Hormonal reactions during heavy training stress and following tapering in highly trained male rowers.

The purpose of this study was to determine whether fasting plasma leptin, cortisol, testosterone and growth hormone concentrations were altered with a heavy increase in training stress followed by a reduced stress in highly trained male rowers. Twelve male national standard rowers (age 20.5 +/- 3.0 years, height 187.9 +/- 6.1 cm, body mass 87.1 +/- 8.3 kg, percent body fat 10.4 +/- 3.2 %) underwent a three-week period of maximally increased training stress followed by a two-week tapering period. The fasting blood samples were obtained every week after the rest day. In addition, the maximal 2000-meter rowing ergometer performance time was assessed before and immediately after the exhaustive training period as well as after the tapering period. A 22 % increase in training stress caused a significant decrease (by 8 %) and increase (by 9 %) in leptin and testosterone, respectively. A further increase in training volume by 25 % significantly reduced leptin further by 35 %. At the same time, no changes were observed in testosterone. Growth hormone was significantly elevated only after the first week of heavy training stress compared to the pretraining level. In the first tapering week, where the physical stress was reduced by 50 %, leptin only significantly increased by 29 %. Testosterone and growth hormone were significantly reduced to almost pretraining levels by the end of the second tapering week. Leptin was further significantly increased during the second tapering week. Cortisol remained relatively constant during the whole study period. Similarly, rowing performance was not significantly changed. We conclude that leptin is more sensitive to the rapid and pronounced changes in training stress compared to measured stress hormones in athletes. In addition, fasting plasma leptin could be regarded as a key signal for metabolic adaptation to exhaustive training stress in highly trained male rowers.     

Plasma adiponectin concentration in healthy pre- and postmenopausal women: relationship with body composition, bone mineral, and metabolic variables

The aim of the current investigation was to determine the possible relationships of fasting adiponectin level with body composition, bone mineral, insulin sensitivity, leptin, and cardiorespiratory fitness parameters in 153 women. Subjects were classified as premenopausal (n = 42; 40.8 +/- 5.7 yr) if they had regular menstrual periods, early postmenopausal (n = 49; 56.7 +/- 3.6 yr) if they had been postmenopausal for more than >1 yr but <7 yr (5.5 +/- 1.3 yr), and postmenopausal (n = 62; 72.2 +/- 4.5 yr) if they had been postmenopausal for >7 yr. All women studied had a body mass index (BMI) <30 kg/m(2). Adiponectin values were higher (P < 0.05) in middle-aged (12.0 +/- 5.1 microg/ml) and older (15.3 +/- 7.3 microg/ml) postmenopausal women compared with middle-aged premenopausal women (8.4 +/- 3.2 microg/ml). Mean plasma adiponectin concentration in the total group of women (n = 153) was 12.2 +/- 6.3 microg/ml and was positively related (P < 0.05) to age, indexes of overall obesity (BMI, body fat mass), and cardiorespiratory fitness (PWC) values. In addition, a negative association (P < 0.05) between adiponectin with central obesity (waist-to-hip and waist-to-thigh ratio), fat-free mass, bone mineral (bone mineral content, total and lumbar spine bone mineral density), and leptin and insulin resistance (insulin, fasting insulin resistance index) values was observed. However, multivariate regression analysis revealed that only age, fasting insulin resistance index, and leptin were independent predictors of adiponectin concentration. In conclusion, circulating adiponectin concentrations increase with age in normal-weight middle-aged and older women. It appears that adiponectin is independently related to age, leptin, and insulin resistance values in women across the age span and menstrual status.     

Predicting maximal aerobic capacity (VO2max) from the critical velocity test in female collegiate rowers

