Physical capacity, body composition and immune-inflammatory markers are associated with risk of cardiovascular disease in sedentary people living with HIV.

BACKGROUND: People living with HIV (PLHIV) are experiencing a high level of non-HIV-related disease mainly related to cardiovascular system however the factors associated with this scenario are widely discussed and indefinite so far. The purpose was to investigate the association of physical capacities, body composition, and immune-inflammatory markers with the Framingham risk score (FRS) in PLHIV. METHODS: Volunteers were recruited and data on age, the time of HIV infection diagnosis and the time of HAART use were collected. The volunteers performed upper limb strength (ULS), lower limb strength (LLS) and cardiorespiratory fitness (VO2peak) tests, body composition evaluation, and blood collection to immune-inflammatory marker markers and the FRS was calculated. Partial age- and sex-adjusted correlation was used to verify associations between factors and multiple linear regression analysis was performed to identify an independent association of FRS and the variables. RESULTS: 113 PLHIV met the eligible criteria and were observed a negative correlation between CD4+ (r=-0.615), time of HIV infection diagnosis (r=-0.237), time of HAART use (r=-0.239), ULS (r=-0.274), LLS (r=-0.213), and VO2peak (r=-0.207) with FRS. There was a positive correlation between fibrinogen and FRS (r=0.363; P<0.001). The TCD4+ count cells were significantly associated with FRS (P=0.001). CONCLUSIONS: Environmental and biological HIV-related factors are inversely associated with FRS while immune-inflammation markers have a positive association.

Effects of Two Different Exercise Training Programs Periodization on Anthropometric and Functional Parameters in People Living with HIV: A Randomized Clinical Trial.

The purpose of this study was to investigate the effects of two different exercise training programs periodization on anthropometric and functional parameters in people living with HIV (PLHIV). This was a randomized clinical trial that involved participants (n = 31) living with HIV aged over 18 years and undergoing antiretroviral therapy which were randomized to periodized exercise training (PET; n = 13), non-periodized exercise training (NPET; n = 13), or control group (CON; n = 15). The PET and NPET groups performed 12 weeks of combined training while the CON group maintained the usual activities. Before and after 12 weeks of intervention were measured body composition and perimeters, muscle strength, Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) test time. Results: The PET and NPET groups increased fat-free mass (p < 0,001), right (p < 0,001) and left thigh perimeter (p < 0,001), muscle strength (p < 0,001), handgrip force (p < 0,001), and reduced the fat mass (p < 0,001), neck perimeter (p < 0,001), chair stand (p < 0,001), and time-up and go test time (p < 0,001) compared to CON. Furthermore, PET was significantly different to increase right thigh and muscle strength (p < 0,05) compared to NPET. Conclusion: Both exercise training periodization protocols were effective to improve body composition and functional outcomes; however, seems that PET presents better results compare to NPET in PLHIV.

Effects of resistance training on muscle strength, body composition and immune-inflammatory markers in people living with HIV: a systematic review and Meta-analysis of randomized controlled trials.

Purpose: The purpose of this review is to evaluate the effect of resistance training (RT) as a unique intervention on muscle strength, body composition, and immune-inflammatory markers in people living with HIV (PLHIV).Methods: The searches were conducted in seven databases and included published randomized clinical trials that assessed the effect of RT vs. no exercise on muscle strength, body composition, and immune-inflammatory markers in PLHIV until June 2021. Random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CI) were performed, and the effect size was estimated by Hedges' g test.Results: Seven RCTs were included (n= 258 PLHIV) and the study duration lasted between six and 24 weeks. In comparison to no exercise, RT improved muscle strength in bench press (MD 10.69 kg, 95%IC 3.44 to 17.93, p= 0.004, g =2.42) and squat (MD 22.66 kg, 95%IC 7.82 to 37.50, p= 0.003, g = 3.8) exercises, lean body mass (MD 2.96 kg, 95%CI 0.98 to 4.94, p= 0.003, g = 1.99), fat body mass(MD -2.67 kg; 95%CI -4.95 to -0.39, p= 0.02, g=-0.99), body fat percentage (MD -3.66%, 95%CI -6.04 to -1.29, p= 0.003, g=-1.99) and CD4+ cells count(MD 100.15 cells/mm3, 95%CI 12.21 to 188.08, p = 0.03, g = 2.91) in PLHIV. There was no effect of RT on IL-6 (MD -1.18 pg/mL, 95%CI -3.71 to 1.35, p = 0.36, g = 0.001) and TNF-α (MD -4.76 pg/mL, 95%CI -10.81 to 1.29, p = 0.12, g=-1.3) concentrations in PLHIV. Conclusions: RT as a unique intervention improves muscle strength, body composition and CD4+ count cells in PLHIV.

