Digital fluoroscopic video assessment of glenohumeral migration: Static vs. Dynamic conditions

The purpose was to compare glenohumeral (GH) migration, during dynamic shoulder elevation and statically held positions using digital fluoroscopic videos (DFV). Thirty male volunteers (25±4 years) without right shoulder pathology were analyzed using DFV (30 Hz) during arm elevation in the scapular plane. DFV were obtained at the arm at side position, 45°, 90°, and 135° for static and dynamic conditions. GH migration was measured as the distance from the center of the humeral head migrated superiorly or inferiorly relative to the center of the glenoid fossa. Inter-rater reliability was considered good; ICC (2,3) ranged from 0.83 to 0.92. A main effect was revealed for contraction type (p=0.031), in which post-hoc t-tests revealed that humeral head was significantly more superior on the glenoid fossa during dynamic contraction. A main effect was also revealed for arm angle (p<0.001), in which post-hoc t-tests revealed significantly more superior humeral head positioning at 45°, 90°, and 135° when compared to arm at side (p<0.001), as well as at 90° compared to 45° (p=0.024). There was no interaction effect between angle and contraction type (p=0.400). Research utilizing static imaging may underestimate the amount of superior GH migration that occurs dynamically.     

Sharper angle,higher risk? The effect of cutting angle on knee mechanics in invasion sport athletes

IntroductionCutting is an important skill in team-sports, but unfortunately is also related to non-contact ACL injuries. The purpose was to examine knee kinetics and kinematics at different cutting angles.Material and methods13 males and 16 females performed cuts at different angles (45°, 90°, 135° and 180°) at maximum speed. 3D kinematics and kinetics were collected. To determine differences across cutting angles (45°, 90°, 135° and 180°) and sex (female, male), a 4 × 2 repeated measures ANOVA was conducted followed by post hoc comparisons (Bonferroni) with alpha level set at α ≤ 0.05 a priori.ResultsAt all cutting angles, males showed greater knee flexion angles than females (p < 0.01). Also, where males performed all cutting angles with no differences in the amount of knee flexion −42.53° ± 8.95°, females decreased their knee flexion angle from −40.6° ± 7.2° when cutting at 45° to −36.81° ± 9.10° when cutting at 90°, 135° and 180° (p < 0.01). Knee flexion moment decreased for both sexes when cutting towards sharper angles (p < 0.05). At 90°, 135° and 180°, males showed greater knee valgus moments than females. For both sexes, knee valgus moment increased towards the sharper cutting angles and then stabilized compared to the 45° cutting angle (p < 0.01). Both females and males showed smaller vGRF when cutting to sharper angles (p < 0.01).ConclusionIt can be concluded that different cutting angles demand different knee kinematics and kinetics. Sharper cutting angles place the knee more at risk. However, females and males handle this differently, which has implications for injury prevention.     

Assessing reproductive biology of Macrobrachium lamarrei in the Ganges River (NW Bangladesh) in relation to environmental parameters

Macrobrachium lamarrei (H. Milne-Edwards, 1837) is a well-known freshwater prawn species of Bangladesh. The aim of the research is to explore various reproductive aspects (size at sexual maturity, reproductive period and fecundity) of M. lamarrei in the Ganges River, Bangladesh through October 2012 to September 2013. We also study the environmental parameters and their impact on reproduction of M. lamarrei. A total 391 (ovigerous = 141, non-ovigerous = 250) female specimens were collected using Drag net. The TL₅₀ (the TL at which 50% of individuals become mature) was calculated by a logistic equation as 5.20 cm. Based on the availability of ovigerous females the spawning season was February-November with the peak June-July. Further, 50% and 90% ovigerous females were observed when Fulton’s condition factor (K_F) was 0.85 and 1.03, respectively. The total fecundity (F_T) was ranged from 65 to 370 where TL was 4.20–6.40 cm and BW was 0.84–2.50 g. Fecundity was found to be highly correlated with TL (r² ≥ 0.96, r_s = 0.96, p < 0.0001) and BW (r² ≥ 0.88, r_s = 0.93, p < 0.0001). Temperature (r_p = 0.82, p = 0.009), dissolved oxygen (DO) (r_p = −0.83, p = 0.0007), pH (r_p = 0.80, p = 0.0014) and total alkalinity (r_p = −0.87, p = 0.0002), were highly correlated with ovigerous females. The average temperature on peak spawning season was 32 °C. Also, the spawning period connected with the peak rainfall and showed a notable relation between rainfall and ovigerous females. In addition, exploration of long data series pointed that yearly average air temperature is rising by 0.029 °C yr⁻¹, whereas yearly average rainfall is falling by 2.96 mm yr⁻¹. Therefore, the result will be helpful for the sustainable management and conservation of M. lamarrei through fixed permissible mesh size and establishment of a ban period in the Ganges River, Bangladesh and adjoining ecosystems.     