The objective of this study was to examine the relationship between the critical velocity (CV) test and maximal oxygen consumption (VO2max) and develop a regression equation to predict VO2max based on the CV test in female collegiate rowers. Thirty-five female (mean ± SD; age, 19.38 ± 1.3 years; height, 170.27 ± 6.07 cm; body mass, 69.58 ± 0.3 1 kg) collegiate rowers performed 2 incremental VO2max tests to volitional exhaustion on a Concept II Model D rowing ergometer to determine VO2max. After a 72-hour rest period, each rower completed 4 time trials at varying distances for the determination of CV and anaerobic rowing capacity (ARC). A positive correlation was observed between CV and absolute VO2max (r = 0.775, p < 0.001) and ARC and absolute VO2max (r = 0.414, p = 0.040). Based on the significant correlation analysis, a linear regression equation was developed to predict the absolute VO2max from CV and ARC (absolute VO2max = 1.579[CV] + 0.008[ARC] - 3.838; standard error of the estimate [SEE] = 0.192 L·min(-1)). Cross validation analyses were performed using an independent sample of 10 rowers. There was no significant difference between the mean predicted VO2max (3.02 L·min(-1)) and the observed VO2max (3.10 L·min(-1)). The constant error, SEE and validity coefficient (r) were 0.076 L·min(-1), 0.144 L·min(-1), and 0.72, respectively. The total error value was 0.155 L·min(-1). The positive relationship between CV, ARC, and VO2max suggests that the CV test may be a practical alternative to measuring the maximal oxygen uptake in the absence of a metabolic cart. Additional studies are needed to validate the regression equation using a larger sample size and different populations (junior- and senior-level female rowers) and to determine the accuracy of the equation in tracking changes after a training intervention.     

Adiponectin is associated with bone mineral density in perimenopausal women.

The aim of the current investigation was to investigate any potential effect of fasting plasma adiponectin concentration on bone tissue, and to find possible relationships of fasting plasma adiponectin level with different body composition, insulin sensitivity and physical performance parameters in a group of healthy perimenopausal women. Twenty-one premenopausal and 17 early postmenopausal women participated in this study. The women were matched for body mass index (BMI) and level of mean daily energy expenditure. Women had similar adiponectin (8.4 +/- 3.9 vs. 9.9 +/- 5.4 microg/ml) and leptin values (12.0 +/- 7.7 vs. 14.0 +/- 8.2 ng/ml) before and after menopause. Significant relationships were observed between plasma adiponectin and bone mineral content, total bone mineral density (BMD) and lumbar spine BMD values (r > - 0.36; p < 0.05). Furthermore, adiponectin had a significant negative association with total BMD (beta = - 1.228; p = 0.004) and lumbar spine BMD (beta = - 0.312; p = 0.005) independent of the influence that other measured body compositional, hormonal or physical performance factors may exert on BMD. Adiponectin was also significantly related to waist-to-hip ratio (WHR) (beta = - 2.300; p = 0.002) and fasting insulin resistance index (FIRI) (beta = - 0.006; p = 0.007) in separate regression models. No relationship was observed between leptin and measured bone, physical performance and insulin resistance values. Leptin significantly correlated to BMI (beta = 0.018; p = 0.034), lean body mass (beta = 0.025; p = 0.024) and fat mass (beta = 0.019; p = 0.001) in separate regression models. In conclusion, the results of present study show that circulating adiponectin appears to exert an independent effect on BMD in perimenopausal women and may represent a link between adipose tissue and bone mineral density.     

Standards and predicted values of anaerobic threshold

Mean values for body size, body composition and endurance indices have been obtained from a homogeneous group of 125 physically active men to find predicted values of AT (age 23.4 +/- 4.3 years; height 175.9 +/- 6.5 cm; weight 72.2 +/- 8.9 kg; body fat 17.9 +/- 4.7% body weight, muscularity index 19.0 +/- 1.5 kg fat-free mass/cm2 X 10(-4) height; forced vital lung capacity 5667 +/- 815 cm3; VO2max 48.5 +/- 6.0 cm3 X kg-1 X min-1; anaerobic threshold 61.0 +/- 7.8% VO2max). Endurance performance and fitness indices were a little higher than average, but about 10% lower than in endurance-trained athletes. The authors suggest that standards of anaerobic threshold (AT) for ergonomics and endurance training should be about 55-65% VO2max, but not lower than 1800 cm3 O2 X min-1. The coefficients of correlation of AT relating to VO2max, PFO2 and submaximal load were significant at the 0.01 level. Using regression analysis, predicted values of AT were developed. A predicted value of AT can be obtained from the regression line of AT on Lsubmax used as a nomogram, during a simple PWC170 exercise test without blood or gas analysis.     

