, TLR-4, MYD88, and TRAF6; and increased the nuclear activity of NF-κB (p50 and p65) DNA binding. Adiponectin and IL-10 inhibited the elevation of IL-6 levels and activated NF-κB (p50 and p65) DNA binding. Taken together, the present results provide evidence that adiponectin and IL-10 have an important role in the anti-inflammatory response in adipocytes. In addition, inhibition of NF-κB signaling pathways may be an excellent strategy for the treatment of inflammation in obese individuals.

Impact of Doxorubicin Treatment on the Physiological Functions of White Adipose Tissue

White adipose tissue (WAT) plays a fundamental role in maintaining energy balance and important endocrine functions. The loss of WAT modifies adipokine secretion and disrupts homeostasis, potentially leading to severe metabolic effects and a reduced quality of life. Doxorubicin is a chemotherapeutic agent used clinically because of its good effectiveness against various types of cancer. However, doxorubicin has deleterious effects in many healthy tissues, including WAT, liver, and skeletal and cardiac muscles. Our objective was to investigate the effects of doxorubicin on white adipocytes through in vivo and in vitro experiments. Doxorubicin reduced the uptake of glucose by retroperitoneal adipocytes and 3T3-L1 cells via the inhibition of AMP-activated protein kinase Thr172 phosphorylation and glucose transporter 4 content. Doxorubicin also reduced the serum level of adiponectin and, to a greater extent, the expression of genes encoding lipogenic (Fas and Acc) and adipogenic factors (Pparg, C/ebpa, and Srebp1c) in retroperitoneal adipose tissue. In addition, doxorubicin inhibited both lipogenesis and lipolysis and reduced the hormone-sensitive lipase and adipose tissue triacylglycerol lipase protein levels. Therefore, our results demonstrate the impact of doxorubicin on WAT. These results are important to understand some side effects observed in patients receiving chemotherapy and should encourage new adjuvant treatments that aim to inhibit these side effects.

Sarcopenia and chemotherapy-mediated toxicity

This narrative review focuses on the role of sarcopenia and chemotherapy-induced toxicity in cancer patients. Consistent evidence shows that sarcopenia in cancer patients leads to decreased overall survival by influencing treatment discontinuation and dose reduction. Therefore, sarcopenia should be considered a robust prognostic factor of negative outcome as well as a determinant of increased healthcare costs.

Creatine supplementation and glycemic control: a systematic review

The focus of this review is the effects of creatine supplementation with or without exercise on glucose metabolism. A comprehensive examination of the past 16 years of study within the field provided a distillation of key data. Both in animal and human studies, creatine supplementation together with exercise training demonstrated greater beneficial effects on glucose metabolism; creatine supplementation itself demonstrated positive results in only a few of the studies. In the animal studies, the effects of creatine supplementation on glucose metabolism were even more distinct, and caution is needed in extrapolating these data to different species, especially to humans. Regarding human studies, considering the samples characteristics, the findings cannot be extrapolated to patients who have poorer glycemic control, are older, are on a different pharmacological treatment (e.g., exogenous insulin therapy) or are physically inactive. Thus, creatine supplementation is a possible nutritional therapy adjuvant with hypoglycemic effects, particularly when used in conjunction with exercise.

Resting energy expenditure and carbohydrate oxidation are higher in elderly patients with COPD: a case control study

BACKGROUND

Elderly patients with chronic obstructive pulmonary disease (COPD) usually have a compromised nutritional status which is an independent predictor of morbidity and mortality. To know the Resting Energy Expenditure (REE) and the substrate oxidation measurement is essential to prevent these complications. This study aimed to compare the REE, respiratory quotient (RQ) and body composition between patients with and without COPD.

METHODS

This case-control study assessed 20 patients with chronic obstructive pulmonary disease attending a pulmonary rehabilitation program. The group of subjects without COPD (control group) consisted of 20 elderly patients attending a university gym, patients of a private service and a public healthy care. Consumption of oxygen (O₂) and carbon dioxide (CO₂) was determined by indirect calorimetry and used for calculating the resting energy expenditure and respiratory quotient. Body mass index (BMI) and waist circumference (WC) were also measured. Percentage of body fat (%BF), lean mass (kg) and muscle mass (kg) were determined by bioimpedance. The fat free mass index (FFMI) and muscle mass index (MMI) were then calculated.

