Moderate-intensity Group Research Articles

The role of High-, Moderate-, and Low-Intensity Training in Enhancing Functional Mobility and Muscle Strength of Aged Female: A Randomized Controlled Trial

Resistance training provides many benefits to the older population, and it is considered one of the most effective ways to counter-attack age-related sarcopenia and dynapenia disorders. This article evaluates the impacts of high, moderate, and low training intensities on muscle strength and functional mobility of older adults. A single-blinded factorial design for 12 weeks was conducted among 60 healthy older Malaysian women (>65 years). The authors assessed the Five times Sit to Stand (5STS), the Timed Up and Go test (TUG), and the 6 Minutes Walking Test (6MWT). The participants were randomly divided to the High- Intensity Group (HIT; n=15) (69.60 ± 3.68); Moderate-Intensity Group (MIT; n=15) (69.27 ± 3.41); Low-Intensity Training (LIT; n=15) (69.27 ± 1.94); and Control Group (CG; n=15) (68.67 ± 2.38). In terms of time, there is a statistically noticeable difference in the means of all the variables (p< .001). Moreover, a statistically significant connection between the intervention and time was seen on all the variables (p< .001). However, there was a statistically significant difference between the means of 5STS (P< .001) and TUG (P= .025) in the intervention groups, there was no statistically significant difference observed in 6MWT (P= .90). The results suggested that all of these intensities training are beneficial for improving muscle strength and functional mobility. In addition, the HIT is more effective in improving the 5STS, TUG, and 6MWT, as compared to the MIT, LIT, and CG. These findings revealed that HIT tends to result in greater improvement of muscle strength and mobility.

Patterns of Healthcare Services Among Children With Advanced Cancer in Concurrent Hospice Care.

Children with advanced cancer have access to comprehensive cancer care and hospice care if they enroll in concurrent hospice care. However, little is known about the patterns of nonhospice healthcare services used by these children. The aim of this study was to examine the patterns of nonhospice healthcare services among children with cancer in concurrent hospice care. This study was a retrospective cohort analysis of 2011-2013 Medicaid claims data from 862 pediatric cancer patients. Data were analyzed using descriptive statistics and latent class analysis (LCA). Children used 120 388 healthcare services, including inpatient and outpatient hospital services, laboratories and x-rays, durable medical equipment, medications, and others. These services clustered into 2 classes with moderate-intensity (57.49%) and high-intensity (42.50%) healthcare service use. Children in the high-intensity cluster were more likely to reside in the South with comorbidities, mental/behavioral health conditions, and technology dependence and were less likely to have solid tumors, compared with the moderate-intensity group. Nonhospice healthcare services clustered together in 2 distinct classes, providing critical insight into the complexity of the healthcare use among children with cancer in concurrent hospice care. Understanding that pediatric patients in concurrent care may have different healthcare service patterns may assist oncology nurses caring for children with advanced cancer. These findings also have policy implications.

Effect of a novel 90-second “Gear” exercise programme on markers of inflammation and cardiorespiratory fitness measurements in person at risk of cardiovascular disease

ABSTRACT The study compared the effect of the novel “Gear” exercise programmes on inflammatory markers and cardiorespiratory fitness measurements. The participants mean age was 38 ± 5.74 years, with a mean body mass of 83 ± 16.93kg. Participants were randomly assigned to either the “Gear” exercise programme repeated at different times during the day (GEP-DT): cycled for 90 seconds, repeated three times per day, three days per week; the “Gear” exercise programme repeated at one point in time (GEP-OT): cycled for 90 seconds followed by four minutes and 30 seconds rest, repeated three times at one point in time, three days per week; moderate-intensity continuous exercise group (MICE): cycled for 30 minutes at 55–69% of HRmax or the control group (CTRL): did not exercise. The GEP-DT demonstrated a moderate increase in load at ventilation threshold (VT-L) (MD = 8.18 ± 12.30, % Δ = 14.53, d = 0.77, d (95% CI): (−0.17, 1.64)). The GEP-OT group demonstrated a large effect size for VT-L (MD = 11.79 ± 18.77, % Δ = 18.86, d = 0.81, d (95% CI): (−0.02, 1.63)). The GEP-DT and GEP-OT raised the VT-L, which prevented premature fatigue and improved the efficiency of the cardiorespiratory system.