Changes in adipocyte hormones leptin, resistin, and adiponectin in thyroid dysfunction

Thyroid hormones as well as the recently discovered secretory products of adipose tissue adiponectin and resistin take part in energy metabolism. To study the changes in the adipocyte hormones with changes in the thyroid functional status, we measured adiponectin, resistin, and leptin in 69 subjects with Graves' disease before and 32 patients at follow up after treatment for hyperthyroidism at hypothyroid state. Concentrations of serum adiponectin and resistin were higher in hyperthyroid state than in hypothyroid state (adiponectin: 5.73 +/- 1.1 vs. 3.0 +/- 0.5 ng/ml, P = 0.03) (resistin: 6.378 +/- 0.6 vs. 5.81 +/- 0.57 ng/ml, P < 0.0001). Resistin levels correlate positively with free t4(r = 0.37, P < 0.01), free t3 levels(r = 0.33, P < 0.01) and negatively with TSH(r = -0.22, P < 0.05). Adiponectin levels correlate with free t4(r = 0.33, P < 0.01) and free t3 (r = 0.44, P < 0.01). Though the adiponectin levels did not correlate with leptin or resistin levels, strong positive correlation of both resistin and adiponectin with thyroid hormones is noted. Serum levels of leptin did not change with change in the thyroid functional status (leptin: 53.38 +/- 2.47 vs. 55.10 +/- 2.58 NS). Leptin levels did not correlate with resistin and adiponectin. We conclude that thyroid function has effect on adipocyte hormones adiponectin and resistin but not leptin.     

Effects of standing cycling and the use of toe stirrups on maximal oxygen uptake

Twenty-eight subjects (6 normal men, 14 distance runners, and 8 rowers) were tested for maximal oxygen uptake (VO2max) and associated physiological measures during bicycle ergometer exercise with toe stirrups while standing (BEts) and during treadmill exercise (TM). Correlation between BEts VO2max and TM VO2max was high (r = 0.901, p less than 0.05). No significant difference existed between the two VO2max values (60.3 +/- 8.9 vs. 60.5 +/- 9.7 ml.kg-1.min-1; n = 28). No differences were found even when three different subgroups were separately compared. It is concluded that the higher VO2max elicited during BEts as compared with normal sitting cycling may be attributed to the increased muscle blood flow and/or involvement of a larger muscle mass, the latter being partly evidenced by the observation of greater electromyographic activity during BEts.     

Investigation of serum leptin levels and VO2max value in trained young male athletes and healthy males

The present study aimed at investigating serum leptin levels of elite young male athletes who have been regularly exercising for a long period of time and males who do not exercise. The study included 24 trained young male athletes and 22 healthy sedentary male subjects. Athletes who participated in the study were from different sports branches and have been regularly exercising for at least 2 years. Serum leptin levels were determined by RIA. VO2max levels were identified during maximal exercise. Lactic acid levels were identified one minute before and one minute after exercise from the fingertip by Pro-lactate kit. As a result of the tests, although BMI values of trained young male athletes and healthy males were close to each other, leptin levels were significantly lower (p<0.01), VO2max values were significantly higher (p<0.01) and test periods were significantly longer (p<0.001) in the former. In conclusion, regular exercise, by reducing body fat percentage, suppresses serum leptin levels.     

Exercise and diet enhance fat oxidation and reduce insulin resistance in older obese adults.

Older, obese, and sedentary individuals are at high risk of developing diabetes and cardiovascular disease. Exercise training improves metabolic anomalies associated with such diseases, but the effects of caloric restriction in addition to exercise in such a high-risk group are not known. Changes in body composition and metabolism during a lifestyle intervention were investigated in 23 older, obese men and women (aged 66 +/- 1 yr, body mass index 33.2 +/- 1.4 kg/m(2)) with impaired glucose tolerance. All volunteers undertook 12 wk of aerobic exercise training [5 days/wk for 60 min at 75% maximal oxygen consumption (Vo(2max))] with either normal caloric intake (eucaloric group, 1,901 +/- 277 kcal/day, n = 12) or a reduced-calorie diet (hypocaloric group, 1,307 +/- 70 kcal/day, n = 11), as dictated by nutritional counseling. Body composition (decreased fat mass; maintained fat-free mass), aerobic fitness (Vo(2max)), leptinemia, insulin sensitivity, and intramyocellular lipid accumulation (IMCL) in skeletal muscle improved in both groups (P < 0.05). Improvements in body composition, leptin, and basal fat oxidation were greater in the hypocaloric group. Following the intervention, there was a correlation between the increase in basal fat oxidation and the decrease in IMCL (r = -0.53, P = 0.04). In addition, basal fat oxidation was associated with circulating leptin after (r = 0.65, P = 0.0007) but not before the intervention (r = 0.05, P = 0.84). In conclusion, these data show that exercise training improves resting substrate oxidation and creates a metabolic milieu that appears to promote lipid utilization in skeletal muscle, thus facilitating a reversal of insulin resistance. We also demonstrate that leptin sensitivity is improved but that such a trend may rely on reducing caloric intake in addition to exercise training.     

