Caracterización del estrés oxidativo pulmonar en ejercicio aeróbico prolongado, usando el método de aire exhalado condensado

[spa] Cada vez son más las personas que practican ejercicio físico de larga duración (>30 minutos) y a altas intensidades. Lo anterior se ve reflejado en el aumento significativo de competencias de carreras urbanas en el mundo. Es reconocido el efecto oxidante e inflamatorio del ejercicio sobre el pulmón, sin embargo aún no existe consenso sobre los niveles de intensidad y duración necesaria para desencadenar ambas reacciones, menos aún, se conocen las consecuencias clínicas que ambas respuestas puedan estar produciendo en el organismo. Se ha descrito como principal desencadenante de la respuesta oxidativa e inflamatoria inducida por ejercicio a la sequedad del epitelio inducido por hiperventilación derivada del ejercicio físico. Sin embargo, existen factores capaces de agravar estas respuestas, es el caso de algunos componentes ambientales como el cloro en piscinas, hipoxia o hiperoxia, aire contaminado, etc. Por otro lado, el nivel de entrenamiento, el tipo de ejercicio, el grado de hidratación, entre otros, también pueden afectar el desarrollo de ambas respuestas en el pulmón. Esta tesis consta de una primera parte donde se describen los mecanismos fisiológicos que producen el aumento de los pro-oxidantes y como se relacionan con la respuesta pulmonar inducida por ejercicio. Una segunda parte contiene tres documentos científicos que han sido publicados en revistas de la especialidad, los cuales han permitido llevar a cabo 3 objetivos: i) Dar a conocer la información actualizada sobre los efectos oxidativo e inflamatorios pulmonares inducidos por ejercicio en modelos animales y humanos; ii) caracterizar los efectos del ejercicio de alta intensidad en ambiente externo (no controlado); y iii) caracterizar los efectos de la duración del ejercicio de intensidad baja en ambiente de laboratorio (controlado). Para el primer objetivo se llevó a cabo una revisión bibliográfica que abordó los mecanismos implicados en la producción de pro-oxidantes, daño oxidativo e inflamación pulmonar inducidos por ejercicio físico en humanos y animales sanos, incluyendo aspectos tales como niveles de entrenamiento físico, duración e intensidad del ejercicio, efecto agudo y/o crónico, e influencia de condiciones ambientales (frío, altitud y contaminación del aire). Las muestras pulmonares incluyeron fueron: i) homogeneizados de tejido pulmonar, líquido de lavado bronco-alveolar y biopsias (invasivas), esputo inducido (semi-invasiva) y aire exhalado condensado y no condensado (no invasivas). En el documento se destaca la masificación del uso del AEC como una técnica no invasiva y confiable, principalmente en humanos. Para el segundo objetivo se realizó un estudio experimental con sujetos levemente entrenados, los cuales que realizaron ejercicio a alta intensidad en una carrera de 10 kilómetros al aire libre. Aquí se compararon variables oxidativas (peróxido de hidrógeno, nitrito, malondialdehído) e inflamatorias (pH) pulmonares (desde el aire exhalado condensado) y sanguíneas, antes y después del ejercicio. Se observó un aumento de pro-oxidantes pulmonares sin provocar lipoperoxidación, no así en la sangre. Si bien no hubo descenso significativo del pH, sí se observó una tendencia a mayor oxidación. Para el tercer objetivo se estudió la oxidación e inflamación pulmonar inducida por un ejercicio de baja intensidad (~30% VO2max) con diferentes tiempos de duración. Se midieron los pro-oxidantes (peróxido de hidrógeno y nitritos) y pH desde el aire exhalado condensado, antes y después del ejercicio. Se observó una mayor concentración de pro-oxidantes pulmonares a mayor tiempo de ejercicio, pero no en sangre. La tercera parte contempla una discusión y conclusión general de los resultados, abarcando todos los aspectos revisados en los tres documentos, entregando una visión determinante sobre ambos fenómenos inducidos por ejercicio, además se presentan algunas proyecciones para encaminar al lector a futuras líneas de investigación en este tema.[eng] Although the oxidative and inflammatory effects induced by exercise in the lungs are well established, there is no consensus in the intensity and duration of the exercise necessary to trigger both reactions. Epithelial dryness induced by hyperventilation during exercise is the main cause of oxidative and inflammatory response in the lungs. However, many other factors are capable of aggravating these responses (chlorine in swimming pools, hypoxia or hyperoxia, polluted air). The first part of this thesis describes the physiological mechanisms that increase pro-oxidants and how these mechanisms are related to oxidative and inflammatory effects of the exercise in the lungs. The second part includes three manuscripts, and three purposes as follows: i) To provide up to date information on the oxidative and inflammatory effects induced by exercise in animal and human models; ii) To characterize the effects of high intensity exercise on an external environment (not controlled), and (iii) to characterize the effects of the duration of the exercise at low intensity in a laboratory environment (controlled). For the first purpose, a bibliographic review was developed addressing the mechanisms involved in the production of pro-oxidants and pulmonary inflammation induced by physical exercise in healthy humans and animals. Levels of physical training, type of the samples, duration and intensity of exercise, acute and/or chronic effects, and the influence of environmental conditions (cold, altitude and air pollution) were measured. For the second purpose, an experimental study was performed in slightly trained subjects, who performed high-intensity exercise in a 10-kilometer outdoor race. An increase in pulmonary pro-oxidants was observed with no lipid peroxidation. For the third purpose, also slightly trained subjects, performed exercise at low intensity and different duration times (10, 30 and 90 minutes). A higher concentration of pulmonary pro-oxidants was observed for a longer time of exercise (90 minutes). The third part includes a general discussion and conclusion of the results of the three manuscripts, providing a determinant vision over the oxidative and inflammatory effects induced by exercise. In addition, some projections are presented