Effects of Acute Moderate- and High-Intensity Aerobic Exercise on Oxygenation in Prefrontal Cortex of Male Methamphetamine-Dependent Patients.

The aim of this study was to explore the influence of different intensities of acute aerobic exercise on brain activation in male methamphetamine (MA)-dependent patients during exercise. Twenty MA-dependent patients were divided randomly into two groups participating in 35 min of either moderate- or high-intensity aerobic exercise. Functional near-infrared spectral imaging (fNIRS) was used to detect hemodynamic changes in prefrontal cortex during the main 25-min exercise stage. The results revealed that high-intensity acute aerobic exercise aroused more cerebral oxygenation changes in the prefrontal cortex and left dorsolateral prefrontal cortex during exercise as compared with moderate-intensity exercise. Furthermore, there was a stronger positive connection observed between orbital frontal cortex and left dorsolateral prefrontal cortex in the high-intensity group than in the moderate-intensity group. Together these results suggest that for submaximal exercise intensities, high-intensity exercise may bring more benefits to male MA-dependent patients than moderate-intensity.

Effect of Aerobic-Based Exercise on Psychological Well-Being and Quality of Life Among Older People: A Middle East Study.

The aimed to evaluate the effects of low and moderate-intensity aerobic exercise on psychological well-being (PWB) and quality of life (QoL) among older people. Forty-five male Iranian adults aged 65–80 years were selected according to the eligibility criteria and randomly assigned to a low-intensity group (LIG) (40–50% of maximum heart rate), moderate-intensity group (MIG) (60–70% of maximum heart rate) and control group (CG). The exercise protocols consisted of 12 weeks of aerobic exercise (two sessions per week). Psychological well-being and QoL were assessed through the Ryff's Psychological Well-being Scale and the World Health Organization QoL Questionnaire. The statistical analysis for psychological well-being indicated that a significant main group (between-group) (F = 11.777, p < 0.001, ηp2 = 0.359), time (within-group) (F = 58.983, p < 0.001, ηp2 = 0.584) and interaction effect (group × time) (F = 20.146, p < 0.001, ηp2 = 0.490) for PWB total score. Bonferroni post-hoc tests revealed that the PWB total score in the MIG group was more significant than both LIG (p = 0.003) and CG (p < 0.001). Results for PWB components including self-acceptance, positive relationships with others, autonomy, purposeful life, and environmental mastery revealed no significant differences (p > 0.05). While there was a significant difference between the groups for personal growth component. Bonferroni post-hoc tests revealed that the personal growth in the MIG group was more significant than both LIG (p = 0.028) and CG (p < 0.001). Result for QoL indicated significant differences for the main group (F = 13.277, p < 0.001, ηp2 = 0.387), time (F = 25.533, p < 0.001, ηp2 = 0.378) and interaction effect (F = 9.992, p < 0.001, ηp2 = 0.332) for QoL total scale. Bonferroni post-hoc tests revealed that the QoL total scale in the MIG group was more significant than both LIG (p = 0.003) and CG (p < 0.001). Results for QoL components including Physical health, Social relationships, Health environment revealed no significant differences (p > 0.05), while there was a significant difference between the groups for the Psychological health component. Bonferroni post-hoc tests revealed that the Psychological health in the MIG group was more significant than both LIG (p = 0.009) and CG (p = 0.002). Therefore, aerobic exercise improves PWB and QoL in older adults, moderate-intensity exercise seems to produce higher benefits than low-intensity, demonstrating a positive dose-response relationship.

Abstract 11193: Incremental Diabetogenic Effect of Statin According to Its Intensity in Acute Myocardial Infarction Patients Following Successful Percutaneous Coronary Intervention

