Healthy Middle-aged Men Research Articles

Vitamin D Supplementation Does Not Enhance Gains in Muscle Strength and Lean Body Mass or Influence Cardiorespiratory Fitness in Vitamin D-Insufficient Middle-Aged Men Engaged in Resistance Training.

This study checked whether vitamin D (Vit-D) supplementation improves the efficacy of resistance training (RT) in terms of increasing muscle strength and lean body mass (LBM), and influencing cardiorespiratory fitness (VO2max) in Vit-D-deficient middle-aged healthy men. Participants (n = 28) were quasi-randomly assigned to one of two groups, which, in a double-blind manner, supplemented their diet daily with either Vit-D (8000 IU; VD) or placebo (PLC) during participation in a 12-week supervised RT program. During the intervention, serum Vit-D concentrations increased 2.6-fold (p < 0.001) in the VD group, while no changes occurred in the PLC group. Muscle strength gains (p < 0.001) as measured in seven exercises performed on RT equipment and increases (p < 0.001) in LBM were similar in the two groups. Total fat mass, percent total fat, and percent android fat decreased (p < 0.05) to a similar extent in both groups, but there was no change in VO2max in either group. In conclusion, in healthy Vit-D-insufficient middle-aged men engaged in resistance training, Vit-D supplementation increases serum 25(OH)D levels but does not enhance gains in muscle strength and LBM, or decreases in fat mass and fat percentage, and does not affect cardiorespiratory fitness.

P101 LEFT VENTRICULAR MASS INDEX (LVMI) IS UNLIKELY TO NORMALISE WITH TREATMENT USING CURRENTLY RECOMMENDED BLOOD PRESSURE TARGETS

Background and Objectives: LVMI is one of the strongest predictors of cardiovascular events. However, it's unclear whether current blood pressure (BP) targets normalise LVMI relative to a truly normotensive population. We therefore compared achieved LVMI in a younger cohort of hypertensive patients (&lt; 55 years) treated for one year to conventional blood pressure targets (&lt; 140/90 mmHg) versus the LVMI of a truly normotensive age-matched healthy population from the UK Biobank (BP ≤ 120/80 mmHg). Methods: The normotensive cohort comprised 101 treatment-naïve men (mean ± SD age: 52 ± 2 years, BP: 112 ± 7/68 ± 7 mmHg) from 77,983 UK Biobank participants who had undergone cardiac Magnetic Resonance Imaging (cMRI) to determine LVMI. The treated hypertensive cohort comprised 44 men from the TREAT CASP study* (mean age: 49 ± 6 years) who achieved mean BP of 129 ± 10/78 ± 8 mmHg after one-year treatment. LVMI in both cohorts was measured accurately via automated analysis of cMRI and manually reviewed for accuracy. Results: LVMI in Biobank cohort was 51.3 ± 6.0 g.m-2 (95% CI: 50.1 to 52.4 g.m-2). In the hypertensive cohort, after one year of treatment, LVMI was reduced (59.2 ± 7.0 versus 56.0 ± 7.0 g.m-2, P &lt;0.001) but remained higher than the Biobank cohort (56.0 ± 7.0 versus 51.3 ± 6.0 g.m-2, P &lt;0.001). Mean LVMI of treated-hypertensive patients achieving truly normotensive BP (≤ 120/80 mmHg) was 52.7 ± 5.7 g.m-2 (95% CI: 48.9 to 56.4 g.m-2; n = 9). Conclusions: This study identified optimal cMRI LVMI for healthy middle-aged men. Antihypertensive treatment reduces but does not restore LVMI to normal levels, suggesting much lower BP targets than currently recommended are likely to be necessary to normalise LVMI in hypertensive patients. *Reference: Lacy, P. S., Jedrzejewski, D., McFarlane, E., &amp; Williams, B. (2023). Blood pressure measurement modalities and indexed left ventricular mass in men with low-risk hypertension confirmed by ambulatory monitoring. Journal of Hypertension, 41(6), 941-950.

Gonadal status modulates large elastic artery stiffness in healthy middle-aged and older men.