Near-Infrared Spectroscopy Used to Assess Physiological Muscle Adaptations in Exercise Clinical Trials: A Systematic Review

[EN] Using muscle oxygenation to evaluate the therapeutic effects of physical exercise in pathologies through near-infrared spectroscopy (NIRS) is of great interest. The aim of this review was to highlight the use of muscle oxygenation in exercise interventions in clinical trials and to present the technological characteristics related to the equipment used in these studies. PubMed, WOS, and Scopus databases were reviewed up to December 2021. Scientific articles that evaluated muscle oxygenation after exercise interventions in the sick adult population were selected. The PEDro scale was used to analyze the risk of bias (internal validity). The results were presented grouped in tables considering the risk of bias scores, characteristics of the devices, and the effects of exercise on muscle oxygenation. All the stages were carried out using preferred reporting items for systematic reviews and meta-analyses (PRISMA). The search strategy yielded 820 clinical studies, of which 18 met the eligibility criteria. This review detailed the characteristics of 11 NIRS devices used in clinical trials that used physical exercise as an intervention. The use of this technology made it possible to observe changes in muscle oxygenation/deoxygenation parameters such as tissue saturation, oxyhemoglobin, total hemoglobin, and deoxyhemoglobin in clinical trials of patients with chronic disease. It was concluded that NIRS is a non-invasive method that can be used in clinical studies to detect the effects of physical exercise training on muscle oxygenation, hemodynamics, and metabolism. It will be necessary to unify criteria such as the measurement site, frequency, wavelength, and variables for analysis. This will make it possible to compare different models of exercise/training in terms of time, intensity, frequency, and type to obtain more precise conclusions about their benefits for patients.S

Effects of Inspiratory Muscle Training on Muscle Oxygenation during Vascular Occlusion Testing in Trained Healthy Adult Males

