The skeleton in diabetes – involvement and interaction

Diabetes mellitus (DM) is characterized by high blood glucose; impairment of the skeleton is among its other deleterious effects. Adverse effect upon the bone tissue is primarily altered bone quality and consequently increased bone fragility. In DM 1, bone mass may be low and in DM2 normal or even increased. Therapy for DM2 also affects bone metabolism as thiazolidine-diones cause differentiation shift of mesenchyme precursors from osteoblasts into adipocytes. Association of bone with glucose metabolism was discovered in the last decade indicating that insulin is necessary for synthesis of undercarboxylated osteocalcin which acts in a hormonal fashion to promote insulin secretion in the pancreas, adiponectin in adipocytes, and increases insulin sensitivity in target tissues. Undercarboxylated osteocalcin is also secreted from resorbed bone. Thus insulin is required for normal bone metabolism and bone acts as an endocrine organ. Additional role of osteocalcin is in promoting testosterone secretion in testes

Glukagonu sličan peptid-1 različito utječe na percepciju okusa u žena: randomizirana, placebom kontrolirana ukrižena studija

Gastrointestinal tract is an important connector between food intake and body weight, it senses basic tastes in a similar manner as the tongue. The aim of the study was to find out how gut hormone glucagon-like peptide-1 (GLP-1) influences taste preference. Fourteen healthy participants (six male and eight female) were included in this double-blind, placebo-controlled crossover study. After overnight fast and salty fluid (oral sodium load), participants were randomized to receive placebo (500 mL of 0.9% saline) or GLP-1 infusion (1.5 pmol/kg/min) over a 3-hour period. At the end of infusion, participants chose food preferences from illustrations of food types representing 5 tastes. After 7 days, the protocol was repeated, this time those that had received placebo first got GLP-1 infusion, and those having received GLP-1 first got placebo. Change of taste preference after GLP-1 infusion but not after placebo was reported as response, and non-response was reported in case of taste persistence. A statistically significant difference in response type was found between genders, with women being more likely to change their taste preference after GLP-1 than men. The change of taste upon GLP-1 infusion observed in women might be ascribed to estrogen weight-lowering effects accomplished by receptor-mediated delivery.Probavni sustav povezuje unos hrane i tjelesnu masu razlikujući osnovne okuse sličnim mehanizmima kao i jezik. Cilj ove studije bio je istražiti kako glukagonu sličan peptid-1 (GLP-1) utječe na sklonost određenom okusu. Četrnaestoro zdravih ispitanika (šest muškaraca i osam žena) uključeno je u randomiziranu, placebom kontroliranu ukriženu studiju. Ispitanicima koji su bili natašte dana je slana tekućina (oralno opterećenje solju), nakon čega su randomizirani za placebo (500 mL 0.9% fiziološke otopine) ili infuziju GLP-1 (1.5 pmol/kg/min) tijekom 3 sata. Na kraju infuzije ispitanicama su predočene slike hrane koje predstavljaju 5 osnovnih okusa pa su birali okus kojem su najviše skloni. Nakon 7 dana postupak se ponovio; onima kojima je prvi puta dan placebo primijenjen je GLP-1, a onima koji su prvi put dobili GLP-1 primijenjen je placebo. Promjena sklonosti određenom okusu nakon infuzije GLP-1, no ne i nakon placeba, smatrala se pozitivnim odgovorom, a negativan je bila nepromijenjena sklonost okusu. Analizirajući ispitanike prema spolu nađeno je da žene imaju veću vjerojatnost promjene sklonosti okusa nakon GLP-1 nego muškarci, što je bilo statistički značajno. Navedeno opažanje promjeni okusa nakon infuzije GLP-1 u ispitanica može se objasniti učinkom estrogena na gubitak tjelesne mase koji se objašnjava receptorski posredovnim prijenosom

Koštana alkalna fosfataza, osteokalcin i C-terminalni telopeptid kao pokazatelji koštane pregradnje u kuja

