Prediction equations for spirometry in healthy children from Djibouti.

OBJECTIVE: To determine normal spirometric values in Djiboutian children and to compare these data with values reported by African studies and by the 2012 Global Lung Function Initiative. METHODS: Spirometric data from healthy Djiboutian children were collected and reference equations derived using the least mean squared method, which includes modelling skewness (λ, L), mean (µ, M) and coefficient of variation (σ, S) according to sex, age and height. In addition, the age-dependent lower limits of normal were calculated. RESULTS: Spirometric values in Djiboutian children were lower than those obtained for other Black children; these differences were relatively small and clinically irrelevant, representing differences of approximately 3% predicted. However, significant differences were observed between our equations and those for Tunisian children. CONCLUSION: The results of the present study could help to improve the clinical diagnosis of respiratory diseases in Djiboutian children.

[Does hyperandrogenic statute in the polycystic ovary syndrome constitute an obstacle to the success of in vitro fertilization?] / Le statut hyperandrogénique, dans le syndrome des ovaires polykystiques, est t-il une entrave à la réussite de la fécondation in vitro ?

OBJECTIVES: The aim of this study was to evaluate the impact of initial androgenic statute of women with polycystic ovary syndrome (SOPK) on the expected results of in vitro fertilization (FIV). MATERIALS AND METHODS: It is about an exploratory study carried out in 61 unfertile SOPK patients, having profited all from a cycle of FIV/ICSI (intracytoplasmic sperm injection). We have divided our population in two groups according to their hormonal androgenic statute: groups with hyperandrogenism and without hyperandrogenism. We proceeded to note the anthropometric and hormonal parameters as well as results of FIV for each of the two groups. RESULTS: SOPK patients with hyperandrogenism are more obese than their counterparts. Also, they have more oocytes collected after ovarian induction. In addition, we did not reveal any significant differences between our two study groups concerning parameters defining FIV response. CONCLUSION: Our findings suggest that hyperandrogenism statute in SOPK infertile women does not seem to compromise the results of FIV. On the contrary, it would make it possible to optimize the chances to puncture more significant number of oocytes.

Multifactorial monitoring of training load in elite rugby sevens players: cortisol/cortisone ratio as a valid tool of training load monitoring.

The effectiveness of selected physiological and perceptual measures for monitoring training load and fatigue was studied in 16 male elite rugby sevens players during a 6-week intense training block (IT) and 2-week tapering (TAP). Daily training load (TL) and strain (TS) as well as weekly total score of fatigue (TSF) were quantified respectively by the session-rating of perceived exertion (RPE) method and an 8-item questionnaire. Also, testing was performed and 24 h urinary cortisol (C), cortisone (Cn), adrenaline (A) and noradrenalin (NA) excretion was measured before (T0) and after the IT (T1) and after the TAP (T2). The TL, TS and TSF increased during the IT and decreased during the TAP, in conjunction with a significant drop and improvement, respectively, of performance standards during the two periods. At T1, C and Cn levels increased while A and NA levels decreased, resulting in a higher C/Cn ratio and lower A/NA ratio, respectively. At T2, both C/Cn and A/NA returned to baseline values. The changes in C/Cn ratio, after the 6-week IT, were more closely related to mean TL, TS and TSF (r=0.75-0.76 vs. r=0.48-0.58, p<0.01) and to changes in the majority of performance measures than to A/NA ratio. Only the changes in C/Cn ratio after the 2-week TAP were related to mean TL, TS and TSF (r=0.61-0.68, p<0.01). The changes in hormone levels, training strain and performance standards reflected the physical and mental stressors of training, with complete recovery, as indicated by physiological homeostasis, achieved after an appropriate tapering period.

Effects of recreational soccer on physical fitness and health indices in sedentary healthy and unhealthy subjects.