Introduction: Although statin therapy is strongly recommended in acute myocardial infarction (AMI) patients, there has been consistent concern regarding the development of new onset diabetes mellitus (NODM). Currently, there has been no data whether diabetogenic effect of statin is intensity dependent. In this study, we investigated the impact of different statin intensity on incidence of NODM up to 3 years. Methods: Among 13,104 AMI patients enrolled in the Korea AMI Registry (KAMIR) between November 2011 and May 2015, we enrolled the 5,906 patients without diabetes mellitus and successful percutaneous coronary intervention (PCI). There were 22.8% (1,349/5,906) of patients received high intensity stain and 76.0% (4,488/5,906) patients received moderate intensity, and only 1.2% (69/5,906) patients received low intensity statin. The incidence of NODM were investigated among three different intensity of statins up to 3 years. Results: At baseline, high intensity statin group showed higher baseline LDL cholesterol level, body mass index, and abdominal circumference compared to other groups. In Kaplan-Meier curve, the cumulative incidence of NODM was significantly higher in high intensity group than mild and moderate intensity group (7.8% vs. 1.5% vs. 5.9% respectively, Log rank p-value = 0.002, Figure 1A). The incremental diabetogenic tendency was observed in each individual statin in dose-dependant manner (Figure 1B). In Cox regression, the intensity of statin was statistically significant prognostic factor of NODM after adjusting age, and other metabolic variables, such as body mass index, abdominal circumstance, and level of serum triglyceride. Conclusions: Among the AMI patients underwent successful PCI, higher intensity statin was associated with higher incidence of NODM, showing the diabetogenic effect of statin intensity.

Comparing Exercise-Induced Musculoskeletal Bleeding in Murine Models of Hemophilia A and B

Background: Hemophilia A and B are recessive X-linked bleeding disorders characterized by the deficiency in coagulation factor VIII and factor IX. Patients with the severe form of the disease can experience bleeding into the joints and muscle either spontaneously or after provoking events including sporting injuries of different degree. Patients are prone to bleeding in the musculoskeletal system. While most research is focused on hemarthrosis, muscle hematomas are not well studied although being the second most common complication of hemophilia, accounting for 10-25% of diagnosed bleeding episodes. There is limited consensus regarding optimal diagnosis and treatment of muscle hematomas in patients with hemophilia. We are investigating the effect of physical activity on muscle and joint bleeds in mouse models of hemophilia.Aim: The objective of this study was to compare the severity of exercise-induced skeletal bleedings in two mouse models of hemophilia A and B.Methods: Hemophiliac F8-KO and F9-KO mice, aged from 8-12 weeks old, were subjected to either mild or moderate daily treadmill exercise for 5 days. The speed was set at 10 meters per minute for the mild intensity group and 15 meters per minute for the moderate intensity group; and the animals were exercised for 30 minutes daily. Mechanical stimulus with a brush was used to encourage the animals to run. Animals were monitored daily and on day 6 (24 hours after the treadmill exercise) the animals were sacrificed to assess bleeding events. The mice skin was carefully removed and the body was macroscopically evaluated for presence of bleeds. If muscle bleedings were present, they were assigned a score in accordance with a previously published protocol (Tranholm M et al., JTH 2015 Jan;13(1):82-91) with minor modifications.Results: The animals were closely monitored during the study periods, and all completed the study. Normal behaviour and appearances were observed. No external bleeding was recorded. No muscle hematoma was observed in the wild-type C57-strain, thus the group received the bleeding score of 0. For the mild exercise group, the mean muscle bleeding score of F8-KO strain was 5.50 (standard error = 2.81), while the mean muscle bleeding score of F9-KO strain was 1 (standard error: 2). The two-tailed P value between the hemophilia A and B group was significant (p<0.01). For the moderate exercise group, the mean muscle bleeding score of F8-KO strain was 4.667 (standard error = 3.51), while the mean muscle bleeding score of F9-KO strain was 2.8 (standard error = 2.86). The two-tailed P value between the hemophilia A and B group was 0.33.Discussions: The preliminary analysis of our data showed that musculoskeletal bleeding induced by exercise appears to be more severe in hemophilia A mice than hemophilia B. This is in accordance with previous observations that hemophilia B may be clinically milder than hemophilia A. In our study, there appears to be a more significant difference between the hemophilia A and B mice when the mice were subject to milder form of exercise. No statistical significance was found between the two groups when moderate exercise was given. Overall, this exercise model can be a useful tool to study the pathophysiology of musculoskeletal bleeding as well as to evaluate new therapeutic strategies in the prevention and management of muscle hematomas in hemophilia. [Display omitted] DisclosuresGross: Leo Pharma: Honoraria; Bayer: Honoraria; BMS-Pfizer: Honoraria; Valeo: Honoraria. Matino: Bayer: Membership on an entity's Board of Directors or advisory committees, Other: research grants and personal fees; Pfizer: Membership on an entity's Board of Directors or advisory committees, Other: research grants and personal fees; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees, Other: research grants and personal fees; Sanofi: Membership on an entity's Board of Directors or advisory committees, Other: research grants and personal fees; Spark: Other: research grants; Octopharma: Membership on an entity's Board of Directors or advisory committees, Other: research grants and personal fees; Sobi: Membership on an entity's Board of Directors or advisory committees, Other: personal fees.

