Mediating Effects of Mental Health Problems in a Clinical Sample of Adolescents with Obesity

IntroductionThe prevalence rates of obesity have increased in recent decades; despite leveling off in recent German studies among children and adolescents, obesity rates remain high. Psychosocial factors have an adverse impact on the maintenance of obesity. Hence, this study examined the mediating effects of mental health problems on the relation between the body mass index standard deviation score (BMI-SDS) and global health-related quality of life (HRQoL) among adolescent inpatients with obesity while controlling for gender and age-group.MethodsThree simple mediation analyses with gender and age-group as covariates were conducted for n = 313 adolescents with obesity (n_female = 193, 61.7%) aged 12–17 (M = 14.19, SD = 1.52; BMI-SDS: M = 2.67, SD = 0.52). The adolescents were asked to report their global HRQoL at admission, and their parents estimated the children''s mental health problems at home prior to inpatient rehabilitation.ResultsEmotional, peer-related, and conduct problems mediated the unfavorable effects of BMI-SDS on global HRQoL, showing high, moderate, and small effect sizes, respectively (completely standardized indirect effect of emotional problems: β = −0.09, SE = 0.03, 95% B-CI = −0.15 to −0.04; conduct problems: β = −0.03, SE = 0.02, 95% B-CI = −0.06 to −0.01; peer-related problems: β = −0.10, SE = 0.03, 95% B-CI = −0.16 to −0.05).ConclusionMental health problems may be one salient pathway through which BMI-SDS impairs global HRQoL among adolescents with obesity. Hence, inpatient rehabilitation programs for adolescents with obesity should increase their focus more on the development of psychosocial skills. Thus, the promotion of emotion regulation and social-emotional competencies is suggested.     

Obesity in Older Adults and Associations with Cardiovascular Structure and Function

IntroductionBody mass index (BMI), despite being widely used as a marker of obesity, fails to fully capture cardiovascular risks as it is an insufficient biomarker of abdominal adiposity, unlike waist circumference (WC). We aimed to characterize associations between BMI and WC with cardiovascular structure and function in older adults.MethodsAmong an observational cohort study of a community of older adults, transthoracic echocardiography determined cardiovascular structure and function, while aerobic capacity was determined by peak oxygen uptake (VO₂) metrics. The cut-offs for obesity were 27.5 kg/m² for BMI, and >90 cm for males and >80 cm for females for WC.ResultsOf 970 older adults without cardiovascular disease (mean age 73 ± 4 years, 432 [44%] males), 124 (12.8%) were obese by BMI definition while 347 (35.7%) were obese by WC definition. Inter-definitional agreement was fair (Cohen''s κ = 0.345). Unlike the BMI definition, participants defined as obese by WC were more likely to be women (65% vs. 50%, p < 0.001), older (65 ± 11 vs. 63 ± 14 years, p = 0.007), and had lower handgrip strength (24 ± 0.6 vs. 26 ± 0.4 kg, p = 0.022). Across BMI categories, high WC was associated with more impaired myocardial relaxation (E/A), and VO₂ measurements (all p < 0.05). Among those with low BMI, high WC was associated with larger left atrial (LA) volumes (p = 0.003). WC, but not BMI, was independently associated with E/A (β = −0.114, SE −0.114 ± 0.024, p < 0.001) in regression analysis.ConclusionWC identified a higher prevalence of obesity, possibly related to central adiposity. Across BMI categories, WC identified more adverse measurements in E/A, aerobic capacity, and LA structure.Trial RegistrationClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02791139","term_id":"NCT02791139"}}NCT02791139.     

Eccentric Cycling Training Improves Health-Related Quality of Life in Adolescents with Obesity