Effects of exercise training and statin on hemodynamic, biochemical, inflammatory and immune profile of people living with HIV: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: The aim of this study is to evaluate the effect of exercise training (ET) and statins on the hemodynamic, biochemical, inflammatory and immune profile of people living with HIV (PLHIV). METHODS: This was a randomized, double-blind, placebo-controlled clinical trial in which 83 PLHIV were assigned to either placebo (PL), statins (STA), placebo + ET (PLET), or statins + ET (STAET) groups. Volunteers assigned to STA and STAET groups were administered 10 mg of rosuvastatin, whereas the PL and PLET groups were administered a placebo. The PLET and STAET groups performed ET three times a week. Before and after the 12-week follow-up, volunteers underwent blood collection to assess the biochemical, inflammatory, and immune profile. RESULTS: There were significant time x group interaction effects (P<0.05) for all variables except for diastolic blood pressure. The PLET and STAET groups had significantly (P<0.05) decreased systolic blood pressure, resting heart rate, fasting glucose, glycated hemoglobin, fasting insulin, homeostatic model assessment for insulin resistance, creatine kinase, lactate, and TNF-α levels, and increased adiponectin, CD4+, and CD8+ levels. There was also a significant group effect (P<0.05) for CK levels among the exercised (PLET and STAET) and STA groups. The latter had a significant increase in fasting glucose (P<0.05) and creatine kinase (P<0.05). CONCLUSIONS: ET improved the hemodynamic, biochemical, inflammatory, and immune profile of PLHIV and this effect was not dependent on the use of statins.

Skinfold reference curves and their use in predicting metabolic syndrome risk in children / Curvas de referência de dobras cutâneas e sua utilização na predição do risco de síndrome metabólica em crianças

Abstract Objectives: To draw skinfold (SF) reference curves (subscapular, suprailiac, biceps, triceps) and to determine SF cutoff points for predicting the risk of metabolic syndrome (MetS) in children aged 6-10 years old. Methods: This was a cross-sectional study with a random sample of 1480 children aged 6-10 years old, 52.2% females, from public and private schools located in the urban and rural areas of the municipality of Uberaba (MG). Anthropometry, blood pressure, and fasting blood samples were taken at school, following specific protocols. The LMS method was used to draw the reference curves and ROC curve analysis to determine the accuracy and cutoff points for the evaluated skinfolds. Results: The four SF evaluated (subscapular, suprailiac, biceps, and triceps) and their sum (∑4SF) were accurate in predicting MetS for both girls and boys. Additionally, cutoffs have been proposed and percentile curves (p5, p10, p25, p50, p75, p90, and p95) were outlined for the four SF and ∑4SF, for both genders. Conclusion: SF measurements were accurate in predicting metabolic syndrome in children aged 6-10 years old. Age- and gender-specific smoothed percentiles curves of SF provide a reference for the detection of risk for MetS in children.

Resumo Objetivos: Desenhar curvas de referência de quatro dobras cutâneas (subescapular, suprailíaca, bíceps, tríceps) e determinar pontos de corte para predizer o risco de SM em crianças de seis a 10 anos. Métodos: Estudo epidemiológico de base populacional, corte transversal, com amostra probabilística, estratificada por segmento de ensino, com 1.480 crianças de seis a 10 anos idade, 52,2% do sexo feminino, oriundas de escolas públicas e privadas nas zonas urbana e rural do município de Uberaba (MG). Antropometria (dobras cutâneas), pressão arterial e as coletas de sangue em jejum foram feitas em espaço reservado na escola, seguiram protocolos específicos. O método LMS foi usado para desenhar as curvas de referência e análise de curva ROC para determinar a acurácia e os pontos de corte para as dobras cutâneas avaliadas. Resultados: As quatro DC avaliadas (subescapular, suprailíaca, bíceps e tríceps) e o seu somatório (∑4DC) foram acurados na predição da SM para meninas e meninos. Adicionalmente, pontos de corte foram propostos e curvas percentílicas (p5, p10, p25, p50, p75, p90 e p95) foram delineadas para as quatro DC e o ∑4DC, para ambos os sexos. Conclusão: Medidas de DC foram acuradas em predizer SM em escolares de seis a 10 anos. As curvas percentílicas de DC desenhadas por idade e sexo fornecem referência na detecção do risco de SM em crianças.

