Abstract Introduction: From the previously published literature on the relationship between obesity and infertility, it is clear that male obesity negatively impacts semen quality. Accordingly, this study was conducted to determine whether regular exercise may improve semen quality in sedentary obese adults. Material and methods: Ninety obese adults were randomly allocated to the intervention (n = 45) or control group (n = 45). Participants in the intervention group performed a 16-week aerobic training program in a treadmill, three sessions per week, consisting of a warm-up (10-15 minutes), 35-50 minutes treadmill exercise (increasing five minutes per four weeks) at a work intensity of 50-65% of peak heart rate (increasing a 5% per four weeks) and cooling-down (5-10 minutes). Semen quality assessment included semen volume, sperm concentration and the percentages of progressive motility and normal morphology. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone and estradiol were determined by ELISA. Body composition and physical fitness were also assessed. Results: After the completion of the training program, sperm count, motility and normal morphology were significantly increased. A second key finding was that exercise improved reproductive hormone levels by increasing serum testosterone. Lastly, significant correlations were found between seminal outcomes and abdominal obesity. Conclusion: A short-term intervention program based on aerobic training improved semen quality in sedentary obese adults. This finding may be explained, at least in part, by an improvement of the reproductive hormone profile.

Resumen Introducción: cada vez existe un mayor nivel de evidencia sobre el impacto negativo de la obesidad en la calidad seminal. Sin embargo, la utilidad del ejercicio en este grupo de pacientes ha recibido escasa atención. El presente estudio pretende determinar la influencia de un programa de entrenamiento aeróbico en la calidad seminal de adultos obesos. Material y métodos: noventa adultos varones se asignaron aleatoriamente al grupo experimental (n = 45) o control (n = 45). El grupo experimental desarrolló un programa de entrenamiento aeróbico en tapiz rodante de 16 semanas con tres sesiones/semana. Cada sesión se estructuró en calentamiento (10-15 minutos), 35-50 minutos en tapiz rodante (incrementando cinco minutos/cuatro semanas) a una intensidad del 50-65% de su frecuencia cardiaca máxima (incrementando 5%/cuatro semanas) y vuelta a la calma (5-10 minutos). La calidad seminal se evaluó mediante determinación de volumen seminal, concentración espermática, así como porcentajes de motilidad y morfología normal según criterios de la Organización Mundial de la Salud (OMS). Los niveles séricos de las hormonas folículo estimulante (FSH), luteinizante (LH) y testosterona se determinaron mediante ELISA. También se evaluó la composición corporal y condición física de los participantes. Resultados: tras finalizar el entrenamiento, la concentración, la motilidad y la normal morfología se incrementaron significativamente. Asimismo, se observó una mejoría de los niveles de testosterona. Finalmente, se observaron correlaciones estadísticamente significativas entre parámetros seminales y marcadores de masa grasa abdominal. Conclusión: el ejercicio aeróbico mejoró la calidad seminal de adultos obesos sedentarios. Estos resultados podrían explicarse, al menos en parte, por la mejora del perfil hormonal de los participantes.

Introduction: It is widely accepted that obesity is associated with endothelial dysfunction. In a recent paper, we have also found circuit resistance training may reduce visceral fat in obese aged women. Accordingly, the current study was conducted to ascertain the effects of circuit resistance training on markers of endothelial dysfunction in this population group. Methods: In the present interventional study, a total of 48 obese aged women were recruited from the community. Twenty-four of them were randomly assigned to perform a 12-week resistance circuit training programme, 3-days per week. This training was circularly performed in 6 stations: arm curl, leg extension, seated row, leg curl, triceps extension and leg press. The Jamar handgrip electronic dynamometer was used to assess maximal handgrip strength of the dominant hand. Lastly, serum samples were analysed using an immunoassay (ELISA) for endothelin-1, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1). Results: When compared to baseline, resistance training significantly reduced serum levels of endothelin-1 (2.28 ± 0.7 vs. 1.98 ± 1.1 pg/ml; p = 0.019; d = 0.67) and ICAM-1 (290 ± 69 vs. 255 ± 76 ng/ml; p = 0.004; d = 0.92) in the experimental group. No significant changes in any of the tested outcomes were found in the control group. Conclusion: A short-term circuit resistance program improved endothelial dysfunction in aged obese women. Further studies on this topic are still required to consolidate this approach in clinical application.