[EN] Inspiratory muscle training (IMT) may have an additional effect on cardiovascular autonomic modulation, which could improve the metabolism and vascular function of the muscles. Aim: To determine the effects of IMT on vascular and metabolic muscle changes and their relationship to changes in physical performance. Methods: Physically active men were randomly placed into an experimental (IMTG; n = 8) or IMT placebo group (IMTPG; n = 6). For IMT, resistance load was set at 50% and 15% of the maximum dynamic inspiratory strength (S-Index), respectively. Only the IMTG’s weekly load was increased by 5%. In addition, both groups carried out the same concurrent training. Besides the S-Index, a 1.5-mile running test, spirometry, and deoxyhemoglobin (HHbAUC during occlusion) and reperfusion tissue saturation index (TSIMB and TSIMP: time from minimum to baseline and to peak, respectively) in a vascular occlusion test were measured before and after the 4-week training program. In addition, resting heart rate and blood pressure were registered. Results: IMTG improved compared to IMTPG in the S-Index (Δ = 28.23 ± 26.6 cmH2O), maximal inspiratory flow (MIF: Δ = 0.91 ± 0.6 L/s), maximum oxygen uptake (Δ = 4.48 ± 1.1 mL/kg/min), 1.5-mile run time (Δ = −0.81 ± 0.2 s), TSIMB (Δ = −3.38 ± 3.1 s) and TSIMP (Δ = −5.88 ± 3.7 s) with p < 0.05. ΔVO2max correlated with S-Index (r = 0.619) and MIF (r = 0.583) with p < 0.05. Both ΔTSIMB and TSIMP correlated with ΔHHbAUC (r = 0.516 and 0.596, respectively) and with Δ1.5-mile run time (r = 0.669 and 0.686, respectively) with p < 0.05. Conclusion: IMT improves vascular function, which is related to additional improvements in physical performance.S

Maximum oxygen consumption and muscle efficiency in non-professional youth and professional adultsoccer players

El fútbol ha sido descrito como un deporte de esfuerzos máximos y/o casi máximos,superpuestos sobre una base de ejercicios de baja o moderada intensidad. La evidencia disponible sugiere que los futbolistas masculinos adultos cubren distancias aproximadas de 10 a 12 km durante un partido y 8,1 km en los jugadores Juveniles.El objetivo del estudio es comparar los parámetros de potencia aeróbica máxima de futbolistas profesionales yjugadores juveniles.Se realizóun estudio de tipo descriptivo correlacional de corte transversal, participaron 52 futbolistas adultos y 57 futbolistas juveniles. Los resultados informaron que el VO2máximoabsoluto no presenta diferencia significativa entre adultos vs juveniles; El VO2máximo relativo en ml/kg-min presenta diferencia significativa en favor de los Juveniles; La velocidad aeróbicamáxima en Km/h presenta diferencia significativa en favor de los adultos y la eficiencia muscular en porcentaje presenta diferencia significativa en favor de los adultos. En conclusión,los futbolistas profesionales adultos presentan un VO2máximoabsoluto similar a futbolistas juveniles; el consumo de oxígeno relativo es mayor en los futbolistas jóvenes; pero la velocidad aeróbica máxima y la eficiencia muscular vuelve a ser mayor en futbolistas adultos.Soccer has been described as a maximal and/or near-maximal effort sport, layered on a low to moderate intensity exercise base. The available evidence suggests that adult male soccer players cover approximate distances of 10 to 12 km during a match and 8.1 km for youth players. The objective of the study is to compare the maximum aerobic power parameters of professional soccer players and youth players. A cross-sectional correlational descriptive study was carried out, 52 adult soccer players and 57 youth soccer players participated. The results reported that the absolute maximum VO2 does not present a significant difference between adults vs juveniles; The relative maximum VO2 in ml/kg-min presents a significant difference in favor of the Juveniles; The maximum aerobic speed in km/h presents a significant difference in favor of the adults and the muscular efficiency in percentage presents a significant difference in favor of the adults. In conclusion, adult professional soccer players have an absolute maximumVO2 similar to youth soccer players; relative oxygen consumption is higher n young soccer players; but the maximum aerobic speed and muscular efficiency are once again higher in adult soccer players