In clinical veterinary practice the measurement of biochemical markers for assessment of bone metabolism is not yet fully established and is only being used for now as a scientifi c method in investigations. The purpose of this research is the better understanding of bone metabolism in dogs and assessing the possible utility of biochemical bone markers in routine clinical veterinary practice. The bone markers selected for this study were: bone alkaline phosphatase and osteocalcin as indicators of bone formation, and C-terminal telopeptide of type I collagen as marker of bone resorption. The research was conducted on 58 canine bitches of different breeds. The results indicate increased bone turnover in young animals and decreased turnover in old ones since the highest activities of the investigated bone markers were in the youngest group and they then declined with age. However, elevated activity of bone alkaline phosphatase was noted in older bitches, which has not been detected in other animal species or in healthy humans. Higher bone resorption and lower formation were noticed in heavier dogs.U veterinarskoj medicini saznanja o biokemijskim pokazateljima koštane pregradnje oskudna su i nedostatna, a njihova primjena je za sada isključivo istraživačka. Cilj ovog istraživanja bio je bolje poznavanje koštanoga metabolizma u pasa na temelju mjerenja biokemijskih pokazatelja koštane pregradnje u krvi te procjena moguće kliničke primjene tih pokazatelja u rutinskoj veterinarskoj kliničkoj praksi. Pokazatelji koštane pregradnje koji su upotrijebljeni u ovom istraživanju jesu: koštana alkalna fosfataza i osteokalcin, kao pokazatelji izgradnje i C-terminalni telopeptid kao pokazatelj razgradnje kosti. Istraživanje je provedeno na 58 kuja različitih pasmina. Rezultati pokazuju pojačanu pregradnju kostiju u mladih životinja i smanjenu u starih životinja budući da su najviše vrijednosti koštanih pokazatelja utvrđene u mladih životinja, te su opadale s dobi. Međutim, povećana aktivnost koštane alkalne fosfataze zabilježena je u starijih kuja, što nije zapaženo u ostalih životinjskih vrsta niti zdravih ljudi. Također je uočena povećana razgradnja i smanjena izgradnja kosti u pasa veće tjelesne mase

Koštana alkalna fosfataza, osteokalcin i C-terminalni telopeptid kao pokazatelji koštane pregradnje u kuja

In clinical veterinary practice the measurement of biochemical markers for assessment of bone metabolism is not yet fully established and is only being used for now as a scientifi c method in investigations. The purpose of this research is the better understanding of bone metabolism in dogs and assessing the possible utility of biochemical bone markers in routine clinical veterinary practice. The bone markers selected for this study were: bone alkaline phosphatase and osteocalcin as indicators of bone formation, and C-terminal telopeptide of type I collagen as marker of bone resorption. The research was conducted on 58 canine bitches of different breeds. The results indicate increased bone turnover in young animals and decreased turnover in old ones since the highest activities of the investigated bone markers were in the youngest group and they then declined with age. However, elevated activity of bone alkaline phosphatase was noted in older bitches, which has not been detected in other animal species or in healthy humans. Higher bone resorption and lower formation were noticed in heavier dogs.U veterinarskoj medicini saznanja o biokemijskim pokazateljima koštane pregradnje oskudna su i nedostatna, a njihova primjena je za sada isključivo istraživačka. Cilj ovog istraživanja bio je bolje poznavanje koštanoga metabolizma u pasa na temelju mjerenja biokemijskih pokazatelja koštane pregradnje u krvi te procjena moguće kliničke primjene tih pokazatelja u rutinskoj veterinarskoj kliničkoj praksi. Pokazatelji koštane pregradnje koji su upotrijebljeni u ovom istraživanju jesu: koštana alkalna fosfataza i osteokalcin, kao pokazatelji izgradnje i C-terminalni telopeptid kao pokazatelj razgradnje kosti. Istraživanje je provedeno na 58 kuja različitih pasmina. Rezultati pokazuju pojačanu pregradnju kostiju u mladih životinja i smanjenu u starih životinja budući da su najviše vrijednosti koštanih pokazatelja utvrđene u mladih životinja, te su opadale s dobi. Međutim, povećana aktivnost koštane alkalne fosfataze zabilježena je u starijih kuja, što nije zapaženo u ostalih životinjskih vrsta niti zdravih ljudi. Također je uočena povećana razgradnja i smanjena izgradnja kosti u pasa veće tjelesne mase

Bone markers in metabolic bone disorder in patients on chronic hemo dialysis and kidney transplant recipients