Hypogonadism is a risk factor for cardiovascular disease (CVD) in men related, in part, to increased oxidative stress. Elevated large artery stiffness and central pulsatile hemodynamics (e.g., pulse pressure and wave reflection magnitude) are independent risk factors for CVD. However, whether large artery stiffness and central pulsatile hemodynamics are (1) elevated in hypogonadal men independent of traditional CVD risk factors and (2) related to increased oxidative stress is unknown. Young men (N = 23; 30 ± 4years) and middle-aged/older (MA/O) men with normal (> 400-1000ng/dL; n = 57; 59 ± 7years) or low testosterone (< 300ng/dL; n = 21; 59 ± 7years) underwent assessments of large artery stiffness (carotid ß-stiffness via ultrasonography) and central pulsatile hemodynamics (pulse wave analysis; SphygmoCor XCEL) following an infusion of saline or vitamin C to test the tonic suppression of vascular function by oxidative stress. Carotid stiffness differed by age (p < 0.001) and gonadal status within MA/O men (low testosterone vs. normal testosterone: 9.3 ± 0.7 vs. 8.0 ± 0.3U, p = 0.036). Central pulsatile hemodynamics did not differ by age or gonadal status (p > 0.119). Vitamin C did not alter carotid stiffness in any group (p > 0.171). There was a significant group × infusion interaction on aortic reflection magnitude (p = 0.015). Vitamin C treatment reduced aortic reflection magnitude in young and MA/O men with normal testosterone (both p < 0.001) but not MA/O men with low testosterone (p = 0.891). Collectively, hypogonadism may accelerate age-related large artery stiffening in MA/O men with low testosterone, independent of CVD risk factors; however, this is not related to increased reactive oxygen species sensitive to an acute vitamin C infusion.

Smartphone app for lifestyle improvement improves brain health and boosts the vitality and cognitive function of healthy middle-aged adults.

The number of smartphone apps for brain training is increasing, and the number of people who are working on brain training is also increasing. However, researchers disagree about the effectiveness of brain training. Therefore, in this study, we conducted an intervention test with the participation of 70 healthy middle-aged men and women and measured the effect of smartphone apps on lifestyle improvement using brain healthcare quotient calculated from brain imaging data. As a result, in the intervention group, significant improvements were seen in fractional anisotropy (FA) of the whole brain, corpus callosum, internal capsule, corona radiata, posterior thalamic radiation, external capsule, and superior longitudinal fasciculus. Additionally, in the intervention group, these FA increments correlated with improvements in cognitive function as measured by the trail-making test and vigor as measured by the Profile of Mood States 2nd Edition. The results of this study suggest that improving lifestyle habits through smartphone apps can improve brain health and cognitive and emotional performance of healthy middle-aged adults. This is consistent with previous research that suggests that FA integrity in the limbic-thalamo-cortical pathway influences cognitive function and emotion regulation.

Combined effects of sleep and objectively-measured daily physical activity on arterial stiffness in middle-aged and older adults

Although sleep quality and physical activity (PA) may influence on arterial stiffness, the combined effects of these two factors on arterial stiffness remain unknown. A total of 103 healthy middle-aged and older men and women (aged 50–83 years) with no history of cardiovascular disease and depression were included in this study. Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), and femoral-ankle PWV (faPWV). Poor sleepers were defined as those with a Pittsburgh Sleep Quality Index score of >5.5. Using an accelerometer for seven consecutive days, low levels of PA were defined as low moderate-to-vigorous-intensity PA (MVPA) <19.0 min/day and low step counts <7100 steps/day, respectively. Poor sleepers with low PA levels, as determined by MVPA and daily steps, showed higher cfPWV, but not faPWV or baPWV, in middle-aged and older adults. Furthermore, in the analysis of covariance (ANCOVA) analyses adjusted for age, obesity, dyslipidemia, and sedentary behavior, the cfPWV result remained significant. Our study revealed that the coexistence of poor sleep quality and decreased PA (low MVPA or daily steps) might increase central arterial stiffness in middle-aged and older adults. Therefore, adequate sleep (good and sufficient sleep quality) and regular PA, especially at appropriate levels of MVPA (i.e., at least of 7100 steps/day), should be encouraged to decrease central arterial stiffness in middle-aged and older adults.