Determinants of insulin-stimulated glucose disposal in middle-aged, premenopausal women

Controversy exists regarding the relative importance of adiposity, physical fitness, and physical activity in the regulation of insulin-stimulated glucose disposal. To address this issue, we measured insulin-stimulated glucose disposal [mg. kg fat-free mass (FFM)(-1). min(-1); oxidative and nonoxidative components] in 45 nondiabetic, nonobese, premenopausal women (mean +/- SD; 47 +/- 3 yr) by use of hyperinsulinemic euglycemic clamp (40 mU. m(-2). min(-1)) and [6,6-2H2]glucose dilution techniques. We also measured body composition, abdominal fat distribution, thigh muscle fat content, maximal oxygen consumption (VO2 max), and physical activity energy expenditure ((2)H(2)(18)O kinetics) as possible correlates of glucose disposal. VO2 max was the strongest correlate of glucose disposal (r = 0.63, P < 0.01), whereas whole body and abdominal adiposity showed modest associations (range of r values from -0.32 to -0.46, P < 0.05 to P < 0.01). A similar pattern of correlations was observed for nonoxidative glucose disposal. None of the variables measured correlated with oxidative glucose disposal. The relationship of VO2 max to glucose disposal persisted after statistical control for FFM, percent body fat, and intra-abdominal fat (r = 0.40, P < 0.01). In contrast, correlations of total and regional adiposity measures to insulin sensitivity were no longer significant after statistical adjustment for VO2 max. VO2 max was the only variable to enter stepwise regression models as a significant predictor of total and nonoxidative glucose disposal. Our results highlight the importance of VO2 max as a determinant of glucose disposal and suggest that it may be a stronger determinant of variation in glucose disposal than total and regional adiposity in nonobese, nondiabetic, premenopausal women.     

Seasonal aerobic performance variations in elite soccer players

The purpose of this study was to examine the seasonal changes in body composition and aerobic performance in elite soccer players. Twelve elite professional soccer players (aged 25 6 5 years, weight 75.7 6 5.3 kg, height 1.79 6 0.06 m) were measured for body fat (%), maximum oxygen consumption (VO2max), running velocity at VO2max (VO2max), running velocity at a fixed blood lactate concentration of 4 mmol · L21 (v-4 mM) at the start of the preseason period, at the beginning of the competitive period, and at midseason. VO2max, v-4 mM, and vVO2max increased significantly (p , 0.05) by 4.5, 10.5, and 7.8,respectively, after the preseason period. Thereafter, the aerobic performance parameters remained relatively constant, with no significant changes throughout the competitive period. The results of this study suggest that moderate improvements were observed in VO2max, and the %VO2max at 4 v-4 mM, whereas higher improvements were observed in VO2max and v-4 mmol · L21 after the preseason training period. On the other hand, during the competitive period, aerobic performance remained unchanged.In addition, this study suggests that heart rate, lactate, vVO2, and VO2max are useful and practical predictors that help monitor aerobic performance changes during a soccer season.     