Uvod: Poremećaj koštanog metabolizma je česta pojava u kroničnom bubrežnom zatajivanju koje se liječi kroničnom dijalizom i presađivanjem bubrega. Ovo stanje obilježava ubrzana ili usporena koštana pregradnja s posljedičnim nastankom osteopenije ili osteoporoze i povećanog rizika prijeloma. Mjerenje biokemijskih pokazatelja koštane pregradnje omogućuje neizravan uvid u koštanu pregradnju i njene promjene u tijeku ove bolesti. U ovom smo istraživanju izmjerili pokazatelje koštane izgradnje i razgradnje u bolesnika na kroničnom liječenju dijalizom i u onih s presađenim bubregom, a rezultate analizirali s obzirom na čimbenike rizika ovog stanja, i to: koncentraciju paratireoidnog hormona (PTH), životnu dob, spol, trajanje liječenja dijalizom i razdoblje nakon transplantacije. Materijali i metode: u 79 bolesnika (50 muškaraca, 29 žena) na kroničnom liječenju dijalizom i 36 bolesnika (20 muškaraca, 16 žena) s presađenim bubregom u krvi je izmjerena koštana alkalna fosfataza (engl. bone alkaline phosphatase, BALP) kao pokazatelj izgradnje, C-terminalni telopeptid kolagena tip I (CTX, engl. crosslaps) kao pokazatelj koštane razgradnje i intaktni PTH komercijalnim kompletima reagensa. Klinički podaci su uključili dob, trajanje liječenja dijalizom i razdoblje nakon transplantacije. Rezultati: U bolesnika na kroničnom liječenju dijalizom je koštana alkalna fosfataza bila statistički značajno niža (18,27 IU/L, p<0,0005), a CTX (1,85 ug/L, p<0,0005) i PTH (21,99 pmol/L, p<0,001) viši u odnosu na bolesnike s presađenim bubregom (CTX 1,18 ug/L, PTH 6,34 pmol/L, BALP 45,78 IU/L). U obje skupine je trajanje dijalize koreliralo značajno i pozitivno s koštanom alkalnom fosfatazom (pacijenti na hemodijalizi r=0,318, p=0,005, pacijenti s bubrežnim presatkom r=0,488, p=0,003) i C-terminalnim telopeptidom (pacijenti na hemodijalizi r=0,338, p=0,002, pacijenti s bubrežnim presatkom r=0,365, p=003), a u bolesnika na dijalizi i s koncentracijama PTH (r=0,255, p=0,03). Statistički značajna i pozitivna korelacija postojala je u obje skupine između PTH i koštane alkalne fosfataze (pacijenti na hemodijalizi r=0,522, p=0,0005, pacijenti s bubrežnim presatkom r=0,456, p=0,02), koštane alkalne fosfataze i CTX (pacijenti na hemodijalizi r=0,459, p=0,0005, pacijenti s bubrežnim presatkom r=0,593, p=0,0005), a samo u bolesnika na dijalizi između PTH i CTX (r=0,323, p=0,004). U bolesnika s presađenim bubregom je razdoblje nakon transplantacije koreliralo značajno i negativno s CTX (r=-0,479, p=0,004). Bolesnici na dijalizi bili su značajno stariji (61 godina, p=0,0005) i značajno dulje liječeni dijalizom (79 mjeseci, p=0,04) nego oni s presađenim bubregom (dob 46 godina, liječenje dijalizom 55 mjeseci). Nije bilo razlike između spolova za parametre ispitivane u ovom istraživanju. Zaključak: Koštana pregradnja, a osobito razgradnja, bila je ubrzana u obje skupine bolesnika. Trajanje liječenja dijalizom i koncentracija PTH pokazali su se kao rizični čimbenici ubrzane koštane pregradnje u ovih bolesnika, a poboljšanje je ovisilo o vremenu proteklom nakon transplantacije. Spol i dob nisu bili povezani s poremećajem koštane pregradnje. Mjerenje biokemijskih pokazatelja koštane pregradnje i PTH važne su laboratorijske pretrage u procjeni i praćenju koštanog poremećaja bolesnika na kroničnom liječenju dijalizom i nakon transplantacije bubrega.Background: Chronic kidney failure treated by chronic dialysis and kidney transplantation is characterised by disorder of bone metabolism and high or low bone turnover, resulting in osteopenia/osteoporosis and increased fracture risk. Measurement of bone markers enables indirect insight into the rate of bone remodeling and its changes in the course of disease. In this study bone formation and bone resorption markers were measured in patients on chronic hemodialysis treatment and in kidney transplant recipients with regard to specific risk factors of this metabolic bone disorder, i.e. parathyroid hormone levels (PTH), age, sex, hemodialysis duration and post-transplant period. Materials and methods: Blood samples were obtained from 79 patients (50 men, 29 women) on chronic hemodialysis and 36 patients (20 men, 16 women) with kidney transplant for measurement of bone alkaline phosphatase (BALP) as a bone formation marker, C-terminal telopeptide of collagen type I (crosslaps) as a bone resorption marker and intact PTH by commercial kits. Data on age, duration of hemodialysis and post-transplant period were included as risk factors for bone disorder. Results: Patients on chronic hemodialysis had significantly higher crosslaps (1.85 ug/L, p<0.0005) and PTH (21.99 pmol/L, p<0,001), and lower BALP (18.27 IU/L, p<0.0005) in comparison to kidney transplant recipients (crosslaps 1.18 ug/L, PTH 6.34 pmol/L, BALP 45.78 IU/L). In both patient groups hemodialysis duration correlated significantly and positively with BALP (hemodialysis patients r=0.318, p=0.005, kidney transplat recipients r=0.488, p=0.003) and crosslaps (hemodialysis patients r=0.338, p=0.002, kidney transplant recipients r=0.365, p=0.03), and in hemodialysis patients with PTH (r=0.255, p=0.03). A statistically significant and positive correlation existed for both patient groups between PTH and BALP (hemodialysis patients r=0.522, p=0.0005, kidney transplant recipients r=0.456, p=0.02), BALPand crosslaps (hemodialysis patients r=0.459, p=0.0005, kidney transplant recipients r=0.593, p=0.0005), and in hemodialysis patients also between PTH and crosslaps (r=0.323, p=0.004). In kidney transplant recipients crosslaps correlated negatively with post-transplant period (r=-0.479, p=0.004). Patients on chronic hemodialysis were significantly older (61 years, p=0.0005) and were significantly longer treated by hemodialysis (79 months, p=0.04) as compared to the kidney transplant recipients (age 46 years, dialysis treatment 55 months). No difference in data existed between sexes in both patient groups. Conclusions: Bone turnover was increased in both patient groups, in particular bone resorption. Duration of hemodialysis and PTH were recognised as determinants of increased bone turnover in both groups, and normalization of bone resorption was related to post-transplantation period. In this bone disorder sex and age were not established as risk factors for impaired bone turnover. Measurement of bone markers together with PTH is a useful clinical tool in assessment and follow-up of metabolic bone disorders of chronic hemodialysis treatment and kidney transplantation

