Inflammatory Cytokine Profiles During Exercise in Obese, Diabetic, and Healthy Children

Objective: Modulation of inflammatory status is considered a key component of the overall health effects of exercise. This may be especially relevant in children with obesity (Ob) or type 1 diabetes (T1DM), in which an imbalance between pro- and anti-inflammatory mediators could accelerate onset and progression of cardiovascular complications. To date, exercise-induced alterations in immuno-modulatory mediators in Ob and T1DM children remain largely unknown

Improved predictive models for plasma glucose estimation from multi-linear regression analysis of exhaled volatile organic compounds

Exhaled volatile organic compounds (VOCs) represent ideal biomarkers of endogenous metabolism and could be used to noninvasively measure circulating variables, including plasma glucose. We previously demonstrated that hyperglycemia in different metabolic settings (glucose ingestion in pediatric Type 1 diabetes) is paralleled by changes in exhaled ethanol, acetone, and methyl nitrate. In this study we integrated these gas changes along with three additional VOCs (2 forms of xylene and ethylbenzene) into multi-linear regression models to predict plasma glucose profiles in 10 healthy young adults, during the 2 h following an intravenous glucose bolus (matched samples of blood, exhaled and room air were collected at 12 separate time points). The four-gas model with highest predictive accuracy estimated plasma glucose in each subject with a mean R value of 0.91 (range 0.70–0.98); increasing the number of VOCs in the model only marginally improved predictions (average R with best 5-gas model = 0.93; with 6-gas model = 0.95). While practical development of this methodology into clinically usable devices will require optimization of predictive algorithms on large-scale populations, our data prove the feasibility and potential accuracy of breath-based glucose testing

Bone mineral density and leg muscle strength in young Caucasian, Hispanic, and Asian women.

Differences in bone mineral density (BMD) of ethnically diverse populations are usually attributed to anthropometric characteristics, but may also be due to life style or diet. We studied healthy young sedentary women with Asian (ASN, n=40), Hispanic (HIS, n=39), or Caucasian (CAU, n=36) backgrounds. Body composition and regional BMD were measured by dual-energy X-ray absorptiometry (Hologic) or PIXI (Lunar GE) for the heel and wrist). Leg strength was quantified with a leg press and dietary calcium was estimated with 3-d diet records. CAU were taller than HIS and ASN (p<0.01). ASN had lower body weights, fat mass, lean body mass, and leg strength than HIS or CAU (p<0.01). Differences in BMD among groups were not eliminated by adjusting for body weight and height at the arm, trochanter, femoral neck, and total hip where BMD values remained lower in the ASN than in HIS or CAU (p<0.01). Conversely, adjusted BMD at the wrist was 7.3% higher in ASN and 8.3% higher in HIS and at the heel, 7.3% higher in ASN and 7.0% higher in HIS than in CAU (p<0.05). Leg strength was a significant predictor of BMD in the hip in CAU (R=0.53, p=0.004), in the hip with dietary calcium in ASN (R=0.65, p=0.02), and in the heel with height in HIS (R=0.57, p=0.03). We conclude that significant factors underlying BMD in ethnically diverse young women vary as a function of ethnicity and include leg strength and dietary calcium as well as anthropometric characteristics

Bone mineral density and leg muscle strength in young Caucasian, Hispanic, and Asian women.

Differences in bone mineral density (BMD) of ethnically diverse populations are usually attributed to anthropometric characteristics, but may also be due to life style or diet. We studied healthy young sedentary women with Asian (ASN, n=40), Hispanic (HIS, n=39), or Caucasian (CAU, n=36) backgrounds. Body composition and regional BMD were measured by dual-energy X-ray absorptiometry (Hologic) or PIXI (Lunar GE) for the heel and wrist). Leg strength was quantified with a leg press and dietary calcium was estimated with 3-d diet records. CAU were taller than HIS and ASN (p<0.01). ASN had lower body weights, fat mass, lean body mass, and leg strength than HIS or CAU (p<0.01). Differences in BMD among groups were not eliminated by adjusting for body weight and height at the arm, trochanter, femoral neck, and total hip where BMD values remained lower in the ASN than in HIS or CAU (p<0.01). Conversely, adjusted BMD at the wrist was 7.3% higher in ASN and 8.3% higher in HIS and at the heel, 7.3% higher in ASN and 7.0% higher in HIS than in CAU (p<0.05). Leg strength was a significant predictor of BMD in the hip in CAU (R=0.53, p=0.004), in the hip with dietary calcium in ASN (R=0.65, p=0.02), and in the heel with height in HIS (R=0.57, p=0.03). We conclude that significant factors underlying BMD in ethnically diverse young women vary as a function of ethnicity and include leg strength and dietary calcium as well as anthropometric characteristics

Resting and exercise-induced IL-6 levels in children with Type 1 diabetes reflect hyperglycemic profiles during the previous 3 days