Time Spent Sitting Is Associated with Changes in Biomarkers of Frailty in Hospitalized Older Adults: A Cross Sectional Study.

Background: Sedentary behavior has gained prominence in the literature as a risk factor for health and mortality independent of physical activity level; however, little is known about the relationship of sedentary behavior with frailty in older adults. The aim of this study was to investigate if time spent sitting can be used as a discriminator of frailty in older hospitalized persons. Methods: The study included 162 hospitalized inpatients aged ≥60 years. Blood samples were taken for analyzing leukocyte counts and serum concentrations of C-reactive protein (CRP). Participants also answered a questionnaire about time spent sitting. Frailty was determined from a combination of CRP concentration and leukocyte count. Receiver operating characteristic (ROC) curves were constructed to analyse the predictive power and cut-points for time spent sitting and the presence of frailty. Results: The areas under the ROC curves indicated that time spent sitting was an independent indicator of frailty (area under curve >0.6). The cut-off points for time spent sitting as an indicator of frailty were >257 min/day for men and >330 min/day for women. Conclusions: Time spent sitting is associated with biomarkers of frailty in persons aged ≥60 years, indicating a need for interventions aimed at reducing sedentary behavior in this age group.

Skinfold reference curves and their use in predicting metabolic syndrome risk in children.

OBJECTIVES: To draw skinfold (SF) reference curves (subscapular, suprailiac, biceps, triceps) and to determine SF cutoff points for predicting the risk of metabolic syndrome (MetS) in children aged 6-10 years old. METHODS: This was a cross-sectional study with a random sample of 1480 children aged 6-10 years old, 52.2% females, from public and private schools located in the urban and rural areas of the municipality of Uberaba (MG). Anthropometry, blood pressure, and fasting blood samples were taken at school, following specific protocols. The LMS method was used to draw the reference curves and ROC curve analysis to determine the accuracy and cutoff points for the evaluated skinfolds. RESULTS: The four SF evaluated (subscapular, suprailiac, biceps, and triceps) and their sum (∑4SF) were accurate in predicting MetS for both girls and boys. Additionally, cutoffs have been proposed and percentile curves (p5, p10, p25, p50, p75, p90, and p95) were outlined for the four SF and ∑4SF, for both genders. CONCLUSION: SF measurements were accurate in predicting metabolic syndrome in children aged 6-10 years old. Age- and gender-specific smoothed percentiles curves of SF provide a reference for the detection of risk for MetS in children.

Atividade física no lazer como critério discriminante do menor nível de estresse percebido em adolescentes / Leisure-time physical activity as discriminant criterion of low level perceived stress in adolescents

O objetivo do presente estudo foi identificar os pontos de corte do tempo de realização de atividades físicas no lazer (AFL) de diferentes intensidades como critério discriminante do menor nível de estresse percebido (MEP) em adolescentes. Trata-se de um estudo transversal com amostra composta por adolescentes de 14 a 18 anos, de ambos os sexos, do ensino médio regular. Dados da atividade física e do MEP foram obtidos por meio de autorrelato, utilizando-se o questionário COMPAC. O MEP (respostas: "raramente" + "às vezes") foi considerado variável de classificação, enquanto minutos em AFL de intensidade moderada (AFLM), vigorosa (AFLV) e moderada a vigorosa (AFLMV) as variáveis de teste. Na análise dos dados foi usada a curva ROC, complementadas por valores de sensibilidade (SE) e especificidade (ES), adotando-se área sob a curva (AUC) > 0,50 e fixando-se p < 0,05. A amostra final deste estudo foi de 984 adolescentes (idade: homens = 15,93 ± 1,10 anos; moças = 15,87 ± 1,04 anos) com maior participação de moças (55,3%). O tempo de realização de AFLM ≥ 40 min/sem (AUC = 0,59; SE = 41,7%; ES = 75,7%; p < 0,002) e AFLMV ≥ 80 min/sem (AUC = 0,58; SE = 83,2%; ES = 36,2%; p < 0,04) para os rapazes apresentou poder discriminante para MEP. Neste estudo transversal, os minutos de realização de AFLM e AFLMV foram discriminantes do MEP para os rapazes. As AUC, para ambas as intensidades de AFL, foram baixas e com desequilíbrio entre valores de SE e ES. É sugerido que outros delineamentos de pesquisa sejam empregados a fim de estabelecer a relação causa e efeito entre a prática de AFL de diferentes intensidades e os níveis de estresse em adolescentes...(AU)