Recreational soccer (RS) is becoming a popular alternative to the classical continuous exercise mode used for the improvement of cardiovascular and metabolic fitness in untrained people. The objective of this paper was to conduct a detailed systematic review of the literature, identifying the physiological responses to RS and the training effects of RS on aerobic fitness and health in untrained healthy individuals and clinical patients. PubMed, Google Scholar and ScienceDirect databases were searched using terms related to recreational soccer. Inclusion criteria were randomized controlled trials (RCT) that assessed acute physiological responses to RS or the training effects of RS on physical fitness and health in sedentary, untrained subjects of any age or health status. All studies were assessed for methodological quality using the PEDro scale. Thirty-five articles met the inclusion criteria; seven examined the acute response to RS, and 28 assessed training effects. Clear evidence was found that RS had positive effects on many health-related indices and variables, including VO2max (gains of 7-16%), blood pressure (reductions of 6-13 mmHg), body composition (decreased fat mass and improved indices of bone health), and metabolic and cardiac function. These positive effects were observed in both healthy individuals and clinical patients, irrespective of age or sex. Although this review provides clear evidence of the positive effects of RS on health, most studies had limitations of methodology (an average PEDro score < 6). Furthermore, many of the training studies were from a small number of research groups. Future studies should be extended to other countries and institutions to ensure generality of the results. Regular RS training leads to significant cardiovascular and muscular adaptations and gains of health both in sedentary individuals and clinical patients at all ages, suggesting that RS is a potentially highly motivational method to enhance population health.

The IGF-1/cortisol ratio as a useful marker for monitoring training in young boxers.

Training effects on plasma insulin-like growth factor-1 (IGF-1)/cortisol ratio were investigated in boxers. Thirty subjects were assigned to either the training or the control group (n = 15 in both). They were tested before the beginning of training (T0), after 5 weeks of intensive training (T1), and after 1 week of tapering (T2). Physical performances (Yo-Yo intermittent recovery test level-1), training loads, and blood sampling were obtained at T0, T1, and T2. Controls were only tested for biochemical and anthropometric parameters at T0 and T2. A significantly higher physical performance was observed at T2 compared to T1. At T1, cortisol levels were significantly increased whereas IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) levels remained unchanged compared to baseline. At T2, cortisol levels decreased while IGF-1 and IGFBP-3 levels increased. The IGF-1/cortisol ratio decreased significantly at T1 and increased at T2, and its variations were significantly correlated with changes in training loads and Yo-Yo intermittent recovery test level 1 (IRT1) performance over the training period. Cortisol variations correlated with changes in training load (r = 0.64; p < 0.01) and Yo-Yo IRT1 performance (r = 0.78; p < 0.001) at T1 whereas IGF-1 variations correlated only with changes in Yo-Yo IRT1 performance at T2 (r = 0.71; p < 0.001). It is concluded that IGF-1/cortisol ratio could be a useful tool for monitoring training loads in young trained boxers.

Improved tolerance of peripheral fatigue by the central nervous system after endurance training.

PURPOSE: The purposes of this study were to evaluate the effect of endurance training on central fatigue development and recovery. METHODS: A control group was compared to a training group, which followed an 8-week endurance-training program, consisting in low-force concentric and isometric contractions. Before (PRE) and after (POST) the training period, neuromuscular function of the knee extensor (KE) muscles was evaluated before, immediately after and during 33 min after an exhausting submaximal isometric task at 15 % of the maximal voluntary contraction (MVC) force. After training, the trained group performed another test at iso-time, i.e., with the task maintained until the duration completed before training was matched (POST2). The evaluation of neuromuscular function consisted in the determination of the voluntary activation level during MVCs, from peripheral nerve electrical (VAPNS) and transcranial magnetic stimulations (VATMS). The amplitude of the potentiated twitch (Pt), the evoked [motor evoked potentials, cortical silent period (CSP)] and voluntary EMG activities were also recorded on the KE muscles. RESULTS: Before training, the isometric task induced significant reductions of VAPNS, VATMS and Pt, and an increased CSP. The training period induced a threefold increase of exercise duration, delayed central fatigue appearance, as illustrated by the absence of modification of VAPNS, VATMS and CSP after POST2. At POST, central fatigue magnitude and recovery were not modified but Pt reduction was greater. CONCLUSION: These results suggest that central fatigue partially adapts to endurance training. This adaptation principally translates into improved tolerance of peripheral fatigue by the central nervous system.