RESULTS

The COPD group had lower BMI than control (p = 0.02). However, WC, % BF, FFMI and MM-I did not differ between the groups. The COPD group had greater RQ (p = 0.01), REE (p = 0.009) and carbohydrate oxidation (p = 0.002).

CONCLUSIONS

Elderly patients with COPD had higher REE, RQ and carbohydrate oxidation than controls.

Sleep duration in elderly obese patients correlated negatively with intake fatty

STUDY OBJECTIVES

The purpose of the present study was to evaluate the relationship between sleep duration and dietary habits in elderly obese patients treated at an institute of cardiology.

METHODS

The fifty-eight volunteers were elderly patients with obesity (classified as obese according to BMI) of both genders, between 60 and 80 years of age. All participants were subjected to assessments of food intake, anthropometry, level of physical activity, and duration of sleep.

RESULTS

The men had significantly greater weight, height, and waist circumference than women. Sleep durations were correlated with dietary nutrient compositions only in men. We found a negative association between short sleep and protein intake (r = -0.43; p = 0.02), short sleep and monounsaturated fatty acids intake (r = -0.40; p = 0.03), and short sleep and cholesterol dietary intake (r = -0.50; p = 0.01).

CONCLUSIONS

We conclude that mainly in men, volunteers that had short sleep duration showed a preference for high energy-density as fatty food, at least in part, may explain the relationship between short sleep duration and the development of metabolic abnormalities.

Muscle Function Loss and Gain of Body Weight during the COVID-19 Pandemic in Elderly Women: Effects of One Year of Lockdown

OBJECTIVE

This study aimed to screen for a one year Brazilian elderly women who were physically active before of COVID-19 pandemic-induced lockdown and to assess the consequences of physical inactivity on body weight and muscle function loss.

MEASUREMENTS

A cohort study of one-year was conducted with twenty-nine physically active elderly (65.5±5.6y) women. Pre-assessment was took in December 2019 and post (a year later) was performed in January 2021, during the lockdown induced by COVID-19 pandemic. Body mass (kg) was obtained using the digital scale. Handgrip strength (HGS) of the non-dominant hand was determined using an electronic dynamometer. Muscle function loss was assessed using the SARC-F questionnaire.

RESULTS

After one year, body weight (p=0.002) and BMI (p=0.001) increased significantly, with an average percentage of change in body mass of +3.0±5.2%. Consequently, there was a change in classification of BMI pre- and post-one year (malnutrition: 17.2% to 17.2%, normal weight: 41.4% to 37.9%, and overweight: 41.4% to 44.9%). Additionally, was found increased muscle function loss (SARC-F≥4) of 13.8% to 27.6% of elderly women.

CONCLUSION

In Brazilian physically active elderly women, we found that the physical inactivity imposed by during the lockdown increased the body mass and muscle function loss.

Impact to short-term high intensity intermittent training on different storages of body fat, leptin and soluble leptin receptor levels in physically active non-obese men: A pilot investigation

BACKGROUND & AIMS

Studies have postulated High Intensity Intermittent Training (HIIT) as a superior strategy to reduce body fat. The purpose of this study was to compare the effects HIIT and steady-state training (SST) on body composition, leptin, soluble leptin receptor (sOB-R) levels, and hunger perception in physically active non-obese men.

METHODS

Twenty men performed five weeks of HIIT (5 km - 1 min running at 100% speed correspondent to VȩO_2peak - v VȩO_2peak - interspersed with 1-min passive recovery; n = 10) or SST (5 km at 70% of vVȩO_2peak continuously; n = 10) three times a week. Body composition, and hunger perception were assessed at pre- and post-training and were compared by a two-way analysis (group and training period) with repeated measures in the second factor. A fasting time-course (baseline, 24 h, and 48 h after an experimental session of exercise) of leptin and sOB-R levels were measured at pre- and post-five weeks of training and assessed by a three-way analysis (group, period and time of measurement) with repeated measures in the second and third factors.

RESULTS

There was no effect on body composition and hunger perception. Leptin was reduced in both groups, while sOB-R was increased post-five weeks of training in HIIT but not in the SST.