IntroductionWhile eccentric (ECC) training appears to be more efficient than concentric (CON) training at improving body composition in adolescent with obesity, its impact on health-related quality of life (HRQOL) has never been studied.ObjectiveThe aim of this study is to compare the effects of 2 cycling training modalities, i.e., ECC vs. CON, in adolescents with obesity on HRQOL and health perception (HP).MethodsA total of 24 adolescents with obesity, aged 12–16 years, were randomized to either a 12-week ECC or a CON cycling training program performed at the same oxygen consumption (VO₂). Anthropometric measurements, body composition, maximal incremental tests, HRQOL (Vécu et Santé Percue de l''Adolescent [VSP-A], Medical Outcome Study Short Form [SF-36]), and HP were assessed at before and after training.Results and ConclusionBoth CON and ECC cycling trainings promoted significant improvements in BMI, VO_2peak, total fat mass, and fat-free mass, with better improvements in body composition parameters in the ECC group (p < 0.05). The VSP-A total score increased after CON (p < 0.01) and ECC (p < 0.001) training, with better enhancement for the ECC group (p < 0.05). The SF-36 physical score increased after both CON (p < 0.01) and ECC (p < 0.001) trainings. The global HP score increased only after ECC training (p < 0.001). Except for the energy-vitality item, no significant correlation was found between changes in HRQOL and its subdomains and anthropometric, body composition, and functional parameters. Both ECC and CON cycling trainings are associated with positive changes in HRQOL and HP. However, ECC seems to induce greater improvements in HRQL and HP than CON cycling training, which is probably not due to the anthropometric, body composition, and functional changes.     

The Relationship between HIF-2α and VEGF with Radiographic Severity in the Primary Osteoarthritic Knee

PurposeThe aim of this study was to determine the relationship of hypoxia-inducible factor-2 (HIF-2α) and vascular endothelial growth factor (VEGF) with radiographic severity in primary osteoarthritis (OA) of the knee. Expression of these two factors in cartilage samples from OA knee joints was examined at mRNA and protein levels.ResultsCartilage degeneration correlated with the radiographic severity grade. OA severity, determined using the Mankin scale, correlated positively with the KL grade (r=0.8790, p<0.01), and HIF-2α and VEGF levels with the radiographic severity of knee OA (r=0.7001, p<0.05; r=0.6647, p<0.05).ConclusionIn OA cartilage, HIF-2α and VEGF mRNA and protein levels were significantly and positively correlated. The expression of both factors correlated positively with the KL grade. HIF-2α and VEGF, therefore, may serve as biochemical markers as well as potential therapeutic targets in knee OA.     

Association between Physical Activity,Sedentary Behaviors,Sleep, Diet,and Adiposity among Children and Adolescents in China

IntroductionPhysical activity (PA), sedentary behaviors (SB), sleep, and diet are related to adiposity among children and adolescents. However, there may be interactions between PA, SB, sleep, and diet, and these lifestyle behaviors may work together to affect body weight. The purpose of this study was to explore the impact of multiple lifestyle behaviors of PA, SB, sleep, and diet on childhood adiposity (body mass index z-score and overweight/obesity), and to investigate the effect of meeting multiple guidelines on adiposity among children and adolescents in China.MethodsCross-sectional results were based on 28,048 children aged 6–17 years from the China National Nutrition and Health Surveillance in 2010–2012. Information about PA, SB, and sleep was measured through interview-administered questionnaire. Dietary intake was assessed with food frequency questionnaire. The associations between multiple lifestyle behaviors and BMI z-score and overweight/obese were examined.ResultsThe prevalence of overweight/obesity in the participants was 19.2%. The average time of moderate-to-vigorous PA (MVPA), leisure SB, and sleep was 76.7 ± 45.5 min, 2.9 ± 1.4 h, and 8.5 ± 1.1 h per day, respectively. The China Dietary Guidelines Index for Youth (CDGI-Y) score was 62.6 ± 11.0. Sleep duration and diet score were negative associated with BMI z-score (both p < 0.001). MVPA and SB time were positive associated with BMI z-score (p = 0.041, 0.004). Meeting the SB, sleep, and diet guidelines had a lower BMI z-score (all p < 0.01) and lower odds of overweight/obesity (all p < 0.05). There were significant interactions between PA and diet. Compared with meeting no guidelines, those who met multiple guidelines had a lower risk of overweight/obesity (all p < 0.01). The more guidelines the participants met, the lower odds of overweight/obesity (p for trend <0.001).ConclusionsPA, SB, sleep, and diet are important behaviors associated with adiposity among children and adolescents. Attaining adequate amounts of appropriate multiple behaviors provided an additional benefit. It is important for children to meet recommended behavioral guidelines or recommendations. Interventions that aim to improve awareness of and compliance with these guidelines are needed in future.     