Introducción: recientes estudios han confirmado que el entrenamiento de fuerza en circuito podría reducir la masa grasa visceral en mujeres mayores obesas. Para seguir avanzando en esta línea de trabajo, nos propusimos determinar su impacto en marcadores de disfunción endotelial. Material y método: participaron voluntariamente 48 mujeres (70-75 años) con obesidad procedentes de la comunidad. De ellas, 24 fueron asignadas aleatoriamente al grupo experimental para desarrollar un programa de entrenamiento de fuerza en circuito de 6 estaciones durante 12 semanas con 3 sesiones/semana. Los marcadores de disfunción endotelial ensayados fueron: endotelina-1, molécula de adhesión intercelular-1 (ICAM-1) y molécula de citoadhesión vascular-1 (VCAM-1). Asimismo se evaluó su influencia en un test funcional para población mayor como el de sentarse-levantarse en 30 segundos. Este protocolo fue aprobado por un comité de ética institucional. Resultados: tras completar el programa de intervención se observó un descenso significativo de los niveles plasmáticos de entotelina-1 (2,28 ± 0,7 vs. 1,98 ± 1,1 pg/ml; p = 0,019; d = 0,67) e ICAM-1 (290 ± 69 vs. 255 ± 76 ng/ml; p = 0,004; d = 0,92). También mejoró significativamente la puntuación del test funcional (18,7 ± 3,1 vs. 23,0 ± 3,6 repeticiones; p = 0,019; d = 0,98). Por el contrario, no se observaron cambios en el grupo control. Conclusión: el entrenamiento de fuerza en circuito mejora la disfunción endotelial presente en mujeres mayores obesas. Futuros estudios siguen siendo necesarios para consolidar su aplicación en clínica.

Introduction: this study was conducted to ascertain the effects of resistance circuit training on epicardial adipose tissue (EAT) in obese aged women. A secondary objective was to assess muscle damage induced by supervised resistance training to confirm the intervention program was effective and safe. Methods: in the present interventional study, a total of 48 obese aged women were recruited from the community. Twenty-four of them were randomly assigned to perform a 12-week resistance circuit training programme, 3-days per week. This training was circularly performed in 6 stations: arm curl, leg extension, seated row, leg curl, triceps extension and leg press. The Jamar handgrip electronic dynamometer was used to assess maximal handgrip strength of the dominant hand. Two experienced observers assessed EAT by transthoracic two-dimensional echocardiography. Lastly, serum samples were analysed using one-step sandwich assays for creatine kinase activity (CK) and myoglobin (MB) concentration. Results: as was hypothesized, resistance training significantly reduced EAT thickness (8.4 ± 1.0 vs. 7.3 ± 1.3 mm; p = 0.014; d = 0.76) in the experimental group. Resistance training induced no significant changes in markers of muscle damage such as CK (181.6 ± 36.9 vs. 194.2 ± 37.8 U/l; p = 0.31) and MB (62.4 ± 7.1 vs. 67.3 ± 7.7 ng/ml; p = 0.26). No significant changes in any of the tested outcomes were found in the control group. Conclusion: resistance training reduced EAT in aged obese women. A secondary finding was that the training program was effective and safe. While current results are promising, future studies are still required to consolidate this approach in clinical application.

Introducción: en la actualidad se acepta la asociación entre masa grasa epicárdica y patología cardiovascular. Recientes estudios sugieren que el ejercicio aeróbico podría reducir la masa grasa epicárdica. La originalidad de este trabajo reside en determinar la utilidad para tal fin de un programa de entrenamiento de fuerza en mujeres adultas mayores obesas. Como segundo objetivo nos propusimos que el programa fuese seguro para las participantes. Material y método: participaron voluntariamente 48 mujeres (70-75 años) con obesidad procedentes de la comunidad. De ellas, 24 fueron asignadas aleatoriamente al grupo experimental para desarrollar un programa de entrenamiento de fuerza en circuito de seis estaciones durante doce semanas con tres sesiones/semana. La masa grasa epicárdica se determinó mediante ecografía transtorácica bidimensional por personal entrenado. También se evaluaron los niveles plasmáticos de creatina cinasa y mioglobina. Este protocolo fue aprobado por un comité de ética institucional. Resultados: el grosor de la masa grasa epicárdica se redujo significativamente tras completar el programa de intervención (8,4 ± 1,0 vs. 7,3 ± 1,3 mm; p = 0,014; d = 0,76). Además, las participantes no mostraron cambios en marcadores de daño muscular como creatin kinasa (181,6 ± 36,9 vs. 194,2 ± 37,8 U/l; p = 0,31) y mioglobina (62,4 ± 7,1 vs. 67,3 ± 7,7 ng/ml; p = 0,26). Conclusión: el entrenamiento de fuerza en circuito reduce la masa grasa epicárdica de forma segura en mujeres mayores obesas. Aunque estos resultados son prometedores, aún son necesarios futuros estudios para consolidar su aplicación en clínica.