Bone markers in metabolic bone disorder in patients on chronic hemo dialysis and kidney transplant recipients

Uvod: Poremećaj koštanog metabolizma je česta pojava u kroničnom bubrežnom zatajivanju koje se liječi kroničnom dijalizom i presađivanjem bubrega. Ovo stanje obilježava ubrzana ili usporena koštana pregradnja s posljedičnim nastankom osteopenije ili osteoporoze i povećanog rizika prijeloma. Mjerenje biokemijskih pokazatelja koštane pregradnje omogućuje neizravan uvid u koštanu pregradnju i njene promjene u tijeku ove bolesti. U ovom smo istraživanju izmjerili pokazatelje koštane izgradnje i razgradnje u bolesnika na kroničnom liječenju dijalizom i u onih s presađenim bubregom, a rezultate analizirali s obzirom na čimbenike rizika ovog stanja, i to: koncentraciju paratireoidnog hormona (PTH), životnu dob, spol, trajanje liječenja dijalizom i razdoblje nakon transplantacije. Materijali i metode: u 79 bolesnika (50 muškaraca, 29 žena) na kroničnom liječenju dijalizom i 36 bolesnika (20 muškaraca, 16 žena) s presađenim bubregom u krvi je izmjerena koštana alkalna fosfataza (engl. bone alkaline phosphatase, BALP) kao pokazatelj izgradnje, C-terminalni telopeptid kolagena tip I (CTX, engl. crosslaps) kao pokazatelj koštane razgradnje i intaktni PTH komercijalnim kompletima reagensa. Klinički podaci su uključili dob, trajanje liječenja dijalizom i razdoblje nakon transplantacije. Rezultati: U bolesnika na kroničnom liječenju dijalizom je koštana alkalna fosfataza bila statistički značajno niža (18,27 IU/L, p<0,0005), a CTX (1,85 ug/L, p<0,0005) i PTH (21,99 pmol/L, p<0,001) viši u odnosu na bolesnike s presađenim bubregom (CTX 1,18 ug/L, PTH 6,34 pmol/L, BALP 45,78 IU/L). U obje skupine je trajanje dijalize koreliralo značajno i pozitivno s koštanom alkalnom fosfatazom (pacijenti na hemodijalizi r=0,318, p=0,005, pacijenti s bubrežnim presatkom r=0,488, p=0,003) i C-terminalnim telopeptidom (pacijenti na hemodijalizi r=0,338, p=0,002, pacijenti s bubrežnim presatkom r=0,365, p=003), a u bolesnika na dijalizi i s koncentracijama PTH (r=0,255, p=0,03). Statistički značajna i pozitivna korelacija postojala je u obje skupine između PTH i koštane alkalne fosfataze (pacijenti na hemodijalizi r=0,522, p=0,0005, pacijenti s bubrežnim presatkom r=0,456, p=0,02), koštane alkalne fosfataze i CTX (pacijenti na hemodijalizi r=0,459, p=0,0005, pacijenti s bubrežnim presatkom r=0,593, p=0,0005), a samo u bolesnika na dijalizi između PTH i CTX (r=0,323, p=0,004). U bolesnika s presađenim bubregom je razdoblje nakon transplantacije koreliralo značajno i negativno s CTX (r=-0,479, p=0,004). Bolesnici na dijalizi bili su značajno stariji (61 godina, p=0,0005) i značajno dulje liječeni dijalizom (79 mjeseci, p=0,04) nego oni s presađenim bubregom (dob 46 godina, liječenje dijalizom 55 mjeseci). Nije bilo razlike između spolova za parametre ispitivane u ovom istraživanju. Zaključak: Koštana pregradnja, a osobito razgradnja, bila je ubrzana u obje skupine bolesnika. Trajanje liječenja dijalizom i koncentracija PTH pokazali su se kao rizični čimbenici ubrzane koštane pregradnje u ovih bolesnika, a poboljšanje je ovisilo o vremenu proteklom nakon transplantacije. Spol i dob nisu bili povezani s poremećajem koštane pregradnje. Mjerenje biokemijskih pokazatelja koštane pregradnje i