Reducing resistance training volume during Ramadan improves muscle strength and power in football players.

We aimed to examine the effect of maintaining or reducing resistance training volume during Ramadan-intermittent-fasting (RIF) on short-term maximal performances. 20 footballers (age: 18.4 ± 0.8 years; body-mass: 72.4 ± 4.1 kg; height: 183.4 ± 4.6 cm) were matched and randomly assigned to a normal-training-group (G1) or a tapering-group (G2). They were tested for muscular strength (maximal-voluntary-contraction) and power (squat-jump and counter-movement-jump) 1 month before RIF (T0), 1 week before RIF (T1), after 2 weeks of fasting (T2) and at the end of RIF (T3). From T1 to T2, subjects performed a whole-body resistance training program (8-repetitions × 4-sets with 4-min recovery in-between). During RIF, G1 maintained the same training program, while G2 performed a period of reduced training volume (3 sets/exercise; - 22%). Muscle strength and power increased significantly from T0 to T1, from T0 to T2 and from T0 to T3 in G1 and G2 and from T1 to T2 and from T1 to T3 only in G2 (p<0.05). Performance was higher in G2 than G1 during T2 (p<0.01). Moreover, the ∆-change of performance between T0 and T2 and T3 was significantly higher in G2 than G1 (p<0.05). For young soccer players, a tapering period characterized by a reduced training volume during RIF may lead to significant improvement in muscle strength and power.

Effects of endurance training on the maximal voluntary activation level of the knee extensor muscles.

PURPOSE: The aim of this study was to investigate the neural adaptations to endurance training, and more specifically the adaptation of the cortical voluntary activation of the knee extensor (KE) muscles. METHODS: Sixteen sedentary men were randomly allocated into an endurance training (n = 8) or a control group (n = 8). All subjects performed a maximal aerobic speed test (MAS) before and immediately after the training period. Training lasted 8 weeks and was based on endurance running. During Pre- and Post-training testing sessions, maximal voluntary contraction (MVC) was measured and voluntary activation (VA) was calculated via peripheral nerve (PNS) and transcranial magnetic stimulations (TMS) superimposed to MVC. Electromyographic activity (EMG) of the KE muscles was also measured during MVC, PNS (M-wave) and TMS (motor evoked potentials-MEP). The cortical silent period following TMS was also assessed. RESULTS: Despite a significant improvement in endurance running performance, as suggested by the increase of MAS in the training group (Pre 15.4 ± 1.6 vs. Post 16.4 ± 1.6 km·h(-1)), endurance training did not affect MVC or VA as measured with PNS and TMS. Similarly, the EMG of KE muscles during MVC did not show any significant changes. Furthermore, the MEP amplitude and the duration of the silent period also remained unchanged after endurance training. CONCLUSIONS: The present study suggests an 8-week endurance-training program does not generate adaptations of neural factors in sedentary subjects.

[The indoor sport: is it a risk factor for allergic rhinitis?]. / La pratique sportive en salle serait-elle un facteur de risque de rhinite allergique ?

INTRODUCTION: The high prevalence of allergic rhinitis that occurs in elite athletes has been extensively investigated. However, data among recreational athletes practicing indoor activities remain contradictory. The aim of the present study was to determine whether taking part in gym based sporting activities constitutes a risk factor for allergic rhinitis in recreational athletes. METHODS: A group of 50 recreational athletes was examined. A specific questionnaire for the screening of allergic rhinitis and a battery of skin prick-tests to aeroallergens were administered to each participant. Measurements of nasal symptoms, peak nasal inspiratory flow (PNIF) and lung function were also obtained before and after a training session. RESULTS: Thirty-two percent of the participants were atopic, 18% suffered from allergic rhinitis. This prevalence is similar to that of the general population (16.9%). After exercise, nasal symptom prevalence did not change significantly. However, an improvement in nasal inspiratory flow was observed in 70% of the participants. No statistically significant change in lung function was noticed. CONCLUSIONS: Our results showed that the occasional practice of sport in the gyms does not constitute a risk factor for atopy or allergic rhinitis. However, this kind of activity induces an increase in the nasal patency of both the healthy and the rhinitic subjects.