Introduction: Nutrition has emerged as a fundamental tool included in the training program of athletes. Body composition seeks different objectives depending on type of sport, position, or time of the season. Furthermore, analysis proteomics allows us to know the structure and function of proteins. Aims: To study, using proteomics, the influence of two different diets on the anthropometric profile in a rugby players group. Methods: It is a prospective and interventionist study. Thirty-two rugby players were included. Two groups were defined, one followed proteic diet (PD) and, the other group subscribed the Mediterranean diet (MD). All participants were evaluated anthropometrically at the beginning and after six months. A blood sample was taken to twenty -two players, half of each group, used for the proteomic analysis. Results: MD highlight more benefit for these athletes. Two groups were defined based on their anthropometric behavior, G1 and G2. The proteomic analysis related significantly some TGF-β family mediators with these groups. CONCLUSIONS: MD improves the muscular mass without increasing the total body weight, so this data could be determinant to define profiles for athletes. Some TGF-β members could be implicated in the adipose tissue and muscular mass balance.

Introducción: La nutrición se ha erigido como una herramienta fundamental incluida en el programa de entrenamiento de los deportistas. La composición corporal persigue diferentes objetivos según el deporte, la posición o momento de la temporada. Por otro lado, la proteómica permite analizar la estructura y función de las proteínas. Objetivos: Estudiar, utilizando la proteómica, la influencia de dos dietas diferentes sobre el perfil antropométrico en un grupo de jugadores de rugby. Metodos: Es un estudio prospectivo y de intervención. Treinta y dos jugadores de rugby fueron incluidos en el estudio. Se definieron dos grupos arbitrariamente, unos siguieron la dieta proteica (DP) y otros la dieta mediterránea (DM). A todos se les realizó una valoración antropométrica al inicio y tras seis meses de seguimiento. A 22 de estos pacientes, la mitad de cada grupo, se les tomo una muestra de sangre que se utilizó para el análisis proteómico. Resultados: La DM se destaca más beneficiosa para estos deportistas. Se definieron dos grupos en función de su comportamiento antropométrico, G1 and G2. En el análisis proteómico estos se relacionaron significativamente con varios mediadores de la familia TGF-β. CONCLUSIONES: La DM promociona el incremento de masa muscular sin incremento del peso total, ello podría ser determinante a la hora de definir los perfiles de los deportistas. Miembros de la familia TGF-β podrían estar implicados en el balance de tejido adiposo y masa muscular.

Abdominal obesity, metabolic syndrome (MS) and oxidative stress may impair seminal quality leading to derangements in fertility. Aim: To identify an association between abdominal obesity and markers of seminal oxidative damage in adults with MS. Material and Methods: Seventy males aged 25 to 40 years, with MS according to ATP-III criteria volunteered for this cross-sectional study. The control group included 70 healthy and normal weight adults. Semen analysis included volume, sperm concentration, motility and normal morphologic features. Body mass index (BMI) and waist circumference (WC) were measured, fat mass was determined by bioelectrical impedance. Results: Sperm concentration and the percentage of sperms with normal motility and morphology were significantly lower in adults with MS, when compared to their healthy normal weight counterparts. Seminal levels of malondialdehyde and 8-hydroxy-2’-deoxyguanosine were significantly higher among participants with MS. Significant correlations were found between WC and seminal markers of oxidative stress. Conclusions: Individuals with MS had an impaired seminal quality that may be explained, at least in part, by increased seminal oxidative damage.