Clinical effect of phytosterol-enriched saw palmetto extract on urinary function in healthy middle-aged and older males: a double-blind, placebo-controlled randomized comparative study

Background: Saw palmetto extract (SPE) is one of the most widely used supplements for benign prostatic hyperplasia (BPH) due to its pharmacological effects. β-sitosterol-enriched saw palmetto oil (VISPO™) contains more than 3% β-sitosterol and 85% total fatty acids and has been shown to improve symptoms in patients with BPH. Lower urinary tract symptoms (LUTS) require primary preventive measures in countries with accelerated population aging, including Japan. VISPO™ is expected to be effective against the early symptoms of LUTS. However, the effect of VISPO™ on urinary function in healthy individuals has not been elucidated. Objective: This clinical study evaluated the efficacy and tolerability of VISPO™ in the management of urinary complaints among healthy middle-aged and older men who did not require treatment. Methods: We conducted a randomized, double-blind, placebo-controlled trial that included 54 male participants who were assigned to consume VISPO™ or placebo (olive oil) capsules for 12 weeks. Biometric data, uroflowmetry results, and salivary hormone levels were assessed at weeks 1 and 12. Urinary function and quality of life were assessed at weeks 1, 4, 8, and 12 using the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Core Lower Urinary Tract Symptom Score (CLSS), and WHOQOL-26. Results: Two-way analysis of variance revealed that IPSS and OABSS were significantly lower in the VISPO™ group that in the placebo group. However, there were no significant differences in urine volume, urinary flow rate, or salivary hormone levels. In addition, no participants reported adverse effects (diarrhea, abdominal pain, etc.). Conclusion: The results of the present study, which is the first randomized controlled trial of VISPO™ conducted among healthy participants, demonstrate the effectiveness of VISPO™ in the management of lower urinary tract complaints that do not require treatment. Trial Registration: University Hospital Medical Information Network Clinical Trials Registry (UMIN000046386). Keywords: saw palmetto, VISPO™, β-sitosterol, fatty acids, healthy subjects, primary preventive, IPSS, OABSS, lower urinary tract symptoms (LUTS)

Risk factors for early atherosclerotic changes in the retinal arterioles in healthy middle-aged men

Risk factors for early atherosclerotic changes in the retinal arterioles in healthy middle-aged men

Aortic stiffness contributes to greater pressor responses during static hand grip exercise in healthy young and middle-aged normotensive men.

Central arterial stiffness can influence exercise blood pressure (BP) by increasing the rise in arterial pressure per unit increase in aortic inflow. Whether central arterial stiffness influences the pressor response to isometric handgrip exercise (HG) and post-exercise muscle ischemia (PEMI), two common laboratory tests to study sympathetic control of BP, is unknown. We studied 46 healthy non-hypertensive males (23 young and 23 middle-aged) during HG (which increases in cardiac output [Q̇c]) and isolated metaboreflex activation PEMI (no change or decreases in Q̇c). Aortic stiffness (aortic pulse wave velocity [aPWV]; applanation tonometry via SphygmoCor) was measured during supine rest and was correlated to the pressor responses to HG and PEMI. BP (photoplethysmography) and muscle sympathetic nerve activity (MSNA) were continuously recorded at rest, during HG to fatigue (35% maximal voluntary contraction) and 2-min of PEMI. aPWV was higher in middle-aged compared to young males (7.1±0.9 vs 5.4±0.7m/s, P<0.001). Middle-aged males also exhibited greater increases in systolic pressure (∆30±11 vs 10±8mmHg) and MSNA (∆2313±2006 vs 1387±1482%/min) compared to young males during HG (both, P<0.03); with no difference in the Q̇c response (P=0.090). Responses to PEMI were not different between groups. Sympathetic transduction during these stressors (MSNA-diastolic pressure slope) was not different between groups (P>0.341). Middle-aged males displayed a greater increase in SBP per unit change of Q̇c during HG (∆SBP/∆Q̇c; 21±18 vs 6±10mmHg/L/min, P=0.004), with a strong and moderate relationship between the change in systolic (r=0.53, P<0.001) and diastolic pressure (r=0.34, P=0.023) and resting aPWV, respectively; with no correlation during PEMI. Central arterial stiffness can modulate pressor responses during stimuli associated with increases in cardiac output and sympathoexcitation in healthy males.