CONCLUSIONS

Although both training groups exerted alterations in leptin levels, only HIIT was able increased sOB-R levels, this suggest a superior impact on central responses in physically active non-obese men.

Modulation of inflammatory response arising from high-intensity intermittent and concurrent strength training in physically active males

The purposes of this study were to determine: (i) the extent of an acute session of high-intensity intermittent exercise (HIIE) followed by a concurrent strength session (Conc) on the increase of systemic inflammatory cytokines and chemokines, and (ii) whether eight weeks of high intensity interval training plus concurrent strength training alters the acute inflammatory response and immune status. Ten recreationally active males (aged 26.9±4.3years) performed two experimental exercise sessions interspersed by eight weeks of HIIT plus concurrent strength training. The experimental exercise session was composed of a 5-km run on a treadmill (1:1 at 100% of maximal aerobic speed (MAS)), and after 10min of passive recovery, back squat exercises were performed (80% 1RM, four sets until exhaustion). Serum samples were collected after fasting, pre-HIIE, post-HIIE, Pre-Conc, Post-Conc, and 30 and 60min post-exercise session. The comparison between both concurrent exercise sessions was performed using repeated measure ANOVA, with the Bonferroni Post-hoc when necessary. Interleukin-6 (IL-6) presented a moment effect (F=6.72; p<0.05), with Post-Conc significantly higher than pre-HIIE, Post-HIIE, and 60min, only a tendency was found between pre-HIIE and post-HIIE (difference=-5.99; p=0.09). MCP-1 and IL-1ra did not present effects for condition, moment, or interaction. Interleukin-10 (IL-10) presented both moment and interaction effects (F=5.31 and 2.50; p=0.005 and 0.036). Pre-Conc and Post-Conc were significantly higher than Pre-HIIE. The interaction between before and after eight weeks of concurrent training probably occurred at Post-Conc (11.42±3.09pgmL^-1 and 8.88±1.29pgmL^-1). In addition, maintenance of immune function was observed. Therefore, HIIE and concurrent strength exercise lead to an increase in cytokines response, but eight weeks of training program promoted anti-inflammatory response after an acute session of concurrent exercise.

Deleterious effects of lard-enriched diet on tissues fatty acids composition and hypothalamic insulin actions

Altered tissue fatty acid (FA) composition may affect mechanisms involved in the control of energy homeostasis, including central insulin actions. In rats fed either standard chow or a lard-enriched chow (high in saturated/low in polyunsaturated FA, HS-LP) for eight weeks, we examined the FA composition of blood, hypothalamus, liver, and retroperitoneal, epididymal and mesenteric adipose tissues. Insulin-induced hypophagia and hypothalamic signaling were evaluated after intracerebroventricular insulin injection. HS-LP feeding increased saturated FA content in adipose tissues and serum while it decreased polyunsaturated FA content of adipose tissues, serum, and liver. Hypothalamic C20:5n-3 and C20:3n-6 contents increased while monounsaturated FA content decreased. HS-LP rats showed hyperglycemia, impaired insulin-induced hypophagia and hypothalamic insulin signaling. The results showed that, upon HS-LP feeding, peripheral tissues underwent potentially deleterious alterations in their FA composition, whist the hypothalamus was relatively preserved. However, hypothalamic insulin signaling and hypophagia were drastically impaired. These findings suggest that impairment of hypothalamic insulin actions by HS-LP feeding was not related to tissue FA composition.

Effects of placebo on bench throw performance of Paralympic weightlifting athletes: a pilot study

BACKGROUND

The aim of the present study was to analyse the effects of placebo on bench throw performance in Paralympic weightlifting athletes.

METHODS

The study involved four Paralympic weightlifting male athletes (age: 40.25 ± 9.91 years, weight: 60.5 ± 8.29 kg, height: 1.60 ± 0.15 m) that visited the laboratory in three occasions, separated by 72 h. In the first session, the athletes were tested for bench press one repetition maximum (1RM). The other two sessions were performed in a randomized counter-balanced order and involved bench throw tests performed either after taking placebo while being informed that the capsule contained caffeine or without taking any substance (control). The bench throw tests were performed with loads corresponding to 50, 60, 70 and 80% of the bench press 1RM.