Purpose To determine the influence of arm-crank exercise in reproductive hormone levels in adults with chronic SCI. Further objectives were to assess the influence of arm-crank exercise on muscle strength and body composition. Materials and Methods Seventeen male adults with complete SCI at or below the 5th thoracic level (T5) volunteered for this study. Participants were randomly allocated to the intervention (n = 9) or control group (n = 8) using a concealed method. The participants in the intervention group performed a 12-week arm-crank exercise program, 3 sessions/week, consisting of warming-up (10-15 min) followed by a main part in arm-crank (20-30 min [increasing 2 min and 30 seconds each three weeks]) at a moderate work intensity of 50-65% of heart rate reserve (HRR) (starting at 50% and increasing 5% each three weeks) and by a cooling-down period (5-10 min). Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone and estradiol were determined by ELISA. Muscle strength (handgrip) and body composition (waist circumference [WC]) were assessed. Results After the completion of the training program, testosterone level was significantly increased (p = 0.0166;d = 1.14). Furthermore, maximal handgrip and WC were significantly improved. Lastly, a significant inverse correlation was found between WC and testosterone (r =- 0.35; p = 0.0377). Conclusion The arm-crank exercise improved reproductive hormone profile by increasing testosterone levels in adults with chronic SCI. A secondary finding was that it also significantly improved muscle strength and body composition in this group.

Introduction: Previous studies have found a significant correlation between parents and offspring regarding overweight and obesity in general population at early life stages. However this issue has received no attention in people with intellectual disability (ID). Therefore, the present study was designed to find out potential correlations in overweight/obesity between young adult women with ID living in the family and their parents. Material and methods: In the present observational cross-sectional study, a total of thirty-four women with Down syndrome (n = 34; 22.6 ± 2.1 years; 29.6 ± 3.3 km/m²) were recruited through different community support groups for people with intellectual disabilities. Furthermore, biological mothers (n = 34; 59.6 ± 4.9 years; 28.5 ± 3.2 km/m²) and fathers (n = 34; 61.5 ± 5.3 years; 26.2 ± 2.7 km/m²) volunteered for this study. They all underwent an anthropometric assessment to determine body mass index (BMI). This protocol was approved by an Institutional Ethics Committee. Results: In the studied population, a total of 26 (76.5%) women with ID were overweight/obese. Furthermore, there were 22 (66.6%) overweight/obese mothers and 16(53.3%) fathers. Results also showed significant correlations between participants BMI and their father (r = 0.327; p = 0.0116) and mother BMI (r = 0.412; p < 0.001). Lastly, overweight/obese women presented a stronger correlation with overweight/obese mothers (odds ratio 4.3; 95%CI 2.9-7.3) than fathers (odds ratio 3.1; 95%CI 1.6-4.4). Conclusion: Parental overweight/obesity, especially maternal one, was strongly associated to overweight/obesity in young adult women with DS. Accordingly, there is an urgent necessity of incorporating parents in the intervention programs designed to the prevention and treatment of overweight and obesity in people with ID.

Fundamento y objetivo: Recientes estudios han encontrado en la población general una correlación entre la incidencia de sobrepeso/obesidad de padres e hijos, especialmente a edades tempranas. Sin embargo, este asunto no ha recibido atención en el caso de hijos adultos con discapacidad intelectual no institucionalizados. El presente estudio pretende determinar una posible correlación entre el sobrepeso/obesidad de padres respecto a sus hijas adultas con discapacidad intelectual que viven en el domicilio. Material y método: Se diseñó un estudio de tipo transversal observacional en el que participaron 34 mujeres adultas con síndrome de Down (22,6 ± 2,1 años; 29,6 ± 3,3 km/m²). Asimismo 34 madres (59,6 ± 4,9 años; 28,5 ± 3,2 km/m2) y 34 padres (61,5 ± 5,3 años; 26,2 ± 2,7 km/m²) biológicos participaron voluntariamente. Todos los participante se sometieron a un estudio cinenatropométrico en el que se obtuvo el índice de masa corporal (IMC). Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: El 76,5% de las mujeres con discapacidad intelectual estudiadas presentaba sobrepeso/obesidad. En cuanto a los progenitores, el 66,6% de las madres y el 53.3 de los padres también presentó sobrepeso/obesidad. El IMC de las participantes se correlacionó significativamente con el de sus madres (r = 0,412; p < 0,001) y padres (r = 0,327; p = 0,0116). Por último, las participantes con sobrepeso/obesidad presentaron una fuerte correlación con sus progenitores con sobrepeso/obesidad, especialmente las madres (odds ratio 4,3; 95%CI 2,9-7,3) y en menor medida sus padres (odds ratio 3,1;95%CI 1,6-4,4). Conclusión: La masa grasa de los padres, especialmente la materna, podría recomendarse como predictor de sobrepeso/obesidad de hijas adultas con discapacidad intelectual no institucionalizadas.

