Background and Purpose-Stroke survivors experience disproportionate muscle atrophy and other detrimental tissue composition changes on the paretic side. The purpose was to determine whether myostatin levels are higher in paretic vs nonparetic muscle and the effects of resistive training (RT) on paretic and nonparetic mid-thigh muscle composition and myostatin mRNA expression in stroke survivors. Methods-Fifteen stroke survivors (50 -76 years) underwent bilateral multi-slice thigh CT scanning from the knee to the hip, bilateral vastus lateralis skeletal muscle tissue biopsies, a total body scan by dual-energy X-ray absorptiometry, and 1-repetition maximum strength test before and after a 12-week, (3 times/week) RT intervention. Results-Total body fat mass and fat-free mass did not change. Bilateral leg press and leg extension 1-repetition maximum strength increased 31% to 56% with RT (PϽ0.001). Paretic and nonparetic muscle area of the mid-thigh increased 13% (PϽ0.01) and 9% (PϽ0.05), respectively, after RT. Muscle attenuation of the mid-thigh increased 15% and 8% (both PϽ0.01) in the paretic and nonparetic thigh, respectively, representing reduced intramuscular fat. Muscle volume increased 14% (PϽ0.001) in the paretic thigh and 16% (PϽ0.05) in the nonparetic thigh after RT. Myostatin mRNA expression levels were 40% higher in the paretic than nonparetic muscle (Pϭ0.001) at baseline and decreased 49% in the paretic muscle (PϽ0.005) and 27% in the nonparetic muscle (Pϭ0.06) after RT. Conclusions-Progressive RT stimulates significant muscle hypertrophy and intramuscular fat reductions in disabled stroke survivors. The increased myostatin mRNA in the paretic thigh and reduction with RT imply an important regulatory role for myostatin after stroke. (Stroke. 2011;42:416-420.)

Intramuscular signaling and glucose transport mechanisms contribute to improvements in insulin sensitivity after aerobic exercise training. This study tested the hypothesis that increases in skeletal muscle capillary density (CD) also contribute to exercise-induced improvements in whole-body insulin sensitivity (insulin-stimulated glucose uptake per unit plasma insulin [M/I]) independent of other mechanisms. The study design included a 6-month aerobic exercise training period followed by a 2-week detraining period to eliminate short-term effects of exercise on intramuscular signaling and glucose transport. Before and after exercise training and detraining, 12 previously sedentary older (65 ± 3 years) men and women underwent research tests, including hyperinsulinemic-euglycemic clamps and vastus lateralis biopsies. Exercise training increased Vo2max (2.2 ± 0.2 vs. 2.5 ± 0.2 L/min), CD (313 ± 13 vs. 349 ± 18 capillaries/mm2), and M/I (0.041 ± 0.005 vs. 0.051 ± 0.007 μmol/kg fat-free mass/min) (P < 0.05 for all). Exercise training also increased the insulin activation of glycogen synthase by 60%, GLUT4 expression by 16%, and 5′ AMPK-α1 expression by 21%, but these reverted to baseline levels after detraining. Conversely, CD and M/I remained 15% and 18% higher after detraining, respectively (P < 0.05), and the changes in M/I (detraining minus baseline) correlated directly with changes in CD in regression analysis (partial r = 0.70; P = 0.02). These results suggest that an increase in CD is one mechanism contributing to sustained improvements in glucose metabolism after aerobic exercise training.

Non-technical summary Circulating angiogenic cells (CACs) repair and maintain the vascular endothelium. CACs are responsive to lifestyle factors such as diet and physical activity. For example, their capacity to regenerate the endothelium is impaired in cardiovascular disease patients, whereas exercise training can improve CAC function. In this study, we examined the effects of a high-fat meal with and without prior endurance exercise on several molecular aspects of CAC function, including levels of reactive oxygen species (ROS), nitric oxide (NO), intracellular lipids, and gene expression. Our results indicated that the high-fat meal induced significant oxidative stress (i.e. ROS production) in the CACs that expressed the cell surface protein CD31. However, when subjects performed a single bout of exercise on the prior day, the meal had no effect on ROS in CD31 + cells. Therefore, we concluded that prior exercise prevents the oxidative stress induced by a high-fat meal in CD31 + CACs.Abstract We hypothesized that prior exercise would prevent postprandial lipaemia (PPL)-induced increases in intracellular reactive oxygen species (ROS) in three distinct circulating angiogenic cell (CAC) subpopulations. CD34 + , CD31 + /CD14 − /CD34 − , and CD31 + /CD14 + /CD34 − CACs were isolated from blood samples obtained from 10 healthy men before and 4 h after ingesting a high fat meal with or without ∼50 min of prior endurance exercise. Significant PPL-induced increases in ROS production in both sets of CD31 + cells were abolished by prior exercise. Experimental ex vivo inhibition of NADPH oxidase activity and mitochondrial ROS production indicated that mitochondria were the primary source of PPL-induced oxidative stress. The attenuated increases in ROS with prior exercise were associated with increased antioxidant gene expression in CD31 + /CD14 − /CD34 − cells and reduced intracellular lipid uptake in CD31 + /CD14 + /CD34 − cells. These findings were associated with systemic cardiovascular benefits of exercise, as serum triglyceride, oxidized low density lipoprotein-cholesterol, and plasma endothelial microparticle concentrations were lower in the prior exercise trial than the control trial. In conclusion, prior exercise completely prevents PPL-induced increases in ROS in CD31 + /CD14 − /CD34 − and CD31 + /CD14 + /CD34 − cells. The mechanisms underlying the effects of exercise on CAC function appear to vary among specific CAC types.