Poor glycemic control in Type 1 diabetes (T1DM) causes long-term cardiovascular complications, at least in part via chronic, low-grade inflammation associated with recurrent hyperglycemia. While physical activity can reduce both inflammation and cardiovascular risks, the underlying molecular mechanisms remain unclear. This is particularly important for T1DM children, for whom the prevention of long-term cardiovascular complications must include optimization of exercise-related anti-inflammatory strategies. We therefore studied the effect of prior hyperglycemia on resting and exercise-induced inflammatory status (plasma IL-6) in T1DM children. Glycemia was continuously recorded with a continuous glucose monitoring system (CGMS) system for 63 h preceding a 30-min intermittent cycling exercise protocol at ∼80% peak rate of oxygen uptake (V̇o2max). Euglycemia (4.4–6.1 mM) was maintained for 90 min before, during, and 30 min after exercise. IL-6 plasma concentration (pg/ml) was measured at baseline, at end exercise, and 30 min postexercise. Subjects were then divided into quartiles based on average glycemia during the CGMS recording. IL-6 levels (pg/ml) were lowest in the quartile with lowest average 3-day glycemia and increased proportionally to greater hyperglycemic exposure; this was observed at baseline (0.86 ± 0.10, 1.06 ± 0.16, 1.14 ± 0.14, 1.20 ± 0.16), absolute IL-6 change (Δ) at end exercise (0.20 ± 0.16, 0.32 ± 0.10, 0.48 ± 0.09, 0.62 ± 0.13), and Δ at 30 min postexercise (0.49 ± 0.13, 0.71 ± 0.16, 0.89 ± 0.14, 1.38 ± 0.33). Therefore, poorly controlled glycemic profile, even in the 63 h preceding an exercise challenge, can alter inflammatory adaptation in T1DM children. Our data underscore the necessity to fully understand all molecular aspects of physical activity to provide the scientific rationale for exercise regimens that will be able to maximize health benefits for T1DM children

Negative energy balance plays a major role in the IGF-I response to exercise training.

Circulating IGF-I is correlated with fitness, but results of prospective exercise training studies have been inconsistent, showing both increases and decreases in IGF-I. We hypothesized that energy balance, often not accounted for, is a regulating variable such that training plus an energy intake deficit would cause a reduction in IGF-I, whereas training plus energy intake excess would lead to an increased IGF-I. To test this, 19 young, healthy men completed a 7-day strenuous exercise program in which they were randomly assigned to either a positive energy balance [overfed (OF), n = 10] or negative energy balance [underfed (UF), n = 9] group. IGF-I (free and total), insulin, and IGF-binding protein-1 were measured before, during, and 1 wk after the training. Weight decreased in the UF subjects and increased in the OF subjects. Free and total IGF-I decreased substantially in the UF group (P < 0.0005 for both), but, in the OF group, IGF-I remained unchanged. The UF group also demonstrated an increase in IGF-binding protein-1 (P < 0.027), whereas glucose levels decreased (P < 0.0005). In contrast, insulin was reduced in both the OF and UF exercise-training groups (P < 0.044). Finally, within 7 days of the cessation of the diet and training regimen, IGF-I and IGF-binding protein-1 in the UF group returned to preintervention levels. We conclude that energy balance during periods of exercise training influences circulating IGF-I and related growth mediators. Exercise-associated mechanisms may inhibit increases in IGF-I early in the course of a training protocol, even in overfed subjects

Negative energy balance plays a major role in the IGF-I response to exercise training.

Circulating IGF-I is correlated with fitness, but results of prospective exercise training studies have been inconsistent, showing both increases and decreases in IGF-I. We hypothesized that energy balance, often not accounted for, is a regulating variable such that training plus an energy intake deficit would cause a reduction in IGF-I, whereas training plus energy intake excess would lead to an increased IGF-I. To test this, 19 young, healthy men completed a 7-day strenuous exercise program in which they were randomly assigned to either a positive energy balance [overfed (OF), n = 10] or negative energy balance [underfed (UF), n = 9] group. IGF-I (free and total), insulin, and IGF-binding protein-1 were measured before, during, and 1 wk after the training. Weight decreased in the UF subjects and increased in the OF subjects. Free and total IGF-I decreased substantially in the UF group (P < 0.0005 for both), but, in the OF group, IGF-I remained unchanged. The UF group also demonstrated an increase in IGF-binding protein-1 (P < 0.027), whereas glucose levels decreased (P < 0.0005). In contrast, insulin was reduced in both the OF and UF exercise-training groups (P < 0.044). Finally, within 7 days of the cessation of the diet and training regimen, IGF-I and IGF-binding protein-1 in the UF group returned to preintervention levels. We conclude that energy balance during periods of exercise training influences circulating IGF-I and related growth mediators. Exercise-associated mechanisms may inhibit increases in IGF-I early in the course of a training protocol, even in overfed subjects

Inflammatory cytokine profiles during exercise in obese, diabetic, and healthy children.

Modulation of inflammatory status is considered a key component of the overall health effects of exercise. This may be especially relevant in children with obesity (Ob) or type 1 diabetes (T1DM), in which an imbalance between pro- and anti-inflammatory mediators could accelerate onset and progression of cardiovascular complications. To date, exercise-induced alterations in immuno-modulatory mediators in Ob and T1DM children remain largely unknown.In this study, we monitored the kinetic profiles of 8 pro-and anti-inflammatory cytokines (TNF-a, IL-6, IL-2, IL-8, IL-5, IL-13, IL-10, IL-4) during a standardized exercise challenge (ten 2-min cycling bouts at 80% VO2max, separated by 1-min intervals) in 23 Ob (12 females, 11 males), 23 T1DM (10 females and 13 males) patients and 20 healthy (CL, 10 females and 10 males) children. Blood glucose of T1DM patients was kept in the 4.4-6.1 mM range for at least 90 minute prior to and during exercise. Blood samples were drawn at rest and after every other exercise bout.In Ob, TNF-a and IL-2 were significantly greater (p<0.0167) as compared to T1DM and CL, both at baseline and throughout exercise. All other variables, while not significant, were quantitatively elevated in Ob vs. CL. In T1DM, IL-4 and IL-8 levels were similar to Ob, IL-2 and TNF-a similar to CL, and IL-6, IL-5, IL-13, IL-4 levels were intermediate between the Ob and CL groups.During exercise, therefore, both Ob and T1DM children displayed exaggerated pro-inflammatory responses, although with clearly different magnitude and involved mediators. Our data support the necessity to identify specific exercise formats through which each at-risk pediatric population can draw maximal beneficial health effects