miRNA-21 plays an important role in necrotizing enterocolitis

IntroductionTo investigate the role and mechanism of miRNA-21 in necrotizing enterocolitis (NEC).Material and methodsCollecting 30 pairs of newborn and NEC children and measuring the miRNA-21 expression in the serum of 30 pairs. Thirty neonatal Wistar rats were randomized to 3 groups: NC, Model and miRNA groups. The rats of model and miRNA groups were based on NEC model groups, after the fabricated NEC model of neonatal rats. The Model group was treated with normal saline and the miRNA group was injected with miRNA-21 from the abdomen. On the 4^th day, all the rats were executed. The intestinal tissue located at the boundary of the ileum and cecum was sampled for histology and cell apoptosis. The relative protein (PTEN, PI3K, AKT and GSK-3β) expression levels of difference groups were evaluated by WB assay.ResultsIn the clinical data, the miRNA-21 gene expression of NEC children was significantly up-regulation compared with that of normal newborns (p < 0.05). In the rat experiments, compared with the NC group, the pathology and cell apoptosis of the Model group showed significant deterioration (p < 0.05) and relative protein (PTEN, p-PI3K, p-AKT and p-GSK-3β) expression levels were significantly different (p < 0.05, respectively). However, the pathology and cell apoptosis of colonic tissue were significantly improved (p < 0.05), the PTEN and p-GSK-3β protein expression levels were significantly suppressed (p < 0.05) and p-PI3K and p-AKT protein expression levels were significantly increased (p < 0.05, respectively) with miRNA-21 over-expression compared with the Model group.ConclusionsmiRNA might be a biological marker and therapeutic target in NEC diagnosis and treatment.     

Development of a BMI-Assigned Stunkard Scale for the Evaluation of Body Image Perception Based on Data of the SOS Reference Study

IntroductionStunkard''s figure rating scale is a widely used tool to assess weight status and, more recently, body image perception in people with obesity. However, large population-based studies on Europeans linking this scale''s silhouettes with measured BMI values are lacking. Therefore, we used measured weight and height data from the Swedish Obese Subjects (SOS) reference cohort to assign a mean BMI to each of the 9 Stunkard Scale silhouettes and to define silhouette cutoff values for categorizing people with obesity and overweight.MethodsA total of 1,128 participants from the SOS reference cohort were included (54% females, BMI = 25.2 [ranging from 17.6 to 45.4] ±3.8 kg/m², and age = 50 [ranging from 36 to 62] ±7 years [means ± standard deviation]). Patients estimated their own body size by choosing a silhouette of the Stunkard Scale. A mean BMI, based on measured weight and height, was assigned to each male and female silhouette of the Stunkard Scale. Measured BMI values were compared with BMI values calculated by simple linear regression analysis. ROC analysis was used to test accuracy of discrimination and the Youden index to assess optimal cutoff.ResultsFigure ratings and BMI were strongly correlated in men, r (518) = 0.76, p < 0.001 and women, r (606) = 0.80, p < 0.001. Silhouette selection significantly predicted BMI values in men, β = 16.03, t (518) = 25.30, p < 0.001, and women, β = 12.06, t (606) = 32.98, p < 0.001, and explained a significant proportion of variance in BMI values in men, R² = 0.55, F (1, 518) = 639.98, p < 0.001, and women, R² = 0.64, F (1, 606) = 1,087.88, p < 0.001. ROC curve analyses resulted in an optimal cutoff value of 6 for identifying people with obesity and 5 for overweight.ConclusionStunkard''s figure rating scale can be used with confidence to assess weight status. Silhouette selection accurately classifies subjects as overweight or obese.     

Changes in the activity of connective tissue matrix enzymes in the metabolic syndrome

Introduction

Early atherosclerotic changes in the endothelium associated with metabolic syndrome are generated with the participation of inflammatory cells, cytokines and enzymes of the extracellular matrix. The study is aimed at a comparison between the activity of inflammatory agents, tumour necrosis factor α (TNF-α) and the enzymes of the connective tissue matrix in the blood of healthy female patients as well as those suffering from the metabolic syndrome.

Material and methods

The examination included 35 women with metabolic syndrome (MS). The control group (C) comprised 35 healthy women. Lipidogram, C-reactive protein level (CRP), fasting glucose level (FGL), matrix metalloproteinase (MMP)-8 and -9 activity, tissue inhibitor of metalloproteinase-1 (TIMP-1) and TNF-α levels in blood were determined.