Influence of muscle anatomical cross-sectional area on the moment arm length of the triceps brachii muscle at the elbow joint

The purpose of this study was to test the hypothesis that the musculotendon moment arm length is affected by the muscle anatomical cross-sectional area. The moment arm length of the triceps brachii (TB) muscle at 30°, 50°, 70°, 90°, 110° elbow flexion positions was measured in sagittal magnetic resonance images (MRI) of 18 subjects as the perpendicular distance between the center of the pulley of the humerus to the line through the center of the TB tendon. The moment arm increased as the elbow flexion angle decreased, from 1.74±0.13 cm at 110° to 2.39±0.14 cm at 30°. The maximal anatomical cross-sectional area of the TB muscle was significantly correlated with the moment arms at all joint positions (r=0.545–0.803, p<0.05). Furthermore, the circumference of the upper arm was also significantly correlated with the moment arms at all joint positions, except for 70° (r=0.504–0.702, p<0.05). These results indicate that the moment arm length of the TB muscle is affected by the muscle anatomical cross-sectional area.     

Correlations of selenium and selenoprotein P with asymmetric dimethylarginine and lipid profile in patients with polycystic ovary syndrome

BackgroundPolycystic ovary syndrome (PCOS) is associated with an increased risk of cardiovascular diseases (CVD). Accumulating evidence has suggested that selenium (Se) is of importance for optimal function of the cardiovascular system. This study aimed to investigate the associations of selenium and selenoprotein P (SePP) with asymmetric dimethylarginine (ADMA) and lipid profile in women with PCOS.MethodsIn this cross-sectional study, 125 females aged 18–45 years diagnosed with PCOS were recruited. An interviewer-administered questionnaire was applied to gather the relevant demographic characteristics, detailed clinical information, and lifestyle habits of participants. Fasting blood samples were obtained to measure biochemical parameters. Serum concentrations of total testosterone, sex hormone-binding globulin (SHBG), ADMA, and lipid profiles as well as anthropometric measurements were assessed across tertiles of serum Se and SePP concentrations.ResultsThere was a positive correlation between serum Se and SePP concentrations (r = 0.434, p < 0.001). Serum Se level was inversely correlated with ADMA (r = −0.21, p = 0.025) and TG (r = −0.17, p = 0.041) concentrations. There were also inverse correlations between SePP and ADMA (r = −0.34, p < 0.001), TG (r = −0.21, p = 0.019), and oxidized low density lipoprotein (ox-LDL) (r = −0.25, p = 0.007) levels. No significant relationship was found between serum Se and SePP concentrations with total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B100), total testosterone, SHBG, and free androgen index as well as anthropometric parameters (All p > 0.05).ConclusionThe present study found that Se and SePP levels were inversely correlated with ADMA and TG concentrations as well as ox-LDL levels.     

The relationship between fetal and maternal selenium concentrations in sheep and goats

In this study, biological samples (slaughterhouse material) were collected from 30 sheep and 36 goats and classified according to gestational stage into either early or late gestation. Samples consisted of allantoic fluid, amniotic fluid, fetal liver, fetal kidney, fetal thyroid gland, maternal plasma and liver to determine selenium (Se) concentrations throughout gestation. The Se concentrations in the allantoic fluid, fetal liver and kidney increased significantly (p < 0.01) during late gestation. Concurrently, the Se concentrations in amniotic fluid, maternal plasma and liver decreased significantly (p < 0.01) over time. Significant (p < 0.01) positive relationships were recorded between the age of the fetus and Se concentrations in the allantoic fluid (r = 0.57–0.75), fetal liver (r = 0.43–0.59) and kidney (r = 0.80–0.81) in both sheep and goats. A significant (p < 0.05) positive relationships were also recorded between the Se concentrations in the allantoic fluid and fetal liver (r = 0.35–0.37), the maternal plasma and liver Se concentrations (r = 0.37–0.57) between sheep and goats. A significant (p < 0.05) negative correlation was recorded between the Se concentrations in the allantoic fluid with maternal plasma of sheep (r = −0.41) as well as between the fetal liver and maternal liver Se (r = −0.22 to 0.50) and a negative correlation (r = −0.42 to 0.43) (p < 0.01) between Se concentrations in the fetal liver and amniotic fluid in both sheep and goats, respectively. Se concentration in the fetal liver was significantly (p < 0.01) higher than that of the kidney and thyroid. In the thyroid gland no morphological differences were noted. Strong fetal–maternal relationships in Se concentration were evident throughout the gestational period and dams seem to sacrifice Se levels in order to maintain that in the fetus. Se concentrations in the amniotic and allantoic fluids could be used as a possible indicator of the Se status of the fetus throughout gestation.     