RESULTS

According to the results, mean velocity (∆: 0.08 m/s, ES 0.36, p < 0.05) and mean propulsive velocity (∆: 0.11 m/s, ES 0.49, p < 0.05) at 50% of 1RM were significantly higher during placebo than control (p < 0.05). However, there were no difference between control and placebo for 60, 70 and 80% of 1RM (p > 0.05).

CONCLUSION

Our results suggest that placebo intake, when the athletes were informed they were taking caffeine, might be an efficient strategy to improve the performance of explosive movements in Paralympic weightlifting athletes when using low-loads. This brings the possibility of using placebo in order to increase performance, which might reduce the risks associated with ergogenic aids, such as side-effects and positive doping testing.

Sleep pattern and locomotor activity are impaired by doxorubicin in non-tumor-bearing rats

Purpose

We sought explore the effects of doxorubicin on sleep patterns and locomotor activity. To investigate these effects, two groups were formed: a control group and a Doxorubicin (DOXO) group.

Methods

Sixteen rats were randomly assigned to either the control or DOXO groups. The sleep patterns were examined by polysomnographic recording and locomotor activity was evaluated in an open-field test.

Results

In the light period, the total sleep time and slow wave sleep were decreased, while the wake after sleep onset and arousal were increased in the DOXO group compared with the control group (p<0.05). In the dark period, the total sleep time, arousal, and slow wave sleep were increased, while the wake after sleep onset was decreased in the DOXO group compared with the control group (p<0.05). Moreover, DOXO induced a decrease of crossing and rearing numbers when compared control group (p<0.05).

Conclusions

Therefore, our results suggest that doxorubicin induces sleep pattern impairments and reduction of locomotor activity.

Low Handgrip Strength Is Not Associated with Type 2 Diabetes Mellitus and Hyperglycemia: a Population-Based Study

Type 2 diabetes mellitus (DM) is commonly linked to muscle weakness and metabolic abnormalities which increase healthcare costs. The study was undertaken to investigate if low handgrip strength, as a marker of muscle weakness, is associated with hyperglycemia and/or DM in Brazilian subjects. In a cross-sectional design, 415 individuals of both sexes (46.7% male) were interviewed by a questionnaire and the DM diagnostic was self-reported. Anthropometric measurements, such as weight, height, body mass index (BMI), arm circumference, mid-arm and calf circumference and handgrip strength, were obtained by trained nutritionists. Blood glucose concentrations were determined by portable monitor analysis. Student's t-test was applied to compare DM cases with non-diabetic individuals, and logistic regression analysis was performed to verify the odds for becoming diabetic or having altered glycemia and p < 0.05 was considered as significant. From 415 subjects, 9.2% (n = 35) were classified as DM. DM patients had significantly higher age, BMI, casual glycemia and lower handgrip strength and normalized (to body weight) handgrip strength (NHS) when compared with non-diabetic patients. Individuals with low NHS have 2.7 odds ratio to DM without adjustment for covariate (crude model, p = 0.006) and have 2.7 times higher the likelihood of DM than individuals with high NHS after adjusting for age (model 1, p = 0.006); however, this association disappeared after further adjusting for sex. In conclusion, low handgrip strength normalized or not to body weight, was not associated with hyperglycemia and DM diagnosis.

Sagital abdominal diameter, but not waist circumference is strongly associated with glycemia, triacilglycerols and HDL-C levels in overweight adults

AIM

To correlate the sagittal abdominal diameter (SAD) and waist circumference (WC) with metabolic syndrome-associated abnormalities in adults.

METHODS

This cross-sectional study included onehundred twelve adults (M=27, F=85) aging 54.0±11.2 yrs and average body mass index (BMI) of 30.5±9.0 kg/m². The assessment included blood pressure, plasma and anthropometric measurements.

RESULTS

In both men and female, SAD and WC were associated positively with body fat% (r=0.53 vs r=0.55), uric acid (r=0.45 vs r=0.45), us-PCR (r=0.50 vs r=0.44), insulin (r=0.89 vs r=0.75), insulin resistance HOMA-IR (r=0.86 vs r=0.65), LDL-ox (r=0.51 vs r=0.28), GGT (r=0.70 vs r=0.61), and diastolic blood pressure (r=0.35 vs r=0.33), and negatively with insulin sensibility QUICKI (r=-0.89 vs r=-0.82) and total cholesterol/TG ratio (r=-0.40 vs r=-0.22). Glycemia, TG, and HDL-c were associated significantly only with SAD (r=0.31; r = 39, r=-0.43, respectively).

