Resistance exercise program for 6 months seems to be effective in reducing inflammation and PEW of HD patients. The universal trial number of this study is U1111-1139-1326.
Irisin, a hormone secreted by myocytes induced in exercise, acts as a muscle-derived energy-expenditure signal that binds to undetermined receptors on the white adipose tissue surface, stimulating its browning and uncoupling protein 1 (UCP1) expression. The purpose of this study was to assess the effect of an intradialytic resistance exercise training program (RETP) on plasma irisin levels of hemodialysis (HD) patients and compare the baseline plasma irisin levels of HD patients to healthy subjects. This longitudinal study enrolled 26 patients undergoing HD (50% men, 44.8±14.1 years, body mass index (BMI) 23.5±3.9 kg/m²). The healthy subjects group consisted of 11 women and 7 men with mean age of 50.9±6.6 years and BMI, 24.2±2.7 kg/m². Anthropometric and biochemistry parameters (Irisin by Enzyme-Linked Immunosorbent Assay) were measured at the baseline and after 6 months of RETP (in both lower limbs). There was no difference regarding gender, age, and BMI between HD patients and healthy subjects. Plasma irisin levels in HD patients were lower than in healthy subjects (71.0±41.6 vs. 101.3±12.5 ng/ml, p<0.05). Although the muscle mass increased in consequence of exercise [evaluated by arm muscle area from 27.9 (24.1) to 33.1 (19.0) cm²], plasma irisin did not differ significantly after exercises (71.0±41.6 vs. 73.3±36.0 ng/ml). HD patients seem to have lower plasma irisin when compared to healthy subjects. Moreover, a resistance exercise training program was unable to augment plasma irisin despite increasing muscle mass.
A autoavaliação da imagem corporal é uma construção multidimensional por meio da qual os indivíduos descrevem as representações internas da estrutura corporal e da aparência física, em relação a si próprio e aos outros. As Escalas de Silhuetas são testes que viabilizam a autoavaliação, especialmente em pesquisas de campo, devido ao baixo custo e facilidade na administração do método. O objetivo deste trabalho foi resgatar as Escalas de Silhuetas construídas ou adaptadas desde 1983 e realizar uma revisão sistemática sobre a validação destas frente a medidas objetivas do estado nutricional. Foram identificados 33 estudos com grande variação na correlação com o estado nutricional de adultos, tanto para as Escalas de Silhuetas adaptadas (coeficientes de correlação de 0,66 a 0,87) quanto para as construídas (0,59 a 0,94). Já em crianças e adolescentes, as correlações entre as Escalas de Silhuetas e o estado nutricional não resultaram em valores satisfatórios em vários dos estudos. Muitos trabalhos utilizaram estatística inapropriada. Os dados da presente revisão indicam que deve-se ter cuidado no uso de Escalas de Silhuetas para estimar o estado nutricional com ou sem a medição antropométrica.
Marinho, SM, Moraes, C, Barbosa, JEdSM, Eduardo, JCC, Fouqe, D, Pelletier, S, and Mafra, D. Exercise training alters the bone mineral density of hemodialysis patients. J Strength Cond Res 30(10): 2918-2923, 2016-Patients with chronic kidney disease undergoing hemodialysis (HD) frequently present low bone mineral density (BMD), and exercise may be useful for treating bone loss. This study aimed to assess the effects of an intradialytic resistance exercise training program (RETP) on BMD in HD patients. Twenty-one patients were enrolled into 2 groups; 10 patients performed exercise (80.0% men; 46.9 ± 12.1 years; 27.0 ± 3.4 kg·m) and 11 patients were in the control group (54.5% men; 50.5 ± 11.5 years; 24.1 ± 8.7 kg·m). Dual-energy x-ray absorptiometry was used to measure the BMD, lean mass, and body fat before and after the supervised RETP (performed with elastic bands and ankle cuffs in both lower limbs 3 times a week for 24 weeks-72 sessions). In the exercise group, 30.0% of patients presented with osteopenia and 20.0% osteoporosis and in the control group, 45.5% osteopenia and 36.4% osteoporosis. Only in the exercise group, the osteoporosis percentage was reduced to 10.0% and the femoral neck BMD and T-score improved from 0.89 ± 0.1 to 0.93 ± 0.1 g·cm and from -1.3 ± 0.8 to -1.0 ± 0.8 g·cm (p ≤ 0.05), respectively, after the intervention. In contrast, these parameters were reduced in the control group. The results suggest that resistance exercise may be useful for improving the BMD in HD patients. In summary, 24 weeks of the supervised RETP played a role in improving the BMD of HD patients.
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