PTH važne su laboratorijske pretrage u procjeni i praćenju koštanog poremećaja bolesnika na kroničnom liječenju dijalizom i nakon transplantacije bubrega.Background: Chronic kidney failure treated by chronic dialysis and kidney transplantation is characterised by disorder of bone metabolism and high or low bone turnover, resulting in osteopenia/osteoporosis and increased fracture risk. Measurement of bone markers enables indirect insight into the rate of bone remodeling and its changes in the course of disease. In this study bone formation and bone resorption markers were measured in patients on chronic hemodialysis treatment and in kidney transplant recipients with regard to specific risk factors of this metabolic bone disorder, i.e. parathyroid hormone levels (PTH), age, sex, hemodialysis duration and post-transplant period. Materials and methods: Blood samples were obtained from 79 patients (50 men, 29 women) on chronic hemodialysis and 36 patients (20 men, 16 women) with kidney transplant for measurement of bone alkaline phosphatase (BALP) as a bone formation marker, C-terminal telopeptide of collagen type I (crosslaps) as a bone resorption marker and intact PTH by commercial kits. Data on age, duration of hemodialysis and post-transplant period were included as risk factors for bone disorder. Results: Patients on chronic hemodialysis had significantly higher crosslaps (1.85 ug/L, p<0.0005) and PTH (21.99 pmol/L, p<0,001), and lower BALP (18.27 IU/L, p<0.0005) in comparison to kidney transplant recipients (crosslaps 1.18 ug/L, PTH 6.34 pmol/L, BALP 45.78 IU/L). In both patient groups hemodialysis duration correlated significantly and positively with BALP (hemodialysis patients r=0.318, p=0.005, kidney transplat recipients r=0.488, p=0.003) and crosslaps (hemodialysis patients r=0.338, p=0.002, kidney transplant recipients r=0.365, p=0.03), and in hemodialysis patients with PTH (r=0.255, p=0.03). A statistically significant and positive correlation existed for both patient groups between PTH and BALP (hemodialysis patients r=0.522, p=0.0005, kidney transplant recipients r=0.456, p=0.02), BALPand crosslaps (hemodialysis patients r=0.459, p=0.0005, kidney transplant recipients r=0.593, p=0.0005), and in hemodialysis patients also between PTH and crosslaps (r=0.323, p=0.004). In kidney transplant recipients crosslaps correlated negatively with post-transplant period (r=-0.479, p=0.004). Patients on chronic hemodialysis were significantly older (61 years, p=0.0005) and were significantly longer treated by hemodialysis (79 months, p=0.04) as compared to the kidney transplant recipients (age 46 years, dialysis treatment 55 months). No difference in data existed between sexes in both patient groups. Conclusions: Bone turnover was increased in both patient groups, in particular bone resorption. Duration of hemodialysis and PTH were recognised as determinants of increased bone turnover in both groups, and normalization of bone resorption was related to post-transplantation period. In this bone disorder sex and age were not established as risk factors for impaired bone turnover. Measurement of bone markers together with PTH is a useful clinical tool in assessment and follow-up of metabolic bone disorders of chronic hemodialysis treatment and kidney transplantation