Introduction: The various diagnostic classifications in the literature concur as regards the important role of abdominal obesity in the onset and progression of metabolic syndrome. Accordingly, this study was aimed at clarifying whether central obesity measurements assessed by dual X-ray absorptiometry (DXA) may predict metabolic syndrome in Spanish postmenopausal women. Material and methods: This historical cohort study included a total of 1326 postmenopausal women aged > 45 years old who had routinely undergone DXA to measure their bone mineral density between january 2006 and january 2011. The regions of interest (ROI) envisaged in our study by using DXA were the lumbar regions L1-L4 and L4-L5. At the same time, they underwent a complete medical examination including personal medical history assessment, biochemical blood analysis, blood pressure measurement and anthropometrical evaluation. Metabolic syndrome was diagnosed attending to the criteria established by National Cholesterol Education Program Adult Treatment Panel III (NECP-ATP-III). Results: During the observation period, 537 women, representing 40.5% of the total studied, met the diagnostic criteria for metabolic syndrome. L1-L4 and L4-L5 abdominal fat mass determinations were associated with the development of metabolic syndrome in all regression models tested, showing an increasing gradient from the lowest to highest quintile. Conclusion: Central adiposity measurements assessed by DXA, especially L1-L4 region of interest, could be considered a powerful predictor of metabolic syndrome in postmenopausal women.

Introducción: En la actualidad se acepta la importancia de la masa grasa abdominal en la fisiopatología del síndrome metabólico tal y como reconocen las diferentes clasificaciones diagnósticas disponibles. Nuestro objetivo fue analizar la utilidad como predictores de síndrome metabólico de marcadores de grasa abdominal obtenidos por DEXA en mujeres postmenopausicas aprovechando su participación en screening rutinarios para el estudio de la densidad mineral ósea. Material y método: El presente estudio de cohortes histórico incluyó a un total de 1.326 mujeres post-menopausicas con edad > 45 años que se habían sometido rutinariamente a DEXA para conocer su densidad mineral ósea entre enero de 2006 y enero de 2011. Además del DEXA, se obtuvo de cada participante la correspondiente anamnesis, bioquímica, tensión arterial e índices de distribución de masa grasa mediante técnicas antropométricas convencionales. Se utilizó la clasificación NCEP-ATP-III para el diagnóstico de síndrome metabólico. Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: Durante el periodo de observación, 537 mujeres, el 40,5% del total de las estudiadas, cumplió los criterios diagnósticos de síndrome metabólico. Los parámetros de masa grasa abdominal obtenidos mediante DEXA fueron significativamente mayores en mujeres postmenopáusicas con síndrome metabólico. Finalmente, la masa grasa abdominal de regiones de interés L1-L4 y L3-L4 obtenidas por DEXA se relacionaron con el desarrollo de síndrome metabólico en los modelos de regresión ensayados. Conclusión: La masa grasa abdominal determinada por DEXA, especialmente la región L1-L4, podría recomendarse como predictor de síndrome metabólico en este grupo.

Introduction: It is accepted low grade systemic inflammation plays a key role in metabolic syndrome. Further, several studies have reported it may be considered a therapeutic target. Accordingly, this study was conducted to ascertain the impact of a short-term aerobic training program on acute phase proteins in women with metabolic syndrome. Material and methods: A total of 135 adult women (38.4 ± 3.3 years) with metabolic syndrome volunteered for this study. Participants assigned to the intervention group underwent a 12-week aerobic training program, 3 sessions/week. The main part of each exercise sessions was performed in a treadmill at moderate intensity (60-75% HRmax; increasing 5% each 3 weeks) for 25-40 minutes (increasing 5 minutes each 3 weeks). Physical fitness was determined by a continuous maximal incremental test. Further, fat mass percentage and indices of obesity were assessed. Plasmatic levels of C reactive protein (CRP-us) and fibrinogen were determined by nephelometry and HPLC respectively. This protocol was approved by an Institutional Ethics Committee. Results: Aerobic training improved physical fitness and reduced both fat mass percentage and indices of obesity. Compared with baseline, it also reduced significantly plasmatic levels of CRP-us (4.90 ± 0.7 vs. 3.77 ± 0.4 mg/l; p = 0.017) and fibrinogen (3.88 ± 0.4 vs. 3.36 ± 0.2 g/l; p = 0.025). Further, a moderate correlation was found between CRP-us and waist circumference (r = 0.66; p = 0.008). No significant changes were found in controls. Conclusion: A short-term, aerobic training program reduced acute phase proteins in young women with metabolic syndrome. Further, long-term, well-conducted studies are still required to determine whether correction of this low-grade inflammation improves clinical outcomes of women with metabolic syndrome.