The aim of this study was to identify the cutoffs of the leisure-time physical activity (LPA), at different intensities, as discriminant criterion of lowest level of perceived stress (LLPS) in adolescents (14-18 years). This is a population-based, cross-sectional study, including regular high school students. PA and LLPS data was self-reported through questionnaire COMPAC. The classification variable was the LLPS (rarely + sometimes). The test variables were the minutes of LPAL of moderate intensity (LPAM) and vigorous (LPAV) and moderate to vigorous (LPAMV). The cutoffs were analyzed by ROC curves, complemented by sensitivity (SE) and specificity (ES) values, adopting area under the curve (AUC > 0.50; p < 0.05). The final sample of 984 adolescents (boys = 15.93 ± 1.10 years; girls = 15.87 ± 1.04 years) with a higher proportion of girls (55.3%). The time spent in LPAM ≥ 40 min/week (SE = 41.7%, ES = 75.7% AUC = 0.59; p < 0.002) and LPAMV ≥ 80 min/week (SE = 83.2%; ES = 36.2%; AUC = 0.58; p < 0.04) for the boys presented discriminant power to LLPS. In this cross-sectional study, LPAM and LPAMV minutes showed discriminatory power for LLPS in male. However, the AUCs for both LPA intensities were low and with imbalance between SE and ES values. Other research designs should be used to establish the cause-effect relationship between PAL and stress levels in adolescents...(AU)

The quantification of game-induced muscle fatigue in amputee soccer players.

BACKGROUND: This study quantified the degree of game-induced muscular fatigue in amputee soccer players. METHODS: Thirty-three male amputee soccer players performed muscular tests (Push Up Test [PUT], Countermovement Jump Test [CMJ] and medicine-ball throw [MBT]) before and after a competitive match. Five players served as a control group. The rating of perceived exertion was recorded after each battery. RESULTS: Control group demonstrated no differences between the two testing batteries (P>0.05, effect size [ES]: 0.1-0.4). However, match group illustrated markedly lower performances for PUT (-17%, P<0.01, ES: 0.9) with less pronounced declines in MBT (-8%, P<0.01, ES: 0.7) and CMJ (-5%, P<0.01, ES: 0.3) compared to pre-match values. The rating of perceived exertion were higher after the match compared to baseline values (+60%, P<0.01, ES: 2.4). CONCLUSIONS: The data demonstrate that the fatigue experienced after amputee soccer matches causes impairments in muscular performance and this could be different to able-bodied players.

Does nonlinear resistance training reduce metabolic syndrome in people living with HIV? A randomized clinical trial.

BACKGROUND: The aim of this study was to evaluate the effectiveness of a 12-week nonlinear resistance training (NLRT) program on metabolic syndrome (MetS) components in people living with human immunodeficiency virus (PLHIV) and diagnosed with MetS. METHODS: Subjects were randomly assigned to either a NLRT (N.=10) or control (CON; N.=11) group. The NLRT group exercised three times per week during the 12 week supervised training program. The CON group was asked to maintain their daily habits. At baseline (pre) and after the intervention (post), both groups completed anthropometric, blood pressure, and biochemical assessments. A 2x2 repeated measures ANOVA (significance level of 5%) was performed to calculate the effects of intervention duration (time), group, and the interaction between the two. RESULTS: There was a significant time*group interaction for lean body mass (LBM) (+5.5%, P<0.0001), body fat mass (BFM) (-10.1%, P<0.0001), body fat percentage (BF%) (-11.4%, P<0.0001), waist circumference (WC) (-1%, P=0.001), high-density lipoprotein (HDL) (+31%, P<0.0001) levels, fasting glucose (FG) (-13.7%, P=0.012), and glycated hemoglobin (HBA1C) (-9%, P<0.0001). After the intervention, the NLRT group included fewer participants with abnormal levels of triglycerides (TG), HDL, systolic blood pressure (SBP), diastolic blood pressure (DBP), and FG while the CON group had more participants with abnormal levels of TG, SBP, and DBP. CONCLUSIONS: Twelve weeks of NLRT was effective in ameliorating some components of MetS in PLHIV.