End-of-Life Healthcare Service Needs Among Children With Neurological Conditions: A Latent Class Analysis.

BACKGROUND: At the end of life, children with neurological conditions have complex healthcare needs that can be met by providing care of their life-limiting conditions concurrently with hospice care (ie, concurrent care). Given the limited literature on concurrent care for children with neurologic conditions, this investigation aimed to identify patterns of nonhospice, healthcare service needs and to assess characteristics of children within each group. METHODS: A nationally representative sample children with neurological conditions enrolled in concurrent hospice care was used. Latent class analysis and descriptive statistics were calculated to identify patterns of healthcare needs and characteristics of children within the groups. A subgroup analysis of infants was conducted. RESULTS: Among the 1601 children, the most common types of services were inpatient hospitals, durable medical equipment, and home health. Two classes of service needs were identified: moderate intensity (58%) and high intensity (42%). Children in the moderate-intensity group were predominantly between 1 and 5 years old, male, White, and non-Hispanic. The most common neurological condition was central nervous system degeneration. They also had significant comorbidities, mental/behavioral health conditions, and technology dependence. They commonly resided in urban areas in the South. Children in the high-intensity group had a wide range of neurological conditions and high acuity. The subgroup analysis of infants indicated a different neurological profile. CONCLUSIONS: Two distinct classes of nonhospice, healthcare service needs emerged among children with neurological conditions at the end of life. The groups had unique demographic profiles.

Effect of Acute Aerobic Exercise on Inhibitory Control of College Students with Smartphone Addiction.

Background Inhibitory control deficits may be one important cause for smartphone addiction. The available studies have shown that acute aerobic exercise may improve the inhibitory control. However, there is still lack of research on how regimens of an acute exercise affect this inhibitory control. The present study was to examine the effects of an acute aerobic exercise at three different exercise intensities on changes in the inhibitory control function including response inhibition and interference control in college students with smartphone addiction. Methods Participants (n = 30; age 20.03 ± 0.96 years) with smartphone addiction were identified by the Mobile Phone Addiction Tendency Scale for College Students and randomized to study 1 and study 2 with 15 individuals each. Fifteen participants in study 1 were tested by the Go/NoGo task to explore the response inhibition, while other fifteen in study 2 were tested by the Flanker task to examine the interference control. The participants in study 1 and 2 were randomly assigned to three groups (5 in each) with exercising at low, moderate, and high intensity. The individual response inhibition and interference control were measured before and after 30 minutes acute aerobic exercise, respectively. Results In study 1, the accuracy of NoGo stimulus after 30 minutes of acute aerobic exercise was significantly increased (p ≤ 0.001) while the response time (RT) of Go stimulus was significantly decreased (p ≤ 0.001). The largest changes occurred in the moderate-intensity group for the accuracy of NoGo stimulus (p=0.012) and for the RT of Go stimulus (p ≤ 0.001). The results in study 2 showed no significant change in all three groups after exercise. Conclusions 30 minutes of acute aerobic exercise could effectively elicit changes of the response inhibition in college students with smartphone addiction. The largest improvement was observed in the moderate intensity of an acute aerobic exercise in college students with smartphone addiction.

Association of the rs2167270 polymorphism of the leptin gene (LEP) with the intensity of pain in patients with osteoarthritis of the knee