[Pulmonary function in rheumatoid arthritis in a Tunisian population]. / La fonction respiratioire dans la polyarthrite rhumatoïde chez une population tunisienne.

BACKGROUND: The rheumatoid polyarthritis (PR) is a frequent pathology in Tunisia. The most frequent extra articular expression of this disease is in the respiratory tract. AIM: To determine the lung functional profile of PR of the Tunisian population by establishing possible relations between ventilatory variables and clinico-biological parameters of PR. METHODS: It is a cross sectional study which concerned 87 patients (77 women) having a confirmed PR. They benefited from a measure of the lung function by a total physical Pléthysmography and by the technique of double transfer NO-CO. Clinical and biological checkup were realized. RESULTS: Three kinds of pulmonary function defects were found: obstructive ventilatory defect (13%), restrictive defect (7%) and mixed defect (1%). Ventilatory flows and the lung volumes correlated negatively with the inflammatory syndrome (p<0.05). Alveolar-capillary diffusion capacity (DLco) was altered in an isolated way or associated with the respiratory functional syndromes (obstructive and restrictive) (6%). This abnormality had a vascular origin with an isolated fall of the lung capillary volume (Vc), a membrane origin with an isolated fall of the diffusion membrane (DM) or a combined origin with the decline of Vc and DM. This latter case was found at a late stage of PR. 58% of PR patients had a normal pulmonary function. CONCLUSION: All these functional findings were linked to PR itself (inflammatory and auto-immune origin) or to the lung toxicity due to the treatment by Methotrexate (alveolar and bronchial damage).

Recovery (passive vs. active) during interval training and plasma catecholamine responses.

The effect of recovery mode (Active [AR] vs. Passive [PR]) on plasma catecholamine (Adrenaline [A] and Noradrenaline [NA]) responses to maximal exercise (Exemax) was studied during interval training (IT). 24 male subjects (21.1±1.1 years) were randomly assigned to a control group (CG, n=6), AR training group (ARG, n=9) or PR group (PRG, n=9). ARG and PRG participated in an IT program 3 times a week for 7 weeks. Before and after training, maximal oxygen uptake (VO2max) and maximal aerobic velocity (MAV) were measured. Plasma A and NA were determined at rest, at the end of Exemax and after 10 and 30 min of recovery. Training induced significant changes only in ARG: an increase of VO2max and MAV along with a significant increase of A and NA at the end of Exemax (2.82±0.15 vs. 1.03±0.15 nmol/l and 7.22±0.36 vs. 6.65±0.57 nmol/l, respectively p<0.05). The ratio A/NA measured at the end of Exemax also increased significantly after training (0.41±0.11 vs. 0.16±0.08, P>0.05). The present results show that IT with AR induces a significant increase of A and NA concentrations in response to maximal exercise. The study furthermore shows that IT program with AR may induce more stress than the same program with PR.

Specific sites of bone expansion depend on the level of volleyball practice in prepubescent boys.

The purpose of this study was to investigate the effect of 18 months of high and low levels of volleyball practice on bone acquisition. 130 prepubescent boys (mean age 11.4 ± 0.7) were divided into a high-level training group (HLG), low-level training group (LLG), and controls. Bone mineral content (BMC) and bone area at the whole body, lumbar spine L2-L4, femoral neck of the dominant leg, and right and left radius were measured using dual-photon X-ray absorptiometry. Enhanced BMC resulted from high-training volleyball activity in all measured sites except the third left and right distal radius, which is not modified by low-level training in prepubescent players but it was accompanied by a bone area expansion in radius and weight-bearing sites for the HLG, and in legs, whole right and left radius for the LLG. Significant improvement of skeletal tissues is associated with the intensity and duration of volleyball training.

Six-minute walking test predicts maximal fat oxidation in obese children.