Fundamento y objetivo: Actualmente se acepta la importancia del estatus proinflamatorio en la fisiopatología del síndrome metabólico. De hecho, ha sido propuesto como diana terapéutica en el manejo clínico de estos pacientes. Por consiguiente este estudio pretende reducir los niveles plasmáticos de reactantes de fase aguda en mujeres con síndrome metabólico mediante un corto programa de entrenamiento. Material y método: Un total de 135 mujeres jóvenes adultas (38,4 ± 3,3 años) con diagnóstico de síndrome metabólico participaron voluntariamente en este estudio. El grupo de intervención se sometió a un programa de entrenamiento aeróbico de 12 semanas, con 3 sesiones/ semana en el que duración e intensidad de la parte principal se incrementaron progresivamente. Los niveles plasmáticos de proteína C-reactiva (PCR) y fibrinógeno se determinaron mediante nefelometría y HPLC respectivamente. También se evaluaron el fitness cardiovascular mediante prueba de esfuerzo máxima e índices de distribución de masa grasa. Este protocolo fue aprobado por un Comité de Ética Institucional. Resultados: Tras completar el programa, se observo una mejora significativa del fitness cardiovascular además de una reducción también significativa de los niveles de fibrinógeno y PCR. Asimismo, se encontraron correlaciones entre niveles de reactantes e índices de distribución de masa grasa, siendo la de mayor fuerza de asociación la establecida entre PCR y perímetro cintura. Conclusión: Un programa de 12 semanas consiguió reducir los niveles de reactantes de fase aguda en mujeres con síndrome metabólico. Futuros estudios longitudinales son necesarios para conocer el impacto del efecto anti-inflamatorio del ejercicio en el manejo de estos pacientes a medio/largo plazo.

Recent studies have reported obesity prevalence in people with intellectual disability is even higher than in the general population what may finally lead to impair their health status and increase healthcare costs. Fortunately several studies have reported regular exercise may improve body composition in obese people with and without intellectual disability. To the best of our knowledge this is the first study conducted exclusively in female participants with intellectual disability, in an attempt to keep our sample homogeneous. To date, many studies focused on the influence of regular exercise in people with intellectual disability have recruited mixed (males and females) groups in order to increase their sample size to strengthen research designs. Therefore, we assessed the influence of a 10-week aerobic training program on fat mass percentage and indices of obesity in women with Down syndrome. To get this goal, twenty obese young women with Down syndrome volunteered for this study. Eleven were randomly assigned to perform a 10-week aerobic training program, 3 sessions/week, consisting of warming-up followed by a main part in a treadmill (30-40 min) at a work intensity of 55-65% of peak heart rate and a cooling-down period. Control group included 9 age, sex and BMI matched women with Down syndrome. Fat mass percentage and fat distribution were measured. This protocol was approved by an Institutional Ethics Committee. When compared to baseline, fat mass percentage, waist circumference and waist to hip ratio were significantly reduced after training. Conversely, no changes were reported in controls. It was concluded a 10-week training program reduced fat mass in obese adult women with Down syndrome.