Background: Osteoarthritis (OA) is a significant social problem as it is the most common disease of the joints. OA is a multifactorial disease in which great attention is paid to hereditary factors. Recently, a number of studies have demonstrated the contribution of a number of genes to the subjective assessment of pain in OA, which is the main symptom of this disease. The association of P2X7, TRPV1 and TACR1 genes and some others with pain sensitivity has been shown. One of the risk factors of pain among many others, is the increased weight. Abdominal adipose tissue is a source of release of pro-inflammatory adipokines that cause systemic inflammation associated with damage to many tissues, including subchondral bone, synovial membrane. Leptin is an endogenous hormone from the adipokine family encoded by the obesity gene leptin (LEP) and which is synthesized primarily in adipocytes.Aims: To investigate the possible association of rs2167270 (A19G) polymorphism of the LEP gene with pain intensity in ­patients with knee OA.Materials and methods: The study was conducted among women diagnosed with OA. Using the VAS scale (Visual analog scale), patients with mild knee pain — group 1 (VAS ≤ 40 mm) and patients with moderate or severe pain — group 2 (VAS&gt;40 mm) were selected for pain assessment. Genetic variants of A19G leptin gene polymorphism were studied by polymerase chain reaction followed by restriction fragment length analysis (PCR-RFLP) method.Results: In the group of patients with moderate or severe pain intensity (group 2, n=61), a statistically significant association was shown with a higher body mass index (p=0.006) and an increased frequency of carriers of the 19GG genotype (p=0,051) compared to group 1 (n=36). Carriers of the 19GG genotype statistically significantly had a higher rate of knee pain and an early age of OA debut compared to carriers of the 19AA genotype (p=0,035 and p=0,015, respectively).Conclusions: The findings open up new possibilities for predicting pain symptoms in patients with knee OA by genetic testing of A19G polymorphic variants of the leptin gene.

Moderate and high intensity exercise improves glycaemia, blood pressure and body composition in menopausal women with type 2 diabetes

Post-menopausal women are at high risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular diseases. Regular physical activity is recommended for treatment of chronic diseases. However, there is still no consensus about the intensity and type of exercise. This study aimed to evaluate the effects of combined functional training intensity on the cardiometabolic parameters of post-menopausal women with T2DM. Ninety-eight post-menopausal women with T2DM enrolled in the public health service of a Brazilian municipality were invited to participate in this study. Sixteen volunteers were divided into the moderate (MI) and high intensity (HI) groups. Functional training was performed 3 times a week. Anthropometric data, blood pressure, heart rate (HR), plasma glucose, glycated haemoglobin, total cholesterol, HDL-C, LDL-C and triacylglyceride (TG) levels were measured. Functional training reduced glycated haemoglobin and blood pressure levels and improved body composition in both groups. HI training improved HDL-C and TG levels, although a reduction in LDL-C was observed only in the MI group. Physical training did not modify the other evaluated parameters. The data showed that 8 weeks of functional training, regardless of intensity, is an effective strategy to improve glucose control and promote health benefits in post-menopausal women with T2DM.

Optimal aerobic exercise intensity and its influence on the effectiveness of exercise therapy in patients with pulmonary arterial hypertension: a systematic review.

BackgroundExercise intensity in exercise training programs is an important determinant of program efficacy, such as improvement in exercise capacity and quality of life (QOL). It is not well known whether differently applied exercise intensities are efficacious when used in exercise-based cardiac rehabilitation programs for patients with pulmonary arterial hypertension (PAH).MethodsThree databases (PubMed, EMBASE, and CINAHL) were searched with the following inclusion criteria: comparative study of exercise interventions for patients with pulmonary arterial hypertension. Three clinical specialists (a physician, nurse, and exercise physiologist) selected the included articles using the process of systematic review. Included articles were grouped according to aerobic exercise intensity: low, moderate-to-vigorous, and vigorous. The level of evidence for each study was rated using Sackett’s levels of evidence.ResultsOf 1,452 studies reviewed, 8 were included according to the inclusion criteria (3 randomized controlled trials (RCTs), 3 prospective studies, and 2 case series). Exercise capacity for a six-minute walk distance (mean: 57.7 m) and QOL improved in the above moderate intensity group, while the low intensity group did not show improvement after intervention. For termination criteria, data obtained from the reviewed articles were not sufficient to suggest any exercise intensity recommendations for patients with pulmonary arterial hypertension.DiscussionThe findings in this study suggest that at least moderate aerobic exercise intensity is needed to significantly improve six-minute walk distance and QOL in individuals diagnosed with World Health Organization Group 1 of pulmonary arterial hypertension. There is a need for prospective RCTs comparing different exercise intensities in this patient population.