BACKGROUND: Obesity is associated with reduced exercise maximal fat oxidation rate (FATmax), which is generally assessed by cardiopulmonary cycling test. The six-minute walking test (6MWT) presents an alternative method in patients. OBJECTIVE: The aim of this study was to establish a practical reference equation facilitating the prediction of FATmax from the 6 MWT in obese children of both genders. DESIGN: This study is a cross-sectional study using mixed linear and multiple regression models. RESEARCH METHODS AND PROCEDURES: Anthropometric measurements were recorded and submaximal cycling test and 6 MWT conducted for 131 school-aged obese children, 68 boys and 63 girls. A multiple regression analysis for FATmax, including six-minute walking distance (6 MWD), anthropometric and cardiac parameters as the dependent variables, was performed for the two genders separately. RESULTS: Mean 6 MWD and FATmax were 564.9 ± 53.7 m and 126.5 ± 12.1 mg min(-1) for boys and 506.7 ± 55.0 m and 120.7 ± 10.0 mg min(-1) for girls, respectively. The 6MWD, body mass index, Z-score, fat-free mass, waist and hip circumferences (WC and HC), rest heart rate, and systolic and diastolic blood pressures were highly correlated with FATmax for both genders. There was a significant correlation between 6 MWD and FATmax in both boys and girls (r = 0.88 and r = 0.81, P<0.001, respectively). Stepwise regression analyses revealed that the combinations of 6 MWD with HC for boys and 6MWD with WC for girls improved the predictability of the model (R(2) = 0.81 for boys and R(2) = 0.72 for girls; P<0.001). CONCLUSION: In obese children, the 6MWT can be used to predict FATmax when formal test of exercise capacity and gas exchange analysis are unavailable or impractical. It is therefore possible to prescript targeted exercises at FATmax, without performing indirect calorimetry, just from a field test.

Crossover and maximal fat-oxidation points in sedentary healthy subjects: methodological issues.

AIM: Our study aimed to assess the influence of protocol on the crossover point and maximal fat-oxidation (LIPOX(max)) values in sedentary, but otherwise healthy, young men. METHODS: Maximal oxygen intake was assessed in 23 subjects, using a progressive maximal cycle ergometer test. Twelve sedentary males (aged 20.5±1.0 years) whose directly measured maximal aerobic power (MAP) values were lower than their theoretical maximal values (tMAP) were selected from this group. These individuals performed, in random sequence, three submaximal graded exercise tests, separated by three-day intervals; work rates were based on the tMAP in one test and on MAP in the remaining two. The third test was used to assess the reliability of data. Heart rate, respiratory parameters, blood lactate, the crossover point and LIPOX(max) values were measured during each of these tests. RESULTS: The crossover point and LIPOX(max) values were significantly lower when the testing protocol was based on tMAP rather than on MAP (P<0.001). Respiratory exchange ratios were significantly lower with MAP than with tMAP at 30, 40, 50 and 60% of maximal aerobic power (P<0.01). At the crossover point, lactate and 5-min postexercise oxygen consumption (EPOC(5 min)) values were significantly higher using tMAP rather than MAP (P<0.001). During the first 5 min of recovery, EPOC(5 min) and blood lactate were significantly correlated (r=0.89; P<0.001). CONCLUSION: Our data show that, to assess the crossover point and LIPOX(max) values for research purposes, the protocol must be based on the measured MAP rather than on a theoretical value. Such a determination should improve individualization of training for initially sedentary subjects.

Spirometric profile of narghile smokers.