En la actualidad se acepta que la obesidad es un grave problema de salud pública. La situación es aún más preocupante entre las personas con discapacidad intelectual, especialmente entre las mujeres. Afortunadamente recientes estudios sugieren la utilidad del ejercicio como estrategia frente a la obesidad. Sin embargo, la mayoría de estos estudios utilizan grupos mixtos (hombres y mujeres) o varones, siendo escasa la información sobre un grupo homogéneo de mujeres. Por consiguiente nos planteamos como hipótesis que un programa de entrenamiento de 10 semanas podría reducir el porcentaje de masa grasa y la distribución abdominal en mujeres obesas con síndrome de Down. En nuestro estudio participaron 20 mujeres adultas (18-30 años) con un cociente intelectual de 50-69 según la escala Stanford-Binet y diagnóstico citogenético de trisomía 21. Todas presentaban obesidad definida como IMC>30 kg/m2. Once de las participantes se asignaron aleatoriamente al grupo experimental y desarrollaron un programa de entrenamiento de 10 semanas de tipo aeróbico con 3 sesiones/semana. El porcentaje de masa grasa se determinó mediante impedanciometría bioeléctrica (Tanita TBF521). Para obtener el índice cintura/cadera se midieron las circunferencias de la cintura y la cadera utilizando una cinta antropométrica. Nuestro protocolo fue aprobado por un Comité de Ética Institucional. Nuestros resultados confirman que el ejercicio aeróbico redujo significativamente el porcentaje de masa grasa, el índice cintura/cadera y el perímetro de la cintura (p<0,05). Por el contrario no se observaron cambios en el grupo control. Concluimos que un programa de entrenamiento de 10 semanas consiguió mejorar la composición corporal de mujeres obesas con síndrome de Down. Futuros estudios longitudinales bien conducidos y controlados son necesarios para conocer el impacto de esta mejora en el manejo clínico de este grupo.

El síndrome metabólico (SM) será la pandemia del siglo XXI. En Europa y en las Américas la prevalencia de obesidad alcanza a 17% de la población que padece SM, duplicándose el riesgo de ASCVD (enfermedad aterosclérotica cerebrovascular). Se debe priorizar la reversión de la obesidad y de la inactividad física. El SM se presenta como una secuencia de alteraciones metabólicas e inflamatorias a nivel molecular, celular o hemodinámico, compartiendo la resistencia a la insulina y la adiposidad de predominio abdominal. La asociación SM y nuevos factores de riesgo independientes como la homocisteína plasmática (HC) y la proteína C reactiva (PCR), son considerados como predictores de riesgo cardiometabólico. Entre los componentes del SM de mayor relevancia actualmente debe considerarse el estrés oxidativo y la influencia del ejercicio físico. La obesidad central o abdominal es un importante elemento diagnóstico del SM, estrechamente relacionada con enfermedades cardiovasculares, no existiendo una clara y directa relación con cardiopatías isquémicas, siendo la edad un factor ligado a la relación entre SM y cardiopatías, llegando a 86% en mujeres de edad avanzada. El valor del riesgo cardiovascular es variable y depende de los factores de riesgo específico. Nuestro objetivo es mostrar los beneficios que nos puede proporcionar el ejercicio físico frente al SM y, como consecuencia, reducir el riesgo de alteraciones vasculares, especialmente cardíacas. Los apartados utilizados en esta revisión son los relacionados con componentes fundamentales como obesidad abdominal, alteración del metabolismo glucídico, dislipidemia e hipertensión, además de aquellos implicados como factores de riesgo de enfermedades cardiovasculares como inflamación sistémica y estado protrombótico.

Resumo A síndrome metabólica (SM) será a pandemia do século XXI. Na Europa e nas Américas, a prevalência de obesidade alcança 17% da população que com SM, duplica o risco de ASCVD (doença aterosclerótica cardiovascular). Deve-se priorizar a reversão da obesidade e da falta de atividade física. A SM se apresenta como uma sequência de alterações metabólicas e inflamatórias a nível molecular, celular ou hemodinâmico tendo como elemento comum a resistência à insulina e a adiposidade predominantemente abdominal. A associação SM e novos fatores de risco independentes, como a homocisteína plasmática (HC) e a proteína C reativa (PCR), são considerados como preditores de risco cardiometabólico. Entre os componentes da SM de maior relevância, atualmente se deve considerar o estresse oxidativo e a influência do exercício físico. A obesidade central ou abdominal é um elemento importante no diagnóstico da SM, fortemente relacionada com doenças cardiovasculares, não existindo uma relação clara e direta com cardiopatias isquêmicas, sendo a idade um fator ligado à relação entre SM e cardiopatias, alcançando 86% em mulheres de idade avançada. O valor do risco cardiovascular é variável e depende dos fatores de risco específico. Nosso objetivo é mostrar os benefícios que o exercício físico pode proporcionar com relação a SM e, como consequência, reduzir o risco de alterações vasculares, especialmente cardíacas. Os artigos utilizados nesta revisão são os relacionados com componentes fundamentais como obesidade abdominal, alteração do metabolismo glicosídico, dislipidemia e hipertensão, além daqueles implicados como fatores de risco de doenças cardiovasculares como inflamação sistêmica e estado pro trombótico.