Effect of fitness on arm vascular and metabolic responses to upper body exercise

We investigated arm perfusion and metabolism during upper body exercise. Eight average, fit subjects and seven rowers, mean +/- SE maximal oxygen uptake (VO2 max) 157 +/- 7 and 223 +/- 14 ml O2. kg(-0.73).min(-1), respectively, performed incremental arm cranking to exhaustion. Arm blood flow (ABF) was measured with thermodilution and arm muscle mass was estimated by dual-energy X-ray absorptiometry. During maximal arm cranking, pulmonary VO2 was approximately 45% higher in the rowers compared with the untrained subjects and peak ABF was 6.44 +/- 0.40 and 4.55 +/- 0.26 l/min, respectively (P < 0.05). The arm muscle mass for the rowers and the untrained subjects was 3.5 +/- 0.4 and 3.3 +/- 0.1 kg, i.e., arm perfusion was 1.9 +/- 0.2 and 1.4 +/- 0.1 l blood.kg(-1).min(-1), respectively (P < 0.05). The arteriovenous O2 difference was 156 +/- 7 and 120 +/- 8 ml/l, respectively, and arm VO2 was 0.98 +/- 0.08 and 0.60 +/- 0.04 l/min corresponding with 281 +/- 22 and 181 +/- 12 ml/kg, while arm O(2) diffusional conductance was 49.9 +/- 4.3 and 18.6 +/- 3.2 ml.min(-1).mmHg(-1), respectively (P < 0.05). Also, lactate release in the rowers was almost three times higher than in the untrained subjects (26.4 +/- 1.1 vs. 9.5 +/- 0.4 mmol/min, P < 0.05). The energy requirement of an approximately 50% larger arm work capacity after long-term arm endurance training is covered by an approximately 60% increase in aerobic metabolism and an almost tripling of the anaerobic capacity.     

Lower extremity muscle size and strength and aerobic capacity decrease with caloric restriction but not with exercise-induced weight loss.

Caloric restriction (CR) results in fat loss; however, it may also result in loss of muscle and thereby reduce strength and aerobic capacity (VO2 max). These effects may not occur with exercise-induced weight loss (EX) because of the anabolic effects of exercise on heart and skeletal muscle. We tested the hypothesis that CR reduces muscle size and strength and VO2 max, whereas EX preserves or improves these parameters. Healthy 50- to 60-yr-old men and women (body mass index of 23.5-29.9 kg/m2) were studied before and after 12 mo of weight loss by CR (n = 18) or EX (n = 16). Lean mass was assessed by dual-energy X-ray absorptiometry, thigh muscle volume by MRI, isometric and isokinetic knee flexor strength by dynamometry, and treadmill VO2 max by indirect calorimetry. Both interventions caused significant decreases in body weight (CR: -10.7 +/- 1.4%, EX: -9.5 +/- 1.5%) and lean mass (CR: -3.5 +/- 0.7%, EX: -2.2 +/- 0.8%), with no significant differences between groups. Significant decreases in thigh muscle volume (-6.9 +/- 0.8%) and composite knee flexion strength (-7.2 +/- 3%) occurred in the CR group only. Absolute VO2 max decreased significantly in the CR group (-6.8 +/- 2.3%), whereas the EX group had significant increases in both absolute (+15.5 +/- 2.4%) and relative (+28.3 +/- 3.0%) VO2 max. These data provide evidence that muscle mass and absolute physical work capacity decrease in response to 12 mo of CR but not in response to a similar weight loss induced by exercise. These findings suggest that, during EX, the body adapts to maintain or even enhance physical performance capacity.     

Aerobic fitness and body fat of young British males entering the army.

Aerobic fitness and percent body fat were measured in a sample of 438 male Army recruits between the ages of 17 and 30 prior to the commencement of training. The sample came from all areas of England and Wales. Aerobic fitness, as represented by maximal oxygen uptake (VO2 max), was predicted from the Astrand submaximal bicycle heart rate test. Body fat was predicted from four skinfold measurements. Total group means +/- SD were: age, 19.5 +/- 2.5 years; VO2 max 41.7 +/- 8.3 ml/kg . min; and body fat, 14.5 +/- 4.8% of body weight. VO2 max varied with age, athletic participation and aptitude score. No relationship was found with occupation of parent, prior civilian occupation or smoking severity. When adjusted for methodological differences, VO2 max was slightly below similar Army entrants in Norway and the United States.     

Changes in maximal aerobic capacity with age in endurance-trained women: 7-yr follow-up.