CONCLUSION

Though the SAD and WC were associated with numerous metabolic abnormalities, only SAD correlated with dyslipidemia (TG and HDL-c) and hyperglycemia (glycemia).

Short-Term Creatine Supplementation May Alleviate the Malnutrition-Inflammation Score and Lean Body Mass Loss in Hemodialysis Patients: A Pilot Randomized Placebo-Controlled Trial

BACKGROUND

Creatine supplementation has been proposed to alleviate muscle loss in various populations, but has not been investigated in hemodialysis (HD) patients. Thus, our objective was to evaluate whether creatine supplementation could attenuate the loss of lean body mass (LBM) and malnutrition-inflammation score (MIS) in HD patients.

METHODS

A randomized, placebo-controlled, double blind, parallel-design study included HD patients, of both sexes, aged 18-59 years. The patients were allocated to a Placebo Group (PG; n = 15; received maltodextrin, 1st week: 40 g/day and 2nd-4th weeks: 10 g/day) and a Creatine Group (CG; n = 15; received creatine plus maltodextrin, 1st week: 20 g/day of creatine plus 20 g/day of maltodextrin and 2nd-4th weeks: 5 g/day of creatine plus 5 g/day of maltodextrin). Pre and post the intervention, patients were evaluated for food intake, MIS, body composition and biochemical parameters.

RESULTS

CG group attenuated the MIS (Pre: 5.57 ± 0.72 vs. Post: 3.85 ± 0.47 score, P = 0.003) compared with PG (Pre: 5.71 ± 0.97 vs. Post: 5.36 ± 0.95 score, P = 0.317) (supplement × time P = 0.017, effect size: 0.964). The change of LBM was greater in CG than in PG (CG: Δ0.95 vs PG: Δ0.13 kg). At post-intervention, 28.6% of PG patients presented LBM loss and 71.4% remain stable. In contrast, 14.4% of CG patients had LBM loss, 42.8% remain stable and 42.8% gained. Food intake and quality of life did not change. CG increased the BMI and gait speed in post-compared to pre-moment, but no difference among the groups.

CONCLUSION

In HD patients, four weeks of creatine supplementation may alleviate the MIS as well as attenuate the LBM loss compared to placebo.

Influence to high-intensity intermittent and moderate-intensity continuous exercise on indices of cardio-inflammatory health in men

The aim of this study was to evaluate the influence to acute exercises performed in different intensities with volume equalized (5 km) on indices of cardio-inflammatory health. Twelve physically active male subjects (age, 23.22±5.47 years; height, 174.75±5.80 m; weight, 75.13±6.61 kg; maximal oxygen uptake, 52.92 mL/kg/min), after determination of peak oxygen uptake (VO_2Peak) and the speed associated with VO_2Peak (sVO_2Peak), completed two randomly experimental trials: high-intensity intermittent exercise (HIIE: 1:1 at 100% sVO_2Peak) and moderate-intensity continuous exercise (MICE: 70% sVO_2Peak). Brain-derived neurotrophic factor (BDNF), adiponectin and plasminogen inhibitor-1 (PAI-1) data were analyzed pre, immediately, and 60 min after the exercise session. Statistical analysis comparisons between moments and between HIIE and MICE were performed using a mixed model and statistical and significance was set at <5%. PAI-1 presented an effect for time from pre to immediately after exercise moment (P<0.018) and from immediately to 60 min after exercise moment (P<0.001) only in MICE. BDNF presented an effect for time from pre to immediately after exercise to HIIE (P<0.022) and from immediately to 60 min after exercise to MICE (P<0.034). HIIE promotes BDNF increase and that there is negative correlation between PAI-1 concentrations and BDNF in both protocols in healthy sportsmen, favoring an anti-atherogenic profile.

SARC-F Is Better Correlated with Muscle Function Indicators than Muscle Mass in Older Hemodialysis Patients

BACKGROUND

Sarcopenia can be characterized by European Consensus for Sarcopenia (EWGSOP2) criteria, but it methods are not easily accessible. Likewise, the Strength, Assistance with walking, Rise from a Chair, Climb stairs and Falls (SARC-F) has been proposed.