English

Objective: The present study aimed to verify the influence of training intensity in the aquatic environment on pain, disability, physical capacity, and quality of life in patients with chronic low back pain. Design/Setting: A randomized clinical trial. Subjects: Twenty-two patients with chronic low back pain of both sexes (13 women and 9 men) participated in the study. Material and method: One group performed deep-water walking/running training at moderate intensity (MIT) and a second group performed deep-water walking/running training at high intensity (HIT). Pain, disability, peak oxygen uptake (VO2peak), and quality of life were assessed before and after an intervention. Results: Decreases in pain and disability were observed within both groups, without differences in these parameters between training groups. VO2peak did not change in either group after the training intervention. The results of the HIT group showed more significant improvements in quality of life than that of the MIT group, highlighting the social domain, psychological domain, and general quality of life. Both groups presented significant improvements in the physical and environmental domains of quality of life. Conclusions: Deep-water aerobic exercise training seems to be effective for improving pain symptoms and reducing the disability of people with chronic low back pain. These improvements seem to be independent of the intensity at which the training is performed. In addition, improving pain and disability does not directly reflect all areas of quality of life. In this case, the group that performed the intervention at high intensity achieved more significant improvements in quality of life.

High-intensity exercise and cognitive function in cognitively normal older adults: a pilot randomised clinical trial

BackgroundPhysical inactivity has been consistently linked to increased risk of cognitive decline; however, studies examining the impact of exercise interventions on cognition have produced inconsistent findings. Some observational studies suggest exercise intensity may be important for inducing cognitive improvements; however, this has yet to be thoroughly examined in older adult cohorts. The objective of the current study was to evaluate the effect of systematically manipulated high-intensity and moderate-intensity exercise interventions on cognition.MethodsThis multi-arm pilot randomised clinical trial investigated the effects of 6 months of high-intensity exercise and moderate-intensity exercise, compared with an inactive control, on cognition. Outcome measures were assessed at pre- (baseline), post- (6 months), and 12 months post-intervention. Ninety-nine cognitively normal men and women (aged 60–80 years) were enrolled from October 2016 to November 2017. Participants that were allocated to an exercise group (i.e. high-intensity or moderate-intensity) engaged in cycle-based exercise two times per week for 6 months. Cognition was assessed using a comprehensive neuropsychological test battery. Cardiorespiratory fitness was evaluated by a graded exercise test.ResultsThere was a dose-dependent effect of exercise intensity on cardiorespiratory fitness, whereby the high-intensity group experienced greater increases in fitness than the moderate-intensity and control groups. However, there was no direct effect of exercise on cognition.ConclusionsWe did not observe a direct effect of exercise on cognition. Future work in this field should be appropriately designed and powered to examine factors that may contribute to individual variability in response to intervention.Trial registrationThis study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000643370). Registered on 3 May 2017—retrospectively registered. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372780

LDL-cholesterol change and goal attainment following statin intensity titration among Asians in primary care: a retrospective cohort study

BackgroundClinical trials have demonstrated that either initiating or up-titrating a statin dose substantially reduce Low-Density Lipoprotein-Cholesterol (LDL-C) levels. However, statin adherence in actual practice tends to be suboptimal, leading to diminished effectiveness. This study aims to use real-world data to determine the effect on LDL-C levels and LDL-C goal attainment rates, when selected statins are titrated in Asian patients.MethodsA retrospective cohort study over a 5-year period, from April 2014 to March 2019 was conducted on a cohort of multi-ethnic adult Asian patients with clinical diagnosis of Dyslipidaemia in a primary care clinic in Singapore. The statins were classified into low-intensity (LI), moderate-intensity (MI) and high-intensity (HI) groups according to the 2018 American College of Cardiology and American Heart Association (ACC/AHA) Blood Cholesterol Guidelines. Patients were grouped into “No statin”, “Non-titrators” and “Titrators” cohorts based on prescribing patterns. For the “Titrators” cohort, the mean percentage change in LDL-C and absolute change in LDL-C goal attainment rates were computed for each permutation of statin intensity titration.ResultsAmong the cohort of 11,499 patients, with a total of 266,762 visits, there were 1962 pairs of LDL-C values associated with a statin titration. Initiation of LI, MI and HI statin resulted in a lowering of LDL-C by 21.6% (95%CI = 18.9–24.3%), 28.9% (95%CI = 25.0–32.7%) and 25.2% (95%CI = 12.8–37.7%) respectively. These were comparatively lower than results from clinical trials (30 to 63%). The change of LDL-C levels due to up-titration, down-titration, and discontinuation were − 12.4% to − 28.9%, + 13.2% to + 24.6%, and + 18.1% to + 32.1% respectively. The improvement in LDL-C goal attainment ranged from 26.5% to 47.1% when statin intensity was up-titrated.ConclusionIn this study based on real-world data of Asian patients in primary care, it was shown that although statin titration substantially affected LDL-C levels and LDL-C goal attainment rates, the magnitude was lower than results reported from clinical trials. These results should be taken into consideration and provide further insight to clinicians when making statin adjustment recommendations in order to achieve LDL-C targets in clinical practice, particularly for Asian populations.