Results

As compared with the control group, the level of inflammatory factors and the activity of extracellular matrix enzymes in the metabolic syndrome were statistically higher (p < 0.05) and concerned the following parameters: TNF-α (pg/ml): MS 6.59 ±3.18, C 4.78 ±2.91; CRP (mg/dl): MS 2.18 ±2.04, C 1,26 ±1.35; TIMP-1 (ng/ml): MS 265.5 ±2.9, C 205.4 ±72.6; MMP-9 (ng/ml): MS 198.2 ±138.6, C 138.6 ±116.1. Statistically significant correlations were also found between TIMP-1 and the following factors: BMI (R = 0.400, p < 0.001), waist/hip ratio (WHR) (R = 0.278, p < 0.05), waistline (R = 0.417, p < 0.001), FGL (R = 0.290, p < 0.05), HDL cholesterol (R = –0.253, p < 0.05) and triglycerides (R = 0.269, p < 0.05).There were positive correlations of MMP-9 with FGL (R = 0.446, p < 0.001) and waistline (R = 0.260, p < 0.05); MMP-8 with FGL (R = 0.308, p < 0.05); and CRP with BMI (R = 0.370, p < 0.01), WHR (R = 0.325, p < 0.01) and waistline (R = 0.368, p < 0.01).

Conclusions

Metabolic syndrome is connected with higher activity of cytokines (TNF-α), inflammatory markers (CRP) and matrix enzymes (MMP-9, MMP-8, TIMP-1).     

Evaluation of TGF-β1, CCL5/RANTES and sFas/Apo-1 urine concentration in children with ureteropelvic junction obstruction

Introduction

The aim of this study was to evaluate changes in expression of soluble biomarkers tumor factor growth-β1 (TGF-β1), CCL5/RANTES, and sFas/Apo-1 in the urine of patients undergoing ureteropyeloplasty for ureteropelvic junction (UPJ) obstruction. These factors are connected with different processes ongoing in the obstructive uropathy. If their urine concentrations correlate with AP diameter of the renal pelvis and differential function of the affected kidney, they can be helpful in making a decision on corrective surgery.

Material and methods

Creatinine, TGF-β1, CCL5/RANTES, and sFas/Apo-1 levels were measured in the urine from the bladder and renal pelvis of 45 patients undergoing ureteropyeloplasty and from bladders of 25 patients undergoing inguinal herniorrhaphy.

Results

Levels of examined biomarkers were higher in the renal pelvis and bladder of children with UPJ obstruction as compared to controls: TGF-β1 in older children and adolescents (p < 0.05), CCL5/RANTES in the youngest and older children (p < 0.05), and sFas/Apo-1 in all patients (p < 0.05). Twelve months after surgery their levels in the bladder decreased: TGF-β1 in younger and older children (p < 0.05), CCL5/RANTES in the youngest patients and adolescents (p < 0.05), and sFas/Apo-1 in the youngest and older children (p < 0.05). A significant decrease in the AP diameter of the renal pelvis post-operatively (32.09 mm vs. 18.72 mm) (p < 0.01) and significant improvement in renal function (36.94% vs. 42.76%) (p < 0.05) were observed in the examined group.

Conclusions

Mean TGF-β1, CCL5/RANTES, and sFas/Apo-1 urine levels are significantly increased in patients with UPJ and decreased 1 year after ureteropyeloplasty. Bladder concentrations of examined factors may be clinically useful markers of obstruction.     

Modulatory Potential of LncRNA Zfas1 for Inflammation and Neuronal Apoptosis in Temporal Lobe Epilepsy