Učinak dugotrajnog treninga umjerenoga intenziteta na frekvenciju srca i metabolički status u netreniranih labrador retrivera.

Heart rate (HR) and oxygen uptake linearly increase during exercise, so the aim of this study was to investigate the effects of moderate exercise in sedentary dogs on heart rate frequency, as a marker of aerobic status. Fifteen Labrador Retrievers participated in a 4-month exercise protocol, and their body mass, serum biochemistry status and HR response were monitored and measured at the baseline and after 2 and 4 months of activity. The baseline control speed was set for each dog and corresponded to the moderate intensity mean HR value of 137.5 ± 2.58 beats per minute (BPM). During the experiment, the running speed was altered to maintain the baseline HR for each dog individually. The mean running speed needed to maintain the control HR increased significantly (P<0.01), measured after 2 and 4 months of aerobic exercise. Then mean HR at control speed after 2 and 4 months of moderate exercise decreased significantly (P<0.01) compared to the baseline value. Body mass decreased significantly after 2 months (P<0.01) and 4 months (P<0.05) compared to the baseline value. After 2 months of exercise albumin, creatinine and cholesterol concentrations significantly decreased, while alkaline phosphatase (ALP) activity significantly increased from the baseline values. After 4 months of exercise a statistically significant increase was found in glucose, triglycerides, and BUN concentrations from the baseline values. Compared to the 2 month results, BUN and albumin concentrations significantly decreased, while ALP activity significantly increased. This study demonstrated the positive effects of a long-term moderate intensity training protocol in sedentary dogs on heart rate and possibly also on aerobic capacity, as observed by the decrease in heart rate during exercise at the end of 4 months’ training.Frekvencija srca i primitak kisika linearno rastu s porastom intenziteta vježbe, stoga je cilj ovoga rada bio istražiti utjecaj vježbe umjerenoga intenziteta na srčanu frekvenciju kao pokazatelja aerobnoga statusa. U istraživanje koje je trajalo 4 mjeseca bilo je uključeno petnaest labrador retrivera čije su tjelesna težina, biokemijski status i srčane frekvencije bilježene prvog dana, nakon dva te nakon četiri mjeseca treninga. Početna kontrolna brzina određena je individualno za svaku jedinku i prosječno je iznosila 137,5 ± 2,58 otkucaja u minuti. Tijekom istraživanja, mijenjali smo brzinu trčanja kako bi psi održali konstantnu vrijednost kontrolne srčane frekvencije. Brzina trčanja pri kojoj su psi održavali kontrolnu frekvenciju srca značajno se smanjila (P<0,01) nakon 2 te nakon 4 mjeseca aerobne vježbe. Tjelesna težina je značajno snižena nakon 2 (P<0,01) te nakon 4 mjeseca (P<0,05) u usporedbi s početnom. Nakon 2 mjeseca razine albumina, kreatinina i kolesterola bile su značajno snižene, dok je aktivnost alkalne fosfataze porasla u usporedbi s početnim mjerenjem. Nakon 4 mjeseca treninga utvrđen je značajan porast vrijednosti glukoze, triglicerida i ureje u odnosu na početnu vrijednost. Istraživanje je pokazalo da dugotrajna fizička aktivnost umjerenoga intenziteta ima pozitivan učinak na frekvenciju srca, a time posljedično i na aerobni kapacitet što je vidljivo iz smanjenja frekvencije srca za isti intenzitet rada nakon 4 mjeseca treninga