OBJECTIVE

The aim of this study was i) to evaluate the prevalence for risk sarcopenia and ii) to correlate the SARC-F with components of the EWGSOP2 consensus in hemodialysis (HD) patients.

MEASUREMENTS

This cross-sectional study enrolled ninety-five (male n= 59; 62%) HD older patients. Sarcopenia risk was assessed using the SARC-F, which ≥4 score indicates sarcopenia risk. Sarcopenia was confirmed through of the EWGSOP2 consensus, including the handgrip strength (HGS <27kg for men and <16kg for women) using the dynamometer, muscle mass through appendicular muscle mass (ASMI/m2 <7.0 kg/m2 for men and 5.5 kg/m2 for women) using the bioimpedance electrical, and physical performance through of gait speed (GS <0.8 m/s).

RESULTS

From 95 patients, n=21(22%) presented sarcopenia risk. SARC-F ≥4 group are older (64.9±13.9 vs. 56.9±14.6 y, p= 0.028), presented lower ASMI (7.4±1.2 vs. 8.3±1.8 kg/m2, p=0.033), HGS (20.5±5.7 vs. 27.2±10.2 kg, p=0.005), and GS (0.5±0.1 vs. 0.7±0.1 m/s, p=0.001) than SARC-F<4 group. SARC-F score was negatively correlated with EWGSOP2 components: ASMI x SARC-F (r=-0.27, p=0.007), HGS x SARC-F (r=-0.35, p=0.0005), and GS x SARC-F (r=-0.47, p<0.0001). Although, no difference of number of patients with low or normal ASMI values was found, 62% and 95% of SARC-F≥4 group patients presented low HGS and gait speed, respectively.

CONCLUSIONS

In older HD patients, 22% presented sarcopenia risk. In addition, SARC-F is better correlated with muscle function indicators (HGS and gait speed) than muscle mass.

Oxintomodulina e obesidade

Desde o descobrimento da leptina, avanços consideráveis foram obtidos na caracterização dos mecanismos hipotalâmicos do controle da ingestão alimentar e, atualmente, a oxintomodulina é reconhecida como um regulador da homeostase energética. O presente artigo de revisão enfoca algumas das mais relevantes inter-relações do hormônio oxintomodulina com o apetite, a homeostase energética e aspectos de seu papel na bioquímica e fisiologia nutricional. A oxintomodulina é um peptídeo intestinal anorexígeno produzido pelas células L do intestino. Recentes estudos têm demonstrado que em longo prazo a administração de oxintomodulina reduz a ingestão alimentar e o ganho de peso. Pesquisas em humanos têm verificado que o seu uso reduz o consumo energértico em 25%. Portanto, a oxintomodulina representa uma potente terapia anti-obesidade. Entretanto, o mecanismo de ação da oxintomodulina ainda é desconhecido. Atuais evidências sugerem que tem ação via receptor do peptídeo semelhante ao glucagon 1. Além disso, a literatura mostra que, juntamente com a adoção de hábitos saudáveis e a mudança do estilo de vida, a oxintomodulina pode proporcionar menor avanço da obesidade.

Waist circumference is better associated with high density lipoprotein (HDL-c) than with body mass index (BMI) in adults with metabolic syndrome

BACKGROUND

The measurement of waist circumference (WC) is the most prevalent cause of the metabolic syndrome (MS).

OBJECTIVE

The aim of this study was to correlate WC and BMI with high-density lipoprotein (HDL-c) levels in patients with MS being consulted by the Family Health Program (PSF), Brazil.

METHODS

This cross-sectional study was conducted from September to November 2008 with 42 patients (29 women and 13 men) from 35 to 77 years. Dietary intake was reported, and biochemical and body composition measures were taken.