Perfil antropométrico e características físicas da equipe brasileira de futebol para amputados / Perfil antropométrico y características físicas del equipo brasileño de fútbol para amputados / Anthropometric profile and physical performance characteristic of the Brazilian amputee football (soccer) team

Amputee football is a variation of conventional soccer in which athletes with lower limb amputation and one athelete with upper limb amputation (the goalkeeper) participate. The objective of this study was to investigate the anthropometric and physical characteristics of amputee football athletes and to verify differences between heart rate peak (HRpeak) and equations for predicting maximum heart rate (HRmax). Twelve amputee soccer players from the Brazilian team participated in this study. The body mass, height and body composition were measured. The physical tests used were: the 20 m running test, the T-square test and the Yo Yo intermitent recovery test - level 1 (YYIRT1). The percentage of fat was significantly different between midfielders and defenders. No significant differences were found between positions in the physical tests. The HRpeak was significantly lower than all of HRmax prediction equations tested. We conclude that the indicators of physical performance did not differ significantly between the different tactics roles of players, and that, after intermittent maximum effort, the cardiac response was lower when compared with the investigated HRmax prediction equations.

O futebol de amputados é uma variação do futebol convencional, onde participam atletas amputados de membros inferiores e membros superiores (goleiro). O objetivo do estudo foi investigar as características físicas e antropométricas de atletas de futebol para amputados e verificar se existem diferenças entre a frequência cardíaca de pico (FCpico) e equações de predição da frequência cardíaca máxima (FCmax). Doze jogadores de futebol para amputados da seleção brasileira participaram do estudo. Foi mensurada a massa corporal, estatura e composição corporal. Os testes físicos utilizados foram: corrida de 20 m, teste do quadrado e o Yo Yo intermitent recovery test - level 1 (YYIRT1). O percentual de gordura foi significativamente diferente entre os meio-campistas e defensores. Não foram encontradas diferenças significativas entre as posições nos testes físicos. A FCpico foi significativamente menor do que todas as equações de predição da FCmax testadas. Conclui-se que os indicadores de desempenho físico não diferenciaram significativamente entre as diferentes funções táticas dos jogadores, e que a resposta cardíaca após esforço máximo intermitente é menor quando comparada com as equações de predição da FCmax investigadas.

El fútbol de amputados es una variante del fútbol convencional, en el cual participan atletas amputados de miembros inferiores y miembros superiores (portero). El objetivo del estudio fue investigar las características físicas y antropométricas de atletas de fútbol para amputados y verificar si hay diferencias entre frecuencia cardíaca pico (FCpico) y ecuaciones de predicción de frecuencia cardíaca máxima (FCmax). Doce jugadores de fútbol para amputados del equipo oficial brasileño participaron del estudio. Fue mensurada la masa corporal, estatura y composición corporal. Los testes físicos utilizados fueron: carrera de 20 m, test del cuadrado y Yo Yo intermitent recovery test - level 1 (YYIRT1). El porcentual de grasa fue significativamente diferente entre los mediocampistas y defensores. No fueron identificadas diferencias significativas entre las posiciones en los testes físicos. FCpico fue significativamente menor que todas las ecuaciones de predicción de FCmax evaluadas. Concluí-se que los indicadores de desempeño físico no diferenciaron significativamente entre las diferentes funciones tácticas de los jugadores y que la respuesta cardíaca tras el esfuerzo máximo intermitente es menor si comparadas con las ecuaciones de predicción de FCmax investigados.