Consumo máximo de oxígeno y eficiencia muscular en futbolistas juveniles no profesionales y adultos profesionales

Soccer has been described as a maximal and/or near-maximal effort sport, layered on a low to moderate intensity exercise base. The available evidence suggests that adult male soccer players cover approximate distances of 10 to 12 km during a match and 8.1 km for youth players. The objective of the study is to compare the maximum aerobic power parameters of professional soccer players and youth players. A cross-sectional correlational descriptive study was carried out, 52 adult soccer players and 57 youth soccer players participated. The results reported that the absolute maximum VO2 does not present a significant difference between adults vs juveniles; The relative maximum VO2 in ml/kg-min presents a significant difference in favor of the Juveniles; The maximum aerobic speed in km/h presents a significant difference in favor of the adults and the muscular efficiency in percentage presents a significant difference in favor of the adults. In conclusion, adult professional soccer players have an absolute maximum VO2 similar to youth soccer players; relative oxygen consumption is higher in young soccer players; but the maximum aerobic speed and muscular efficiency are once again higher in adult soccer players.El fútbol ha sido descrito como un deporte de esfuerzos máximos y/o casi máximos, superpuestos sobre una base de ejercicios de baja o moderada intensidad. La evidencia disponible sugiere que los futbolistas masculinos adultos cubren distancias aproximadas de 10 a 12 km durante un partido y 8,1 km en los jugadores Juveniles. El objetivo del estudio es comparar los parámetros de potencia aeróbica máxima de futbolistas profesionales y jugadores juveniles. Se realizó un estudio de tipo descriptivo correlacional de corte transversal, participaron 52 futbolistas adultos y 57 futbolistas juveniles. Los resultados informaron que el VO2 máximo absoluto no presenta diferencia significativa entre adultos vs juveniles; El VO2 máximo relativo en ml/kg-min presenta diferencia significativa en favor de los Juveniles; La velocidad aeróbica máxima en Km/h presenta diferencia significativa en favor de los adultos y la eficiencia muscular en porcentaje presenta diferencia significativa en favor de los adultos.&nbsp; En conclusión, los futbolistas profesionales adultos presentan un VO2 máximo absoluto similar a futbolistas juveniles; el consumo de oxígeno relativo es mayor en los futbolistas jóvenes; pero la velocidad aeróbica máxima y la eficiencia muscular vuelve a ser mayor en futbolistas adultos

Association between Fractional Oxygen Extraction from Resting Quadriceps Muscle and Body Composition in Healthy Men

[EN] This study aimed to associate body composition with fractional oxygen extraction at rest in healthy adult men. Fourteen healthy adults (26.93 ± 2.49 years) from Chile participated. Body composition was assessed with octopole bioimpedance, and resting muscle oxygenation was evaluated in the vastus lateralis quadriceps with near-infrared spectroscopy (NIRS) during a vascular occlusion test, analyzing the muscleVO2, resaturation velocity during reactive hyperemia via the muscle saturation index (%TSI), and the area above the curve of HHb (AACrep). It was observed that the total and segmented fat mass are associated with lower reoxygenation velocities during hyperemia (p = 0.008; β = 0.678: p = 0.002; β = 0.751), and that the total and segmented skeletal muscle mass are associated with higher reoxygenation velocities during hyperemia (p = 0.020; β = −0.614: p = 0.027; β = −0.587). It was also observed that the total and segmented fat mass were associated with a higher area above the curve of HHb (AACrep) during hyperemia (p = 0.007; β = 0.692: p = 0.037; β = 0.564), and that total and segmented skeletal muscle mass was associated with a lower area above the curve of HHb (AACrep) during hyperemia (p = 0.007; β = −0.703: p = 0.017; β = −0.632). We concluded that fat mass is associated with lower resaturation rates and lower resting fractional O2 extraction levels. In contrast, skeletal muscle mass is associated with higher resaturation rates and fractional O2 extraction during reactive hyperemia. The AACrep may be relevant in the evaluation of vascular adaptations to exercise and metabolic health.S