RESULTS

The HDL-c levels were higher in women when compared to men (48.4 ± 8.1 mg/dL vs. 36.4 ± 7.8 mg/dL). However, the triglycerides (TG)/HDL-c ratio and TG concentrations were lower in women (3.8 ± 1.5 and 178.0 ± 57.8 mg/dL, respectively) than in men (9.4 ± 8.5 and 471.5 ± 501.5 mg/dL, respectively). Regarding skinfold profile, the triceps was greater in females (37.0 ± 8.4 cm vs. 20.7 ± 10.5 cm). The dietetic profile showed that women had a lower intake of energy, fiber, phosphorus and sodium. The fruits and vegetables intake was diminished in the participants of this study, as less than 60% of the women and 50% of men met the daily recommendations. Approximately 54% of men and 28% of women had a lower intake of dairy products daily. Moreover, the results shows that the WC was negatively correlated to HDL-c (r = -0.41, p < 0.05) whereas the BMI is not associated with HDL-c (r = -0.34, p > 0.06).

CONCLUSION

Our findings showed that WC is a better predictor of changes in HDL-c than BMI.

Correlation between SARC-F Score and Ultrasound-Measured Thigh Muscle Thickness in Older Hospitalized Cancer Patients

BACKGROUND

Strength, Assistance for walking, Rise from a chair, Climb stairs, and Falls (SARC-F) score is frequently used for screening the sarcopenia risk in older people. However, the agreement between SARC-F and loss of ultrasound-derived muscle thickness in hospitalized older cancer patients is unexplored.

OBJECTIVE

The primary objective was to evaluate the relationship between the SARC-F score and ultrasound-derived muscle thickness of rectus femoris and vastus intermedius in older hospitalised cancer patients. The secondary objective was to identify the presence of sarcopenia.

MEASUREMENTS

A cross-sectional study enrolled forty-one older hospitalised cancer patients ongoing chemotherapy or surgical treatment. Body weight (kg) was measured using a digital scale and height using a portable stadiometer to assess body mass index. SARC-F was performed to assess and classify sarcopenia risk (with (SARC-F: ≥4), without (SARC-F: <4). US-derived muscle thickness of rectus femoris and vastus intermedius was assessed using a portable ultrasound. Relationship between the SARC-F and muscle thickness was tested using Pearson´s correlation and Bland-Altman analyses.

RESULTS

Approximately, 46.3% of the patients presented sarcopenia and a lower non-significant muscle thickness of rectus femoris and vastus intermedius (SARC-F ≥4: 18.54±6.28 vs. SARC-F <4: 22.22±9.16 mm, p=0.07). There was a moderate negative correlation between SARC-F and muscle thickness (r=-0.40, p=0.004). Additionally, Bland-Altman plots no found systematic bias risk between SARC-F and ultrasound-derived muscle thickness.

CONCLUSIONS

Approximately, 46.3% of older hospitalized cancer patients presented sarcopenia. Additionally, we found a moderate inverse correlation and no systematic bias risk between SARC-F and ultrasound-measured muscle thickness.

Creatine supplementation does not promote additional effects on inflammation and insulin resistance in older adults: A pilot randomized, double-blind, placebo-controlled trial

BACKGROUND

A chronic, low-grade inflammation is commonly present in older adults and has been associated with the onset of age-related chronic diseases. Resistance training (RT) and creatine (CR) supplementation emerged as promising strategies to reduce circulating pro-inflammatory cytokines. This study aimed to investigate the effects of CR supplementation combined with RT on markers of inflammation and insulin resistance in community-dwelling older adults.

METHODS

In a pilot randomized, double-blind, placebo-controlled trial, participants were allocated to one of the following groups: 1) Creatine supplementation and resistance training (CR + RT, n = 13); 2) Placebo and resistance training (PL + RT, n = 14). While engaged in a 12-week RT program, participants from CR + RT group received 5 g/day of CR monohydrate and participants from PL + RT group received the same dose of maltodextrin. At baseline and at week 12, blood samples were collected for glucose, insulin, adiponectin, leptin, interleukin 6, interleukin 10, monocyte chemo-attractant protein-1 and C-reactive protein analysis.

RESULTS

After 12 weeks of intervention, there were no differences between groups in any of the variables analyzed. Monocyte chemoattractant protein-1 was reduced in both groups (CR + RT: -55.66 ± 48.93 pg/mL, p < 0.01, dz = 1.13; PL + RT: -46.52 ± 55.21 pg/mL, p < 0.01, dz = 0.84).

CONCLUSION

Resistance training, regardless of CR supplementation, decreased MCP-1 concentration in older adults.