PurposeThis study aimed to elucidate whether lncRNA ZFAS1 is involved in neuronal apoptosis and inflammation in temporal lobe epilepsy (TLE).Materials and MethodsNinety-six TLE patients were recruited, and their peripheral venous blood was gathered to determine Zfas1 expression with polymerase chain reaction. Neurons were separated from hippocampal tissue of newborn SD rats, and si-Zfas1 or pcDNA3.1-Zfas1 was transfected into the neurons. Inflammatory cytokines released by neurons were determined, and neuronal activities were evaluated through MTT assay, colony formation assay, and flow cytometry.ResultsSerum levels of Zfas1 were higher in TLE patients than in healthy controls (p<0.05). Furthermore, Zfas1 expression in neurons was raised by pcDNA3.1-Zfas1 and declined after silencing of Zfas1 (p<0.05). Transfection of pcDNA-Zfas1 weakened the viability and proliferation of neurons and increased neuronal apoptosis (p<0.05). Meanwhile, pcDNA3.1-Zfas1 transfection promoted lipopolysaccharide-induced release of cytokines, including tumor necrosis factor-α, interleukin (IL)-1, IL-6, and intercellular adhesion molecule-1 (p<0.05), and boosted NF-κB activation by elevating the expression of NF-κB p65, pIκBα, and IKKβ in neurons (p<0.05).ConclusionOur results indicated that lncRNA ZFAS1 exacerbates epilepsy development by promoting neuronal apoptosis and inflammation, implying ZFAS1 as a promising treatment target for epilepsy.     

Variations in Serum Transforming Growth Factor-β1 Levels with Gender,Age and Lifestyle Factors of Healthy Japanese Adults

Elevated serum or plasma Transforming Growth Factor-β1 (TGF-β1) levels have been linked to cancer and other diseases in numerous studies; however, very few studies have reported an association between circulating TGF-β1 and lifestyle factors in healthy people. We examined the association between serum TGF-β1 levels and gender, age, body mass index (BMI), smoking, and drinking in a large population-based cohort study (N = 9,142). Serum TGF-β1 levels were detected by the Quantikine enzyme-linked immunoassay kit (R&D Systems). The data indicated highly significant (p<0.0001) difference in serum TGF-β1 levels between men (mean value: 37.6 ± 0.12 ng/mL, N = 4888) and women (mean value: 35.1 ± 0.12 ng/ml, N = 4254). Serum TGF-β1 levels decreased with age (trend p < 0.0001) and were positively associated with obesity (trend p < 0.0001) in both men and women. We observed a significant trend with increased serum TGF-β1 levels corresponding to increased amount of tobacco and alcohol consumption in men (trend p < 0.0001). These findings suggest that serum TGF-β1 levels appear to be modulated by gender, age and lifestyle factors such as obesity, cigarette smoking, and alcohol drinking in healthy Japanese adults.     

Hepatic Steatosis Is Associated with Elevated Serum Iron in Patients with Obesity and Improves after Laparoscopic Sleeve Gastrectomy

BackgroundIron is closely related to metabolism. However, the relationship between iron and hepatic steatosis has not been fully elucidated.ObjectiveWe aimed to investigate the triangular relationship between iron and hepatic steatosis and laparoscopic sleeve gastrectomy (LSG) in patients with obesity.MethodsA total of 297 patients with obesity and 43 healthy individuals with a normal BMI were enrolled. Eighty-two patients underwent LSG. Anthropometrics, glucose-lipid metabolic markers, and hepatic steatosis assessed by FibroScan (CAP value and E value) were measured at baseline, and again at follow-up time intervals of 6 months and 1 year after surgery.Results(1) Iron was significantly higher in patients with obesity or overweight than in the individuals with normal BMI (8.18 ± 1.47 vs. 7.46 ± 0.99 mmol/L, p = 0.002). Iron was also higher in subjects with high blood pressure, dyslipidemia, and hyperuricemia than non-corresponding disorders (all p < 0.05). Moreover, iron was significantly higher in the severe than mild or moderate non-alcoholic fatty liver disease (NAFLD) group (p = 0.046 and 0.018). (2) Iron was positively associated with body weight, BMI, waist-to-hip ratio, uric acid, liver enzymes, postprandial blood glucose, fasting insulin, HOMA-IR, triglycerides, free fatty acid, and hepatic steatosis (CAP value), and negatively associated with high-density lipoprotein cholesterol (all p < 0.05). Iron was also positively associated with the visceral adipose area in patients with obesity and negatively associated with the subcutaneous adipose area in patients with overweight (all p < 0.05). (3) Iron levels and CAP values were decreased gradually 6 months and 1 year after surgery (all p < 0.05).ConclusionsOverall, our results indicated that iron is associated with hepatic steatosis in obesity. The iron level was significantly higher in patients with severe NAFLD than with mild or moderate NAFLD. LSG may reduce iron levels while improving fat deposition in the liver.     