A higher skeletal muscle mass and lower adiposity phenotype is associated with better cardiometabolic control in adults with hip and knee osteoarthritis: results from the Chilean National Health Survey 2016-2017

Objective: This study aimed to (1) characterize cardiometabolic factors in self-reported hip and knee osteoarthritis (OAD) across four body composition phenotypes defined by muscle mass and adiposity, and (2) associate risk factors with diabetes and hypertension (HTN). Methods: A crosssectional analysis of the Chilean National Health Survey 2016–17 (n = 4996) stratified participants into four groups: low skeletal muscle mass/high waist circumference (Low-SMM/High-WC), low SMM/low WC (Low-SMM/Low-WC), high SMM/high WC (High-SMM/High-WC), and high SMM/low WC (reference group). Each group was further divided into subgroups with or without diagnosed hip or knee OAD. The main outcomes were fasting plasma glucose, systolic (SBP)/diastolic (DBP) blood pressure (continuous outcomes), and other secondary factors such as cardiovascular risk (CVR). Results: In the hip OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (145 vs. 127 mmHg, p < 0.0001, diff +18 mmHg). In the knee OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (141 vs. 134 mmHg, p < 0.0001, diff +7 mmHg). The SBP showed a significant interaction between the group and OAD diagnosis (p = 0.007 hip OAD; p < 0.0001 knee OAD). Conclusions: Hip and knee OAD associates with elevated SBP/DBP in older adults. OAD groups showed an OR above 2 for diabetes, 2.7 for HTN, 4.5 for metabolic syndrome, and over 2 for moderate-to-high cardiovascular risk. OAD interacts substantially with cardiometabolic factors, especially in low muscle mass/high adiposity phenotypes. Lifestyle optimization of physical activity and nutrition to preserve muscle mass and mitigate adiposity is essential for cardiometabolic health promotion in OAD patients

Characteristics of body composition, phase angle and body water in elite Chilean skydivers

[ES] Durante la práctica del paracaidismo, una deficiente composición corporal no sólo puede afectar el rendimiento deportivo, sino que, además, incrementa la probabilidad de sufrir una lesión o accidente grave. Conocer las características de sus componentes, podría ayudar a prevenirlas. El objetivo del estudio fue describir la composición corporal, ángulos de fase y agua corporal total en paracaidistas chilenos de alta competencia. Participaron del estudio 8 paracaidistas profesionales del Team Chile® (33,4 ± 4,9 años) con más de seis años de experiencia. La evaluación de las masas grasa, muscular, libre de grasa, magra y visceral, así como el ángulo de fase y el agua corporal total obtenida a través de impedancia bioeléctrica. Los deportistas presentaron un peso corporal de 76,7 ± 5,7 kg, estatura 1,72 ± 0,1 m e IMC 26,0 ± 1,9 kg/m2. La composición corporal promedio mostró un 20,6 ± 3,0 % de masa grasa, 44,9 ± 2,0 % de masa muscular y 79,4 ± 3,0 % de masa libre de grasa. El ángulo de fase promedio fue de 7,25 ± 0,33°. El agua corporal total de los participantes fue de 44,6 ± 3,2 1. Se concluye que los resultados obtenidos pueden ser utilizados por los profesionales de las ciencias del deporte como valores de referencia para el control de la composición corporal, fase angular y agua corporal en paracaidistas para optimizar el rendimiento deportivo y evitar lesiones[EN] Unsuitable body composition in skydivers not only affect the sport performance but also could increase the probability of risk injury or severe accident; hence, to determine body composition characteristics could be helpful to prevent such events. This study aimed to describe body composition, phase angle, and total body water in highly trained Chilean skydivers. Eight Team Chile® professional skydivers (33.4 ± 4.9 years) with more than 6 years of experience participated in this study. Fat mass, muscle mass, fat-free mass, lean mass, visceral mass, phase angle, and total body water were measured by bioelectrical impedance. Skydivers had a bodyweight of 76.7±5.7 kg, a height of 1.72 ±0.1 m, and a body mass index of 26.0 ±1.9 kg/m2. Regarding body composition, they had a fat mass of 20.6 ±3.0 %, a muscle mass of 44.9 ±2.0 %, and a fat-free mass of 79.4 ±3.0 %. Phase angle and total body water were 7.25 ±0.3° and 344.6±3.2, respectively. The present findings could be useful to science sport professionals as reference values of body composition, phase angle, and total body water of highly trained skydivers to improve sports performance and avoid injuries.S