Renal Functional Response-Association With Birth Weight and Kidney Volume

Renal functional response (RFR) is the acute increase in glomerular filtration rate (GFR) after a protein load. Low RFR is a marker of single nephron hyperfiltration. Low birth weight (LBW) is associated with reduced number of nephrons, lower kidney function, and smaller kidneys in adults. In the present study, we investigate the associations among LBW, kidney volume, and RFR. We studied adults aged 41 to 52 years born with either LBW (≤2300 g) or normal birth weight (NBW; 3500-4000 g). GFR was measured using plasma clearance of iohexol. A stimulated GFR (sGFR) was measured on a separate day after a protein load of 100 g using a commercially available protein powder, and RFR was calculated as delta GFR. Kidney volume was estimated from magnetic resonance imaging (MRI) images using the ellipsoid formula. A total of 57 women and 48 men participated. The baseline mean ± SD GFR was 118 ± 17 ml/min for men and 98 ± 19 ml/min for women. The overall mean RFR was 8.2 ± 7.4 ml/min, with mean RFR of 8.3 ± 8.0 ml/min and 8.1 ± 6.9 ml/min in men and women, respectively (P= 0.5). No birth-related variables were associated with RFR. Larger kidney volume was associated with higher RFR, 1.9 ml/min per SD higher kidney volume (P= 0.009). Higher GFR per kidney volume was associated with a lower RFR,-3.3ml/min per SD (P< 0.001). Larger kidney size and lower GFR per kidney volume were associated with higher RFR. Birth weight was not shown to associate with RFR in mainly healthy middle-aged men and women.

PS-BPC12-1: AGE-RELATED DIFFERENCES IN LONGITUDINAL ASSOCIATIONS BETWEEN ALCOHOL INTAKE AND ARTERIAL STIFFNESS, PRESSURE WAVE REFLECTION, AND INFLAMMATION IN MALE EMPLOYEES

Backgrounds: The effect of alcohol intake on arterial stiffness related to macro-vascular damage, pressure wave reflection related to both macro- and micro- vascular damages and inflammation have not been fully concluded. Aims: In the present longitudinal observational study, which conducted in annually repeated measurements data, mixed model analyses were applied to examine the difference of longitudinal associations of amount of alcohol intake (i.e., non, mild, moderate and heavy) with arterial stiffness, pressure wave reflection and inflammation. Methods: In 4016 middle-aged (43 ± 9 years) healthy Japanese men without cardiovascular disease (CVD) at the study baseline, alcohol intake, which obtained by questionnaire, risk factors for CVD, brachial-ankle pulse wave velocity (brachial-ankle PWV), radial augmentation index (rAI), and serum C-reactive protein levels (CRP) were measured annually during a 9-year study period. Results: In this repeated measurements data, mix model linear regression analyses demonstrated that alcohol intake had a significant longitudinal association with brachial-ankle PWV and rAI in dose-dependent manner {i.e., non, Mild (1–10 g/day), Moderate (10–30 g/day) and heavy (Over 30 g/day) ethanol intake} (Figure). When baPWV was included as a covariate, the association of alcohol intake with rAI was significant. On the other hand, the serum CRP levels were significantly lower in mild to moderate alcohol intake groups as compared to other groups (i.e., U-shaped) (Figure). Conclusion: The amount of alcohol intake may have longitudinal linear association with increased arterial stiffness and abnormal pressure wave reflection, but it may have a U-shaped relationship with inflammation reflected by serum CRP levels. Thus, the alcohol intake may longitudinally affect both macro- and micro- vascular damages in a linear dose-dependent manner without mediating inflammation.