On the basis of cross-sectional data, we previously reported that the absolute, but not the relative (%), rate of decline in maximal oxygen consumption (VO(2 max)) with age is greater in endurance-trained compared with healthy sedentary women. We tested this hypothesis by using a longitudinal approach. Eight sedentary (63 +/- 2 yr at follow-up) and 16 endurance-trained (57 +/- 2) women were reevaluated after a mean follow-up period of 7 yr. At baseline, VO(2 max) was ~70% higher in endurance-trained women (48.1 +/- 1.7 vs. 28.1 +/- 0.8 ml. kg(-1). min(-1). yr(-1)). At follow-up, body mass, fat-free mass, maximal respiratory exchange ratio, and maximal rating of perceived exertion were not different from baseline in either group. The absolute rate of decline in VO(2 max) was twice as great (P < 0.01) in the endurance-trained (-0.84 +/- 0.15 ml. kg(-1). min(-1). yr(-1)) vs. sedentary (-0.40 +/- 0.12 ml. kg(-1). min(-1). yr(-1)) group, but the relative rates of decline were not different (-1.8 +/- 0.3 vs. -1.5 +/- 0.4% per year). Differences in rates of decline in VO(2 max) were not related to changes in body mass or maximal heart rate. However, among endurance-trained women, the relative rate of decline in VO(2 max) was positively related to reductions in training volume (r = 0.63). Consistent with this, the age-related reduction in VO(2 max) in a subgroup of endurance-trained women who maintained or increased training volume was not different from that of sedentary women. These longitudinal data indicate that the greater decrease in maximal aerobic capacity with advancing age observed in middle-aged and older endurance-trained women in general compared with their sedentary peers is due to declines in habitual exercise in some endurance-trained women. Endurance-trained women who maintain or increase training volume demonstrated age-associated declines in maximal aerobic capacity not different from healthy sedentary women.     

Exercise-induced reversal of insulin resistance in obese elderly is associated with reduced visceral fat.

Exercise improves glucose metabolism and delays the onset and/or reverses insulin resistance in the elderly by an unknown mechanism. In the present study, we examined the effects of exercise training on glucose metabolism, abdominal adiposity, and adipocytokines in obese elderly. Sixteen obese men and women (age = 63 +/- 1 yr, body mass index = 33.2 +/- 1.4 kg/m2) participated in a 12-wk supervised exercise program (5 days/wk, 60 min/day, treadmill/cycle ergometry at 85% of heart rate maximum). Visceral fat (VF), subcutaneous fat, and total abdominal fat were measured by computed tomography. Fat mass and fat-free mass were assessed by hydrostatic weighing. An oral glucose tolerance test was used to determine changes in insulin resistance. Exercise training increased maximal oxygen consumption (21.3 +/- 0.8 vs. 24.3 +/- 1.0 ml.kg(-1).min(-1), P < 0.0001), decreased body weight (P < 0.0001) and fat mass (P < 0.001), while fat-free mass was not altered (P > 0.05). VF (176 +/- 20 vs. 136 +/- 17 cm2, P < 0.0001), subcutaneous fat (351 +/- 34 vs. 305 +/- 28 cm2, P < 0.03), and total abdominal fat (525 +/- 40 vs. 443 +/- 34 cm2, P < 0.003) were reduced through training. Circulating leptin was lower (P < 0.003) after training, but total adiponectin and tumor necrosis factor-alpha remained unchanged. Insulin resistance was reversed by exercise (40.1 +/- 7.7 vs. 27.6 +/- 5.6 units, P < 0.01) and correlated with changes in VF (r = 0.66, P < 0.01) and maximal oxygen consumption (r = -0.48, P < 0.05) but not adipocytokines. VF loss after aerobic exercise training improves glucose metabolism and is associated with the reversal of insulin resistance in older obese men and women.     