Statins can benefit patients with primary membranous nephropathy on venous thromboembolism

Objective The aim of this study was to investigate the role of prophylactic use of statin in venous thromboembolism (VTE) in patients with primary membranous nephropathy (PMN). Methods A total of 734 patients with PMN were consecutively enrolled in this retrospective study. 564 patients had received statins prescription, while 170 patients did not. Kaplan–Meier methods were used for cumulative incidence plots of thromboembolic events and Cox proportional hazards regression models were used to assess risk factors. Finally, the effects of different potency of statins were evaluated. Results In the cohort, 37 patients (5.0%) experienced VTE. In a univariate Cox proportional hazard model, the hazard ratio (HR) for VTE in statin users versus statin non-users was 0.5 (95% CI 0.3–0.8, p = .03). Multivariable model proportional-hazards analysis corrected for co-medications and risk factors revealed that adjusted HR was 0.4 (95% CI 0.1–0.7, p = .03). According to the type and dose, statin users were assigned into 3 groups: high-intensity group (n = 278), moderate-intensity group (n = 186), and low-intensity group (n = 49). In comparison, incidences of VTEs in the three groups were similar (2.9% vs 4.8% vs 2.0%, p = .45). Conclusions The prophylactic use of statins could effectively decrease the occurrence of VTE in patients with PMN, and the benefits have no difference in different potency of statins.

The impact of aerobic training intensity on skeletal muscle PGC-1α, interferon regulatory factor 4, and atherogenic index in obese male Wistar rats

Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) is the main regulator in energy metabolism. Training stimulates many processes like mitochondrial biogenesis, glucose metabolism, and fatty acids metabolism. It also increases the capacity of fat oxidation. The purpose of this study was to investigate the effects of eight-week aerobic training of different intensities on PGC-1α, interferon regulatory factor 4 (IRF4), and atherogenic index in obese male Wistar rats. Twenty-four obese male rats induced by a high-fat diet (weight: 250 to 300 gr, BMI >30g/cm2) were divided into three groups: aerobic training of moderate intensity (MI), aerobic training of high intensity (HI), and the control group (C). The MI and HI training groups carried out exercise training by eight weeks of walking on a treadmill for five sessions/week, 60 min per session, and at a speed of 28 m/min and 34 m/min, respectively. The levels of PGC-1a in the MI and HI groups significantly increased compared to the C group (p 0.05). The serum HDL-C levels increased only in the MI group compared to the C group (p < 0.05). The LDL-C, TG, TC, and atherogenic index levels reduced more significantly in MI and HI groups than in the C group (p < 0.05). The results show that eight-week aerobic training of two moderate and high intensities may be the signaling pathways to the activation of the PGC-1a protein (i.e., a key regulator of energy metabolism and mitochondrial biogenesis) in skeletal muscle.

The Regulation of the Concentrations of Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-Alpha and Sirtuin 1 Protein in the Soleus Muscle by Aerobic Exercise Training in Obese Wistar Rats