INTRODUCTION: Studies of the spirometric profiles of narghile smokers are few, have some methodological limits (i.e. small sample size), and present contradictory conclusions. AIMS: (i) To determine the percentage of narghile smokers with obstructive ventilatory defect (OVD) and/or restrictive ventilatory defect (RVD) or static hyperinflation (SHI); (ii) to compare the chronological and estimated lung ages. INCLUSION CRITERIA: men aged 20 to 60 years, narghile smokers (>1 narghile-year [NY]). EXCLUSION CRITERIA: cigar or cigarette smokers and comorbidity. Narghile use quantification: NY and kg of cumulative tobacco use (1 NY=9.125 kg of cumulative tobacco use). DEFINITIONS: Large airway obstructive ventilatory defect (OVD): forced expired volume in one second (FEV(1))/forced vital capacity (FVC) less than lower limit of normal (LLN). Small airway OVD: FVC more than LLN and decrease (less than LLN) of one or more peripheral flows. RVD: total lung capacity (TLC) less than LLN. SHI: residual volume (RV) more than upper limit of normal. SPIROMETRIC MEASURES: (Vmax 22 Series/6200 Autobox, SensorMedics, Yorba Linda, California, USA with measurement of functional residual capacity by nitrogen washout). Measurements were made according to international recommendations. RESULTS: One hundred and ten narghile smokers were included (34±10 years; 1.76±0.07m; 84±14kg). Thirty-six percent of the subjects had SHI; 14% had small airway OVD; 14% had RVD, and 6% had large airway OVD. Estimated lung age was higher than chronological lung age (47±18 years vs. 34±10 years, P<0.05). CONCLUSION: Narghile use accelerates lung ageing. This study provides the health authorities with valid arguments to fight this blight on society, which increasingly involves children and pregnant women.

North African reference equation for peak nasal inspiratory flow.

AIM: To assess, in healthy North African subjects, the applicability and reliability of a previously published reference equation and normal values for peak nasal inspiratory flow, and to calculate a peak nasal inspiratory flow reference equation in this population. SUBJECTS AND METHODS: Anthropometric data were recorded in 212 volunteers (100 females and 112 males) aged 13-27 years. Peak nasal inspiratory flow was measured several times. Univariate and multiple linear regression analyses were used to determine the reference equation. RESULTS: The previously published reference equation and normal values did not reliably predict peak nasal inspiratory flow in the study population. In our subjects, the reference equation (r2 = 30 per cent) for peak nasal inspiratory flow (l/min) was 1.4256 × height (m) + 33.0215 × gender (where 0 = female, 1 = male) + 1.4117 × age (years) - 136.6778. The lower limit of normal was calculated by subtracting from the peak nasal inspiratory flow reference value (84 l/min). CONCLUSION: This is the first published study to calculate a reference equation for peak nasal inspiratory flow in North African subjects. This equation enables objective evaluation of nasal airway patency in patients of North African origin.

Effect of an individualized physical training program on resting cortisol and growth hormone levels and fat oxidation during exercise in obese children.

OBJECTIVES: The aim of this study was to characterize the resting levels of cortisol and growth hormone (GH), and the substrate profile during exercise of obese children before and after an individualized training program. PATIENTS AND METHODS: Twenty-two obese children (13.1 ± 0.8 yrs) were included in the study. Twelve individuals (six boys and six girls; 31.1 ± 1.1 kg/m², VO2(peak)=1.92 ± 0.16l/min) participated in a two-month endurance training program and 10 individuals (five boys and five girls; 30.9 ± 1.7 kg/m², VO2(peak)=1.98 ± 0.12l/min) served as controls. Training was individualized and targeting at the point were fat oxidation was maximal (Lipox(max)). Substrate oxidation was evaluated by indirect calorimetry. To determine plasma cortisol and GH concentrations, blood was collected at rest before and after the two-month period. RESULTS: Before the program, no significant differences were detected between the training group and the control group for any of the measured anthropometric, metabolic or hormonal variables. At the end of the two-month program, training group showed an increase in VO2(peak) and fat oxidation during exercise. After the program, resting levels of GH and cortisol were significantly increased in the training group (+0.9 ± 0.3 ng/mL and +55.4 ± 10.3 ng/mL respectively, p < 0.01). Following the two-month period, there was no change in any variables measured in control group. CONCLUSION: The present data show that an individualized endurance training program targeting Lipox(max) improves fat oxidation during exercise and increases resting levels of GH and cortisol.

Adiponectin responses to acute moderate and heavy exercises in overweight middle aged subjects.