The influence of aerobic fitness status on ventilatory efficiency in patients with coronary artery disease

OBJECTIVE:

To test the hypotheses that 1) coronary artery disease patients with lower aerobic fitness exhibit a lower ventilatory efficiency and 2) coronary artery disease patients with lower initial aerobic fitness exhibit greater improvements in ventilatory efficiency with aerobic exercise training.

METHOD:

A total of 123 patients (61.0±0.7 years) with coronary artery disease were divided according to aerobic fitness status into 3 groups: group 1 (n = 34, peak VO₂<17.5 ml/kg/min), group 2 (n = 67, peak VO₂>17.5 and <24.5 ml/kg/min) and group 3 (n = 22, peak VO₂>24.5 ml/kg/min). All patients performed a cardiorespiratory exercise test on a treadmill. Ventilatory efficiency was determined by the lowest VE/VCO₂ ratio observed. The exercise training program comprised moderate-intensity aerobic exercise performed 3 times per week for 3 months. Clinicaltrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT02106533","term_id":"NCT02106533"}}NCT02106533

RESULTS:

Before intervention, group 1 exhibited both lower peak VO₂ and lower ventilatory efficiency compared with the other 2 groups (p<0.05). After the exercise training program, group 1 exhibited greater improvements in aerobic fitness and ventilatory efficiency compared with the 2 other groups (group 1: ▵ = -2.5±0.5 units; group 2: ▵ = -0.8±0.3 units; and group 3: ▵ = -1.4±0.6 units, respectively; p<0.05).

CONCLUSIONS:

Coronary artery disease patients with lower aerobic fitness status exhibited lower ventilatory efficiency during a graded exercise test. In addition, after 3 months of aerobic exercise training, only the patients with initially lower levels of aerobic fitness exhibited greater improvements in ventilatory efficiency.     

Serum concentrations of adiponectin,leptin, resistin,ghrelin and insulin and their association with obesity indices in obese normo- and hypertensive patients – pilot study

Introduction

Hypertension often coexists with obesity. Adipokines, ghrelin and insulin play important roles in the pathogenesis of both diseases. The aim of this study was to compare adiponectin, leptin, resistin, insulin and ghrelin mean serum concentrations and insulin resistance (HOMA-IR) in normo- and hypertensive patients with obesity.

Material and methods

All included patients were divided on the following groups: non-diabetic hypertensive patients with class I obesity (group A, n = 21) and class II/III obesity (group B, n = 10), and normotensive obese (class I)patients (group C, n = 7). Correlations between obesity indices (body mass index [BMI], waist-to-hip ratio [WHR], waist circumference [WC]), HOMA-IR, and hormone and adipokine serum levels were also analyzed.

Results

Leptin level and HOMA-IR were significantly higher in group B compared to group C (9.74 ±3.88 ng/ml vs. 4.53 ±3.00 ng/ml; p < 0.02 and 3.30 ±1.59 vs. 1.65 ±0.41; p < 0.02, respectively). A negative correlation between WC and adiponectin level (R = –0.6275; p < 0.01) and a positive correlation between WC and insulin concentration (R = 0.5122; p< 0.05) as well as with HOMA-IR (R = 0.5228; p < 0.02) were found in group A. Negative correlations between BMI and ghrelin level (R = –0.7052; p < 0.05), WHR and adiponectin level (R = –0.6912; p < 0.05) and WHR and leptin level (R = –0.6728; p < 0.05) were observed in group B.

Conclusions

Insulin resistance and leptin may be important pathogenic factors in hypertensive patients with severe obesity. Indices of abdominal obesity (WC, WHR) correlate better than BMI with HOMA-IR, insulin, adiponectin and leptin serum levels in hypertensive obese patients.     