PS-C29-8: EFFECT OF WEIGHT GAIN ON ARTERIAL STIFFNESS AND PRESSURE WAVE REFLECTION: A 9-YEAR LONGITUDINAL STUDY

Background and Aim: Obesity is a causal factor for conventional risk factors for cardiovascular disease (CVD), and these risk factors affect increased arterial stiffness and also abnormal pressure wave reflection in arterial tree. Even so, because of the potent direct influences of these risk factors on arterial stiffness and pressure wave reflection, the direct effect of obesity on these vascular abnormalities has been still controversial. Then, the present study examined the effect of weight gain on those vascular abnormalities. Methods and Results: In 4016 middle-aged (43 ± 9 years) healthy Japanese men without CVD at the study baseline, body weight, risk factors for CVD, brachial-ankle pulse wave velocity (baPWV), and radial augmentation index (rAI) were measured at the baseline and end of study period (mean duration of follow-up was 6.3 years). The study subjects were divided into 3 groups by the change of BMI during the study period. While the change of baPWV in the highest tertile range of increase in BMI (57 ± 138 cm/sec) was larger than that in the lowest tertile range of increase in BMI (46 ± 136 cm/sec)(P &lt; 0.05), these differences were not significant after the adjustment of changes of blood pressure. In addition, the change of rAI was similar between both groups. Conclusions: Weight gain may affect increase in arterial stiffness rather than abnormal pressure wave reflection, and this effect may be mediated by increase in blood pressure related to weight gain rather than the direct effect of weight gain.

Relationship Between Atherogenic Index of Plasma and Serum Uric Acid in Patients With Untreated Essential Hypertension in China: A Cross-Sectional Study.

Several studies have reported that the atherogenic index of plasma (AIP) is associated with serum uric acid (SUA) in healthy middle-aged men, kidney transplant patients, and diabetic patients. We assessed the relationship between AIP and SUA in patients with untreated essential hypertension (EH) in China. In the cross-sectional study, we evaluated 5003 patients with untreated EH in China; 1490 were assigned to the hyperuricemia (HUA) group and 3513 to the normouricemia (non-HUA) group according to the diagnostic criteria of HUA (SUA level≥6mg/dL in females and ≥7mg/dL in males). A higher AIP level was found in the HUA group (P < .001), and AIP was positively and independently correlated with SUA after adjusting for statistically significant variables (β = .204, P < .001). Moreover, multivariate logistic regression analysis showed that the AIP was closely and independently related to HUA after adjusting for confounders (odds ratio [OR]: 11.980, 95% confidence interval [CI]: 3.186-45.047, P < .001). Our findings suggested that the AIP was positively and independently associated with SUA, and elevated AIP might be a significant risk factor for HUA in patients with untreated EH in China.

Leisure-time regular exercise and prevention of the side effects of immune system activity in middle-aged healthy subjects

Regular exercise is recommended to improve immune system function and antioxidant activity, while conversely, it may cause inflammation by increasing neutrophil-derived main enzyme, myeloperoxidase, which produces reactive oxygen species. The present study aimed to investigate changes in myeloperoxidase level, its influence on total oxidant status, and the capacity of the antioxidant defence system to counteract oxidative stress in middle-aged men participating in leisure-time regular exercise compared to untrained peer subjects. Twenty trained (age 53.58±2.94 years, body mass index (BMI) 25.47±1.6) and 17 untrained (age 54.17±2.83 years, BMI 27.83±1.12) healthy middle-aged men participated in this study [Rasht, Gilan, Iran]. Participants performed a modified Bruce treadmill test as a model of progressive exercise training. Blood samples were taken before, immediately after, and one hour after the end of the test. A mixed ANOVA and Bonferroni post hoc test was used for the analysis of variables. A significant difference was observed in myeloperoxidase levels between groups, while the trained group showed a significantly lower concentration than the untrained group (P&lt;0.018). This result was also consistent with the lower total oxidant status in this group (P&lt;0.001). Total antioxidant capacity changed significantly in both groups with higher concentration in the trained group (P&lt;0.001). The leisure-time regular exercise can reduce myeloperoxidase concentration and total oxidant status in healthy middle-aged men while increasing the total antioxidant capacity, which may potentially protect them from the side effects of immune system activity induced by exercise training.

Left Ventricular Diastolic Response to Isometric Handgrip Exercise in Physically Active and Sedentary Individuals.