AIM: The purpose of this study was to investigate the effect of acute moderate and heavy exercises on adiponectin, leptin and insulin concentrations in untrained subjects. METHODS: Seven overweight middle-aged males participated in this study (age: 36.00 ± 5.16 years; body weight: 93.94 ± 6.48 kg; percent body fat: 26.64 ± 2.75%; Body Mass Index: 28.32 ± 1.74 kg.m2). They took part in two sub-maximal cycling exercises; moderate; 20 min cycling at 60% of peak aerobic power (PAP) and heavy: 20 min cycling at 80% of PAP. Venous blood samples were obtained before, after 30, 60 and 90 min recovery. RESULTS: Adiponectin concentrations were unchanged (P>0.05) after exercises. However, leptin was significantly decreased under resting values after 30 min (-12.74%, P=0.0023), 60 min (-11.66%, P=0.0084) and 90 min (-8.42%, P=0.0023) after the heavy exercise. Similarly, insulin was lowered after 90 min after the heavy exercise (-55.96%, P=0.014). Basal adiponectin during moderate exercise was significantly and negatively related to BMI (r=-0.778, P=0.033) and percent body fat (r=-0.897, P=0.0061). CONCLUSION: In conclusion our results suggested that 20 min moderate or heavy sub-maximal exercises not stimulate the production and the release of adiponectin during 1.5 hour recovery post-acute exercises. Furthermore, it appears that after acute heavy exercise adiponectin is not associated with leptin or/and insulin modifications.

Exercise improves the ApoB/ApoA-I ratio, a marker of the metabolic syndrome in obese children.

AIM: This study was designed to examine the effect of training on components of the metabolic syndrome and ApoB/ApoA-I ratio in obese children. METHODS: We studied thirty-two obese children (13.3 ± 0.4 years) with 16 subjects who participated to 8-week training and 16 subjects serving as a control group. Training was individualized at the point where fat oxidation was maximal (Fat max). In each subject, pre- and postintervention anthropometric measures and biochemical tests on fasting blood were performed. RESULTS: After the programme, the training group showed an increase in VO(2peak) and fat oxidation during exercise. Body mass index (BMI), blood glucose and triglycerides were reduced, and high-density lipoprotein (HDL) was increased. ApoB/ApoA-I ratio decreased significantly (-0.43%, p < 0.01). Systolic and diastolic blood pressure also decreased (-8.4% and -10.9%, respectively). Among the training group, 10 subjects were classified as having the metabolic syndrome before the intervention and none after. No significant changes in any other variables were measured in the control group. CONCLUSIONS: Training targeted at Fat max reduces the prevalence of metabolic syndrome and its associated factors in obese children. In particular, this intervention decreases the ApoB/ApoA-I ratio, which may be considered as a marker for following this syndrome.

[Submaximal exercise capacity and quality of life in exclusive water-pipe smokers]. / Aptitude aérobie sous-maximale et qualité de vie des fumeurs exclusifs de narguilé

BACKGROUND: It is well known that oxidative stress is increased significantly by regular water-pipe smoking (WPS). This could lead to muscle dysfunction and thus to impairments of exercise and quality of life (QOL). Considering the impressive number of WP smokers, we intend to investigate the potential effect of WPS on submaximal exercise capacity and QOL. AIMS: (1). To evaluate the submaximal exercise capacity by the 6-minutes walking test (6-MWT). (2). To compare the deficiency, incapacity and QOL data of exclusive WPS with those of two control groups (never smokers and exclusive cigarette smokers). (3). To determine the factors influencing the 6-minutes walk distance (6-MWD) of WPS subjects. METHODS: A multicentre study including 180 exclusive WPS [> or =5 WP-year] men aged > or =40 years. Cigar or cigarette smoking, contraindications to the 6-MWT or cortico-steroid therapy will be exclusion criteria. QOL evaluation, spirometry, electrocardiogram and two 6-MWT will be performed. Signs of exercise impairment will be: 6-MWD< or =lower limit of normal, end of walk dyspnoea > or =5/10, haemoglobin saturation fall > or =5 points. Data from WPS subjects will be compared with those from 90 never smoking subjects and 90 exclusives cigarettes smokers. EXPECTED RESULTS: (1). WPS will affect significantly the submaximal exercise capacity. (2). Resting spirometric, 6-MWT and QOL data of exclusive WPS subjects will be significantly reduced compared to never smoking subjects. (3). The 6-MWD's of exclusive WPS subjects will be significantly influenced by cumulative WP consumption, by resting spirometric data, by obesity and by physical activity score.