Elevated circulating adiponectin levels in liver cirrhosis are associated with reduced liver function and altered hepatic hemodynamics

Adiponectin is a novel adipocytokine negatively correlated with parameters of the metabolic syndrome, such as body mass index (BMI), body fat mass (BFM), and circulating insulin levels. Furthermore, metabolic actions directly on the liver have been described. The aim of the present study was to characterize circulating adiponectin levels, hepatic turnover, and the association of adiponectin with key parameters of hepatic as well as systemic metabolism in cirrhosis, a catabolic disease. Circulating adiponectin levels and hepatic turnover were investigated in 20 patients with advanced cirrhosis. Hepatic hemodynamics [portal pressure, liver blood flow, hepatic vascular resistance, indocyanine green (ICG) half-life], body composition, resting energy expenditure, hepatic free fatty acids (FFA) and glucose turnover, and circulating levels of hormones (catecholamines, insulin, glucagon) and proinflammatory cytokines (IL-1beta, TNF-alpha, IL-6) were also assessed. Circulating adiponectin increased dependently on the clinical stage in cirrhosis compared with controls (15.2 +/- 1.7 vs. 8.2 +/- 1.1 microg/ml, respectively, P < 0.01), whereas hepatic extraction decreased. Adiponectin was negatively correlated with parameters of hepatic protein synthesis (prothrombin time: r = -0.62, P = 0.003; albumin: r = -0.72, P < 0.001) but not with transaminases or parameters of lipid metabolism. In addition, circulating adiponectin increased with portal pressure (r = 0.67, P = 0.003), hepatic vascular resistance (r = 0.60, P = 0.008), and effective hepatic blood flow (ICG half-life: r = 0.69, P = 0.001). Adiponectin in cirrhosis was not correlated with BMI, BFM, parameters of energy metabolism, insulin levels, hepatic FFA and glucose turnover, and circulating proinflammatory cytokines. These results demonstrate that 1) adiponectin plasma levels in cirrhosis are significantly elevated, 2) the liver is a major source of adiponectin extraction, and 3) adiponectin levels in cirrhosis do not correlate with parameters of body composition or metabolism but exclusively with reduced liver function and altered hepatic hemodynamics.     

Gender-related differences in elite gymnasts: the female athlete triad.

High-intensity training can alter the normal pattern of pubertal development in elite gymnasts. We investigated sex hormones, the ob gene product leptin, body composition, nutrition, and eating habits in female and male elite gymnasts from national cadres to elucidate gender-related differences. Serum leptin levels were decreased, particularly in pubertal girls, and did not show the normal developmental pattern. After leptin levels were transformed into standard deviation scores, mainly pubertal female gymnasts had significantly lower values than normal controls of the same gender, pubertal stage, and body mass index. The percentage of body fat was reduced compared with a normal age-matched population in both genders but to a higher degree in female gymnasts. When leptin standard deviation scores were based on percent body fat instead of body mass index, mean values were still significantly decreased compared with those of normal controls: -1.05 in girls (P < 0.001) and -0.60 in boys (P = 0.025). In both genders, total energy consumption and nutritional intake were insufficient, although to a lesser extent in male gymnasts. Pubertal development is influenced to a different degree in female and male elite gymnasts. In contrast to their male counterparts, high-intensity training takes place during the sensitive phase of pubertal maturation in female gymnasts. Whereas the girls displayed low estrogen levels, hypoleptinemia, reduced body fat mass, insufficient caloric intake, and retarded menarche, the pubertal development of male gymnasts remained almost unaltered.     

Adiponectin is not altered with exercise training despite enhanced insulin action

Adiponectin is an adipocytokine that is hypothesized to be involved in the regulation of insulin action. The purpose of the present investigation was to determine whether plasma adiponectin is altered in conjunction with enhanced insulin action with exercise training. An insulin sensitivity index (S(I)) and fasting levels of glucose, insulin, and adiponectin were assessed before and after 6 mo of exercise training (4 days/wk for approximately 45 min at 65-80% peak O(2) consumption) with no loss of body mass (PRE, 91.9 +/- 3.8 kg vs. POST, 91.6 +/- 3.9 kg) or fat mass (PRE, 26.5 +/- 1.8 kg vs. POST, 26.7 +/- 2.2 kg). Insulin action significantly (P < 0.05) improved with exercise training (S(I) +98%); however, plasma adiponectin concentration did not change (PRE, 6.3 +/- 1.5 microg/ml vs. POST, 6.6 +/- 1.8 microg/ml). In contrast, in a separate group of subjects examined before and after weight loss, there was a substantial increase in adiponectin (+281%), which was accompanied by enhanced insulin action (S(I), +432%). These data suggest that adiponectin is not a contributory factor to the exercise-related improvements in insulin sensitivity.