Abstract The metabolic syndrome (MS) will be the 21st Century syndrome. In Europe and the Americas, prevalence of obesity accounts for 17% of the population suffering from metabolic syndrome, doubling the risk for atherosclerotic cardiovascular disease (ASCVD). The metabolic syndrome will be the 21st Century pandemia. We need to prioritize reversing obesity and the lack of exercise The metabolic syndrome is characterized by a series of hemodynamic, molecular or cellular metabolic and inflammatory alterations. It also includes insulin resistance and localized adiposity in the abdominal area. The association of the MS and new, independent risk factors such as plasma homocysteine and C-reactive protein are considered risk predictors of cardiometabolic risk factors. Among the most relevant components of MS today, we need to consider oxidative stress and the impact of exercise. Central or abdominal obesity is an important diagnostic element for MS, closely related to cardiovascular diseases, there being no clear and direct relation with ischemic heart disease. Also, age is associated to the relation between MS and heart disease, accounting for 86% of women of old age. The rate of cardiovascular risk is variable and it depends on specific risk factors. We aim to show the positive impact of exercise on the MS and as a consequence, how it reduces the risk of vascular alterations, in particular heart alterations. This review examined the main components of abdominal obesity, alterations the glucidic metabolism, dyslipidemia and high blood pressure, apart from those that have to do with heart disease risk factors, such as systemic inflammatory response syndrome and prothombotic state.

A 12-week training protocol increased antioxidant defense system in young adult women with metabolic syndrome. It is generally accepted that oxidative stress is implicated in the pathogenesis of metabolic syndrome. Furthermore, recent studies have reported that stress may be acting as a therapeutic target in metabolic syndrome. Consequently, this study was designed to explore whether aerobic training may increase plasmatic total antioxidant status in women with metabolic syndrome. A total of 100 young adult women with metabolic syndrome according to the criteria reported by the National Cholesterol Education Program (Adult-Treatment-Panel-III) volunteered for this study. Of them, 60 were randomly included in the experimental group to enter a 12-week aerobic training program, 5 days/week, at low/moderate intensity. The control group included 40 age, sex and body mass index (BMI)-matched women with metabolic syndrome who did not enter any training program. Total antioxidant status (TAS) was assayed in plasma using colorimetric Randox kits. This protocol was approved by an Institutional Ethics Committee. When compared to baseline, plasmatic TAS was significantly increased (0.79 ± 0.05 Vs 1.01 ± 0.03 mmol/l; p = 0.027). No changes were found in controls. A 12-week aerobic training program increased plasmatic TAS in adult women with metabolic syndrome. Further long-term well-conducted studies are required in order to highlight the potential clinical benefits of TAS improvement.

En la actualidad se acepta que el daño oxidativo juega un papel esencial en la patogénesis del síndrome metabólico. Estudios recientes proponen al daño oxidativo como diana terapéutica frente al síndrome metabólico. Precisamente nuestro objetivo fue mejorar el estatus total antioxidante (TAS) de mujeres con síndrome metabólico mediante ejercicio aeróbico. Participaron voluntariamente 100 mujeres con síndrome metabólico de acuerdo con los criterios del National Cholesterol Educational Program (Adult-Treatment-Panel-III) distribuidas aleatoriamente en grupo experimental (n = 60) y control (n = 40). El grupo experimental desarrolló un programa de entrenamiento aeróbico sobre tapiz rodante de intensidad ligera/moderada de 12 semanas (5 sesiones/semana). La determinación del TAS plasmático se realizó mediante espectrofotometría utilizando kits comercializados por Randox Lab. Este protocolo fue aprobado por un Comité de Etica Institucional. Tras completar el programa de entrenamiento se incrementó significativamente el TAS (0.79 ± 0.05 vs.1.01 ± 0.03 mmol/l; p = 0.027). No hubo cambios en grupo control. El ejercicio aeróbico de intensidad ligera/moderada aumenta las defensas antioxidantes en mujeres con síndrome metabólico. Son necesarios futuros estudios longitudinales para conocer su impacto en la evolución clínica.