This study aims to investigate the diastolic left ventricular (LV) response to isometric handgrip exercise among healthy middle-aged men with high physical activity levels, versus matched sedentary individuals. Two groups of 10 men aged 41-51 years were studied. Men in the first group had high weekly self-reported physical activity levels (&gt;3000 METs × min/week). In comparison, men in the second group reported low physical activity levels (&lt;300 METs × min/week). An isometric handgrip exercise (IHE) stress echocardiography test was performed in all of them. Both groups showed a similar and statistically significant increase in heart rate, systolic, diastolic, and mean arterial pressure following IHE. The group of active men under study did not show a statistically significant change in the ratio of early diastolic mitral valve inflow velocity to early diastolic lateral wall tissue velocity (E/e' ratio) in response to IHE. Conversely, the inactive participants' E/e' ratio was higher at peak activity in the isometric handgrip exercise. Apparently, healthy middle-aged men with high levels of physical activity seem to have an improved lusitropic cardiac function compared to men with low levels of physical activity, as observed by the different diastolic LV responses induced by isometric handgrip exercise.

Zinc supplementation raises serum zinc and 5'-nucleotidase activities in healthy, USA middle-aged men.

Background: Many types of people have been noted to show less than maximum zinc functional status. One group that has not been examined is healthy middle-aged, non-vegetarian men in the USA. Aim: To determine if supplementation with zinc improves values for two plasma indicators of zinc status. Methods: Zinc arginate (30 mg zinc/day) was given for 6 weeks to healthy middle-aged men. Results: Supplementation produced statistically significant, but small increases in plasma values for zinc and activity of 5'-nucleotidase, a zinc enzyme. Conclusion: These results suggest that middle-aged, healthy, meat-eating US males tend to show close to maximal zinc functional status. However, such men may not have a safety margin in zinc stores that covers situations where higher than normal zinc needs develop.

Abdominal adipose tissue associates with adiponectin and TNF in middle-aged healthy men

Background and Aims : Backgroun: Adipokines, including adiponectin, visfatin and TNF (tumor necrosis factor)-α, are highly active bio-peptides involved in glucose metabolism, insulin regulation and the development and progression of obesity and its associated diseases. It includes, among others Aim: In this cross-sectional study, we aimed to investigate whether gene expression levels in subcutaneous adipose tissue (SAT) of selected adipokines and their corresponding circulating levels associate with the amount of AT in superficial (sSAT), deep (dSAT) and visceral (VAT) AT, assessed by computed tomography (CT). Any association with glucometabolic variables were also exploredMethods: Methods: In 103 healthy Caucasian men, fasting venous blood and SAT samples from the gluteal region were collected. Ninety-four of the participants underwent CT assessment of the abdominal AT, which was divided into VAT and superficial - and deep subcutaneous AT (sSAT and dSAT). Circulating levels were measured by ELISA and AT gene-expression by PCR. Insulin sensitivity was determined by glucose clamp, assessing glucose disposal rate (GDR).Results: Results: Circulating adiponectin and TNF gene expression correlated inversely and positively to sSAT, dSAT and VAT (r=-0.266 to -0.276, p<0.05 for all) and (r=0.323 - 0.368, p<0.05 for all), respectively, with strongest correlations to the amount of AT in sSAT and dSAT. Circulating adiponectin correlated inversely to insulin, C-peptide and waist circumference (r=-456 to -0.373, p<0.001) and positively to GDR (r=0.356, p<0.001). AT-expressed visfatin correlated inversely to insulin and C-peptide (r=-0.370 and r=-0.404, p<0.001).Conclusions: Conclusion: Increased amount of AT is associated with low levels of adiponectin and increased levels of TNF. Background and Aims : Backgroun: Adipokines, including adiponectin, visfatin and TNF (tumor necrosis factor)-α, are highly active bio-peptides involved in glucose metabolism, insulin regulation and the development and progression of obesity and its associated diseases. It includes, among others Aim: In this cross-sectional study, we aimed to investigate whether gene expression levels in subcutaneous adipose tissue (SAT) of selected adipokines and their corresponding circulating levels associate with the amount of AT in superficial (sSAT), deep (dSAT) and visceral (VAT) AT, assessed by computed tomography (CT). Any association with glucometabolic variables were also explored Methods: Methods: In 103 healthy Caucasian men, fasting venous blood and SAT samples from the gluteal region were collected. Ninety-four of the participants underwent CT assessment of the abdominal AT, which was divided into VAT and superficial - and deep subcutaneous AT (sSAT and dSAT). Circulating levels were measured by ELISA and AT gene-expression by PCR. Insulin sensitivity was determined by glucose clamp, assessing glucose disposal rate (GDR). Results: Results: Circulating adiponectin and TNF gene expression correlated inversely and positively to sSAT, dSAT and VAT (r=-0.266 to -0.276, p<0.05 for all) and (r=0.323 - 0.368, p<0.05 for all), respectively, with strongest correlations to the amount of AT in sSAT and dSAT. Circulating adiponectin correlated inversely to insulin, C-peptide and waist circumference (r=-456 to -0.373, p<0.001) and positively to GDR (r=0.356, p<0.001). AT-expressed visfatin correlated inversely to insulin and C-peptide (r=-0.370 and r=-0.404, p<0.001). Conclusions: Conclusion: Increased amount of AT is associated with low levels of adiponectin and increased levels of TNF.