Bone Response to High-Intensity Interval Training versus Moderate-Intensity Continuous Training in Adolescents with Obesity

IntroductionSince adolescents with obesity are prone to bone fragility during weight loss, the aim was to compare the impact of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on bone density, geometry, and strength.MethodsSixty-one adolescents were randomly assigned to 2 cycling trainings (HIIT and MICT) and a control (CTR, without training) group. Anthropometry, dual-energy X-ray absorptiometry with hip structural analysis and the trabecular bone score (TBS) were assessed before and after the 16-week intervention.ResultsBody mass index (BMI) and fat mass (FM) percentage decreased at T1 versus T0 in both training groups (p < 0.001 for HIIT, p = 0.01 for MICT), though to a larger extent in HIIT (p < 0.05). Total body bone mineral density (BMD) and bone mineral content (BMC) increased in both training groups (p < 0.001), but to a greater extent in HIIT for BMC (p < 0.05). Lumbar spine BMD and BMC increased in both training groups (p < 0.001 for HIIT, p < 0.01 for MICT), with a time × group interaction between HIIT and CTR (p < 0.05) only. TBS increased in both training groups (p < 0.01 for HIIT, p < 0.05 for MICT). Hip BMD and BMC increased in both HIIT (p < 0.001 and p < 0.01) and MICT (p < 0.01 and p < 0.05). At the narrow neck (NN), endocortical diameter, width (p < 0.01), cross-sectional moment of inertia, and section modulus (Z) (p < 0.05) increased only in the HIIT group, such as BMD and Z (p < 0.05) at the intertrochanteric region (IT) and average cortical thickness (p < 0.001) and width (p < 0.05) at the femoral shaft. At the NN and IT, the buckling ratio decreased only in the HIIT group (p < 0.05), predicting higher resistance to fracture.ConclusionsIn addition to inducing greater BMI and FM percentage decreases in comparison to MICT, HIIT improves multisite bone density, geometry, and strength, which heighten the justification for HIIT as part of weight loss interventions in adolescents with obesity.     

Influence of central obesity in estimating maximal oxygen uptake

OBJECTIVE:To assess the influence of central obesity on the magnitude of the error of estimate of maximal oxygen uptake in maximal cycling exercise testing.METHOD:A total of 1,715 adults (68% men) between 18-91 years of age underwent cardiopulmonary exercise testing using a progressive protocol to volitional fatigue. Subjects were stratified by central obesity into three quartile ranges: Q1, Q2-3 and Q4. Maximal oxygen uptake [mL.(kg.min)^-1] was estimated by the attained maximal workload and body weight using gender- and population-specific equations. The error of estimate [mL.(kg.min)^-1] and percent error between measured and estimated maximal oxygen uptake values were compared among obesity quartile ranges.RESULTS:The error of estimate and percent error differed (mean ± SD) for men (Q1=1.3±3.7 and 2.0±10.4; Q2-3=0.5±3.1 and -0.5±13.0; and Q4=-0.3±2.8 and -4.5±15.8 (p<0.05)) and for women (Q1=1.6±3.3 and 3.6±10.2; Q2-3=0.4±2.7 and -0.4±11.8; and Q4=-0.9±2.3 and -10.0±22.7 (p<0.05)).CONCLUSION:Central obesity directly influences the magnitude of the error of estimate of maximal oxygen uptake and should be considered when direct expired gas analysis is unavailable.     

Factors Influencing Hearing Aid Satisfaction in South Korea

PurposeThe purpose of this study is three-fold: 1) to evaluate factors influencing hearing aid (HA) satisfaction; 2) to provide a profile of HA satisfaction in daily life; and 3) to examine the reasons why people gave up using HAs.Materials and MethodsData for 1148 respondents were statistically analyzed and reported.ResultsIn the study, age (β=-0.03, p<0.01), level of education (β=1.21, p<0.01), HA purchase price (β=1.50, p<0.01), bilateral amplification (β=1.23, p<0.01), wearing time (β=0.28, p<0.01), and HA fitting and fine tuning on a regular basis (β=1.71, p<0.01) significantly influenced HA satisfaction. In addition, the authors observed that the most satisfactory factors were clarity of sound (53.5%), people’s trust in their HA (61.7%), and listening from a quiet environment (72.8%) in the domains of sound quality, HA features, and listening environments, respectively. Finally, with multiple choices being possible, 65% of the 40 respondents who no longer used HAs answered that their HAs ended up in a drawer since the background noise was annoying and distracting.ConclusionThis study is significant in that it is a large-scale multi-center research to comprehensively examine the factors influencing HA satisfaction in South Korea. This data will provide helpful information that could lead to the successful rehabilitation of hearing loss with HAs.