Association between infrared thermography, anthropometry parameters and rest energy expenditure in men

[ES] Es reconocido que un incremento de la grasa corporal subcutánea es capaz de alterar el patrón de liberación de calor a través de la piel. Sin embargo, la asociación con otras variables antropométricas y la influencia del gasto energético en reposo (GER), han sido escasamente abordadas. Este estudio determinó la relación de la temperatura de la piel con variables antropométricas, peso corporal y GER de hombres adultos sanos. Participaron en el estudio un total de 24 varones sanos de 33,9±8,7 años de edad, 85,8±9,7 kg de peso corporal, 172,5±6,1 cm de estatura y 28,9±3,4 kg/m2 de índice de masa corporal (IMC). Se realizaron evaluaciones antropométricas, de termografía por infrarrojo y del GER por calorimetría indirecta, con analizador de gases. La temperatura promedio de los 6-pliegues, y las individuales (toracoabdominales, supra-espinal y abdominal), tuvieron correlaciones negativas con el IMC, perímetro de cintura, índice cintura cadera, índice cintura estatura, y la sumatoria de 6 pliegues; todos con p<0,05. Además, la temperatura del pliegue supraespinal tuvo una correlación negativa con el porcentaje de masa adiposa (MA%), r=0,47(p=0,0194). La MA% y el IMC tuvieron correlaciones negativas con el GER, con r=-0,59 (p=0,002) y r=-0,53 (p=0,006), respectivamente. El promedio de temperatura de los 6-pliegues presentó una correlación positiva con el GER (r=0,44; p=0,02). La composición corporal causa una modificación en los patrones de termografía superficial local, sin afectar la relación entre el promedio de la temperatura superficial total con el GER, pudiendo éste ser un factor predictor.[EN] It is known that an increase in the subcutaneous body fat can alter the pattern of heat release through the skin. However, the relationship with other anthropometric va- riables and the influence of the Resting Energy Expenditure (REE) have scarcely been addressed. To determine the relationship of skin temperature with different anthropometric variables, body weight, and the REE of healthy adult males. The participants were a total of 24 healthy males of 33.9±8.7 years-old, 85.8±9.7 kg of body mass, 172.5±6.1 cm of height, and 28.9±3.4 kg/m2 of body mass index (BMI). Anthropometric, infrared thermography, and indirect calorimetry REE assessments were performed with gas analyzer. The six skinfolds average temperature, as well as the individual skinfolds (thoracoabdominal, supraspinal, and abdominal), had negative correlations with the BMI, waist circumference, waist- hip ratio, waist-to-height ratio, and the sum of the six skinfolds, all with p<0.05. In addition, the temperature of the supraspinal fold had a negative correlation with the percentage of fat mass (MA%), r=0.47 (p=0.0194). MA% and BMI had negative correlations with REE, with r=-0.59 (p=0.002) and r=-0.53 (p=0.006), respectively. The six-skinfolds average temperature presented a positive correlation with the REE (r=0.44; p=0.02). Body composition changes cause a modification in the local surface thermography patterns without affecting the relationship between the average total body surface temperature with the REE; therefore, this could act as a predictive factor.S