Prospective evaluation of cardiac effects of first-time marathon training, running, and recovery in middle-aged men: cohort study rationale and design.

BackgroundSeveral phenomena may point to potentially detrimental cardiac effects of endurance exercise, such as elevated circulating cardiac troponin levels and reductions in systolic and diastolic function directly after marathon completion. Furthermore, while myocardial abnormalities have been reported in patients who recovered from COVID-19, the cardiac impact of extensive endurance exercise in individuals who recovered from COVID-19 remains unknown. We therefore aim to investigate (potentially detrimental) cardiac effects of first-time marathon training and participation, including a subset of participants who recovered from COVID-19, in apparently healthy middle-aged men.Study designThis exploratory prospective cohort study investigates cardiac effects of first-time marathon running in 24 middle-aged (35–50 years) healthy men. Primary outcomes are cardiac morphological changes from pre-training up to 1 month after marathon completion, measured with magnetic resonance imaging (MRI) at 4 time points: 1) baseline (4 months before the marathon), 2) pre-marathon (2 weeks before the marathon), 3) post-marathon (< 24 h post-marathon), and 4) recovery (4 weeks after the marathon). Secondary parameters include other cardiac or non-cardiac changes: 1) quantitative MRI myocardial mapping, including mean diffusivity and extracellular volume fraction, 2) echocardiographic morphology and function changes, 3) VO2max, 4) electrocardiogram changes, and 5) levels of cardiac biomarkers.DiscussionThis study will contribute to our understanding of cardiac adaptations and maladaptations to first-time marathon running in middle-aged men, and the interaction between extreme endurance exercise and potential detrimental cardiac effects, also in the context of COVID-19. Results will inform on future research directions while providing new clinical insights for health professionals involved in athlete care.

Higher Levels of Serum Uric Acid Have a Significant Association with Lower Incidence of Lower Urinary Tract Symptoms in Healthy Korean Men.

Gout has been correlated with the risk of incident benign prostatic hyperplasia. In line with increasing prevalence of hyperuricemia, the aim of this study was to investigate the relationship between serum uric acid (SUA) level and the incidence of lower urinary tract symptoms (LUTS) among clinically healthy middle-aged men. We performed a cohort study in 101,091 Korean men without LUTS at baseline who completed health checkups between 2011 and 2016. LUTS were evaluated using the International Prostate Symptom Score, where a score ≥ 8 was defined as significant LUTS. Men were divided into six groups according to their SUA levels in mg/dL (<5.5, 5.5–6.4, 6.5–7.4, 7.5–8.4, 8.5–9.4, and ≥9.5). Throughout the follow-up—encompassing a total of 358,982.6 person years—13,424 people had significant LUTS (37.3 per 1000 person years for incidence rate). The multivariable models demonstrated that the highest level of SUA (≥9.5 mg/dL) was related to the lowest risk of significant LUTS compared with the reference category (<5.5 mg/dL) (0.77 (95% CI 0.59–0.99) for adjusted HR). In this large cohort composed of middle-aged men, higher SUA levels were related to a reduced risk of LUTS. This result suggests another potential role of SUA in restraining LUTS. Additional studies are needed to explain the underlying biological mechanisms of this phenomenological relationship.