Background: Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1a) and Sirtuin 1 (SIRT1) are significant indicators of obesity and other metabolic disorders. Objectives: The present study aimed to investigate the regulation of the concentrations of PGC-1a and SIRT1 protein in the soleus muscle by aerobic exercise training in obese Wistar rats. Methods: This study was conducted on 24 obese male rats, which were randomly categorized into three groups of control, medium-intensity training (28 m/min), and high-intensity training (34 m/min) after obesity induction through a high-fat diet. A series of aerobic trainings in five sessions of 60-minute aerobic training per week was performed for eight weeks. Data analysis was performed using one-way ANOVA to examine the mean differences between the groups. In addition, Tukey’s post-hoc test was used for the paired comparisons of the groups. Results: Significant differences were observed in the concentrations of the PGC-1a (P &lt; 0.001) and SIRT1 proteins between the study groups (P &lt; 0.001). Tukey’s post-hoc test revealed a significant difference between the moderate-intensity aerobic exercise and control groups (P &lt; 0.01) regarding their mean concentration of the PGC-1a protein. However, the high- and moderate-intensity groups showed no difference in this regard (P &lt; 0.028). Moreover, there was a significant difference in the concentration of the SIRT1 protein between the moderate-intensity aerobic exercise and control groups (P &lt; 0.02), and the high-intensity training and control groups (P &lt; 0.005). Conclusions: According to the results, aerobic exercise training could activate SIRT1 and PGC-1a and might enhance mitochondrial biogenesis in the subcutaneous fat. Therefore, aerobic training is recommended as a therapeutic approach to obesity and several other metabolic diseases.

Association between exercise and health-related quality of life and medical resource use in elderly people with diabetes: a cross-sectional population-based study

BackgroundExercise improves glycemic control and functional capacity in elderly people with diabetes; however, its effect on health-related quality of life (HRQoL) and medical resource use remains unclear. This study aims to clarify the effect of exercise.MethodsUsing the data from National Health and Nutrition Examination Survey between 2007 and 2016, we identified 1572 elderly people with diabetes for this cross-sectional population-based study. Demographic characteristics, health conditions, comorbidities, HRQoL, and medical resource were compared among four groups (no exercise, low-intensity exercise, moderate-intensity exercise, and high-intensity exercise).ResultsThe mean age of all participants was between 71.5 and 73.3 years. Male participants with higher education performed more exercise than their counterparts. The moderate- and high-intensity groups reported better general health condition than the no exercise group. Depression and worse health were more common in the no exercise group. Participants in the moderate-intensity exercise group had lower risk for depression than those in the no exercise group (adjusted odds ratio: 0.13, 95% confidence interval: 0.02–0.92) after adjusting for demographic characteristics, health conditions, and comorbidities, whereas participants in the low- and high-intensity exercise did not have a lower risk. The no exercise group had the highest proportions of emergency, hospitalization, and total healthcare visits.ConclusionsExercise is associated with better HRQoL, and lack of exercise is associated with higher medical resource use in elderly people with diabetes. Encouraging exercise is recommended in this population.

Concurrent Training and Detraining: The Influence of Different Aerobic Intensities.

Sousa, AC, Neiva, HP, Gil, MH, Izquierdo, M, Rodríguez-Rosell, D, Marques, MC, and Marinho, DA. Concurrent training and detraining: the influence of different aerobic intensities. J Strength Cond Res 34(9): 2565-2574, 2020-The aim of this study was to verify the effects of different aerobic intensities combined with the same resistance training on strength and aerobic performances. Thirty-nine men were randomly assigned to a low-intensity group (LIG), moderate-intensity group (MIG), high-intensity group (HIG), and a control group. The training program consisted of full squat, jumps, sprints, and running at 80% (LIG), 90% (MIG), or 100% (HIG) of the maximal aerobic speed for 16-20 minutes. The training period lasted for 8 weeks, followed by 4 weeks of detraining. Evaluations included 20-m sprints (0-10 m: T10; 0-20 m: T20), shuttle run, countermovement jump (CMJ), and strength (1RMest) in full squat. There were significant improvements from pre-training to post-training in T10 (LIG: 4%; MIG: 5%; HIG: 2%), T20 (3%; 4%; 2%), CMJ (9%; 10%; 7%), 1RMest (13%; 7%; 8%), and oxygen uptake (V[Combining Dot Above]O2max; 10%; 11%; 10%). Comparing the changes between the experimental groups, 1RMest gains were significantly higher in the LIG than HIG (5%) or MIG (6%). Furthermore, there was a tendency for higher gains in LIG and MIG compared with HIG, with "possibly" or "likely" positive effects in T10, T20, and CMJ. Detraining resulted in performance decrements, but minimal losses were found for V[Combining Dot Above]O2max in LIG (-1%). Concurrent training seems to be beneficial for strength and aerobic development regardless of the aerobic training intensity. However, choosing lower intensities can lead to increased strength and is recommended when the cardiorespiratory gains should be maintained for longer.