Abdominal Adipose Tissue Associates With Adiponectin and TNFα in Middle-Aged Healthy Men.

IntroductionAdipokines are highly active biopeptides involved in glucose metabolism, insulin regulation and the development and progression of obesity and its associated diseases. It includes, among others, adiponectin, visfatin and tumor necrosis factor alpha (TNFα). The sources of adipokines and their associations with glucometabolic variables are not completely understood.AimIn this cross-sectional study, we aimed to investigate whether gene expression levels in subcutaneous adipose tissue (SAT) of selected adipokines and their corresponding circulating levels associate with the amount of AT in superficial (sSAT), deep (dSAT) and visceral AT (VAT), assessed by computed tomography (CT). Any association with glucometabolic variables were also explored.MethodsIn 103 healthy Caucasian men, aged 39.5 years, fasting venous blood and SAT samples from the gluteal region were collected. Ninety-four of the participants underwent CT assessment of the abdominal AT, which was divided into VAT, sSAT and dSAT. Circulating levels of adipokines were measured by ELISA and AT gene-expression by PCR. Insulin sensitivity was determined by glucose clamp, assessing glucose disposal rate (GDR).ResultsCirculating adiponectin and TNFα gene expression correlated inversely and positively to the amount of AT in all three compartments (r=-0.266 to -0.276, p<0.05 for all) and (r=0.323 - 0.368, p<0.05 for all), respectively, with strongest correlations to the amount in sSAT and dSAT. When dividing AT compartments into quartiles, a tendency was observed towards lower circulating adiponectin and higher TNFα gene expression levels, respectively, with increasing amount of sSAT and dSAT. Circulating adiponectin correlated inversely to insulin, C-peptide and waist circumference (r=-456 to -0.373, p<0.001) and positively to GDR (r=0.356, p<0.001). AT-expressed visfatin correlated inversely to insulin and C-peptide (r=-0.370 and r=-0.404, p<0.001).ConclusionIncreased amount of AT is associated with lower levels of adiponectin and increased levels of TNFα AT expression.

Effects of low vs. moderate dose of recreational football on cardiovascular risk factors

ABSTRACT This study aimed to compare the effectiveness of recreational football performed once (LOW) vs. twice (MOD) a week on cardiovascular risk factors in healthy, sedentary men. Body composition, resting blood pressure, blood lipid profile and maximal oxygen consumption (VO2max) were measured at baseline, after a 12-week control and training period, using an interrupted time-series study (study 1, n = 18: n = 8, LOW and n = 10, MOD) nested in a randomized parallel trial (study 2, n = 34: n = 18 LOW and n = 16 MOD). After the intervention in study 1, LDL-cholesterol (−12.3 mg·dLˉ1 [−22.7 to −2.0]) and VO2max (4.5 ml·kgˉ1·minˉ1 [1.2–7.8 ]) changed in LOW whereas differences were found in weight (−2.1 kg [−3.7 to −0.4]), BMI (−0.7 kg·m−2 [−1.2 to −0.1]), total cholesterol (−22.2 mg·dLˉ1 [−36.0 to −8.4]), no-HDL-cholesterol (−17.5 mg·dLˉ1 [−30.5 to −4.5]), LDL-cholesterol (−14.9 mg·dLˉ1 [−23.6 to −6.2]) and VO2max (5.7 ml·kgˉ1·minˉ1 [2.8–8.6]) in MOD. Study 2 showed no evidence of differences between groups. Our results therefore suggest positive health effects of recreational football even when performed at low frequency as it can happen in real context. Highlights Moderate and high amount of recreational football practice (i.e. 2 or 3 h a week) have been shown to be effective to improve health-related factors in both healthy and unhealthy people. Scarce data are present regarding the effect of a low frequency of recreational football practice (i.e. 1 h a week) that is often usual in a real context. Our results showed the practice of recreational football, once a week, is effective for improving some cardiovascular risk factors (maximal oxygen consumption and LDL-cholesterol) in sedentary, healthy middle-aged men. Moreover, practising recreational football once or twice a week seems to lead to similar positive health adaptations.