Tibio-femoral joint contact in healthy and osteoarthritic knees during quasi-static squat: A bi-planar X-ray analysis

The aim of this study was to quantify the tibio-femoral contact point (CP) locations in healthy and osteoarthritic (OA) subjects during a weight-bearing squat using stand-alone biplanar X-ray images.Ten healthy and 9 severe OA subjects performed quasi-static squats. Bi-planar X-ray images were recorded at 0°, 15°, 30°, 45°, and 70° of knee flexion. A reconstruction/registration process was used to create 3D models of tibia, fibula, and femur from bi-planar X-rays and to measure their positions at each posture. A weighted centroid of proximity algorithm was used to calculate the tibio-femoral CP locations. The accuracy of the reconstruction/registration process in measuring the quasi-static kinematics and the contact parameters was evaluated in a validation study.The quasi-static kinematics data revealed that in OA knees, adduction angles were greater (p<0.01), and the femur was located more medially relative to the tibia (p<0.01). Similarly, the average CP locations on the medial and lateral tibial plateaus of the OA patients were shifted (6.5±0.7 mm; p<0.01) and (9.6±3.1 mm; p<0.01) medially compared to the healthy group. From 0° to 70° flexion, CPs moved 8.1±5.3 mm and 8.9±5.3 mm posteriorly on the medial and lateral plateaus of healthy knees; while in OA joints CPs moved 10.1±8.4 mm and 3.6±2.8 mm posteriorly. The average minimum tibio-femoral bone-to-bone distances of the OA joints were lower in both compartments (p<0.01).The CPs in the OA joints were located more medially and displayed a higher ratio of medial to lateral posterior translations compared to healthy joints.     

Fire service instructor's undergarment choice to reduce Interleukin-6 and minimise physiological and perceptual strain

Fire Service Instructors frequently experience high levels of physiological and perceptual strain during live fire exposures. Instructors are also at risk of cardiovascular illnesses, with cardiac death being the greatest cause of fire fighter death. Current practice for UK instructors is to select undergarment type based on personal preference, between a boiler suit (BOILER) and a wicking base layer (WBL). Research suggests that shorts and t-shirt (SHORTS) may also be a beneficial alternative undergarment choice. The UK South East Fire Service requested an investigation to identify if undergarment selection can lessen the strain experienced by instructors, and reduce the acute inflammatory response to fire exposures. Eight males completed three 45 min sessions in a heat chamber (49.5±1.4 °C and 16.9±4.3% RH) whilst performing intermittent walking. At the end of heat exposure change in heart rate was not effected by garment type (p=0.061, ηp²=0.373). Change in rectal temperature was different between garments (p=0.009, η_p²=0.271), with trends suggesting that BOILER resulted in a greater change (1.03±0.60 °C) than SHORTS (0.76±0.37 °C, p=0.589, d=0.21) and WBL (0.72±0.33 °C, p=0.545, d=0.25). Interleukin-6 post exposure was greater for BOILER (6.96±0.28 pg mL⁻¹) than both SHORTS (6.59±0.30 pg mL⁻¹, p=0.043, d=0.42) and WBL (6.45±0.43 pg mL⁻¹, p=0.031, d=0.51). Overall, undergarment type had little impact on physiological or perceptual strain. However, wearing WBL or SHORTS may reduce the inflammatory response, and consequently decrease the risk of cardiovascular events.     

Effect of different iodide intake during pregnancy and lactation on thyroid and cardiovascular function in maternal and offspring rats

ObjectiveWe aimed to investigate the impact of different iodide intake during pregnancy and lactation on iodine concentration in urine and serum, fatty acid metabolism, thyroid and cardiovascular function in maternal and offspring rats.MethodsPregnant rats were randomly assigned to four groups: normal adult iodide intake (NAI, 7.5 μg/d), normal pregnant iodide intake (NPI, 12.5 μg/d), 5 times (5 HI, 62.5 μg/d) and 10 times higher-than-normal pregnant iodide intake (10 HI, 125 μg/d). The maternal rats were continuously administered potassium iodide until postnatal day 16 (PN16). Thyroid function was measured by enzyme-linked immunosorbent assay (ELISA). The iodine concentration in urine and serum were detected by inductively coupled plasma mass spectrometry (ICP-MS). The messenger ribonucleic acid (mRNA) expressions of Krüppel-like factor 9 (KLF9) and thioredoxin reductase 2 (Txnrd2) were measured using quantitative real-time polymerase chain reaction (RT-qPCR). Characteristic distribution of KLF9 expression and its interaction with TRβ was assessed by immunohistochemical and immunofluorescence staining. Serum fatty acids were analyzed by Liquid Chromatography-Mass Spectrometry (LC-MS). Cardiac function and blood pressure were measured by echocardiography and a non-invasive tail-cuff system.ResultsHigh iodide intake (5 HI and 10 HI) during pregnancy and lactation results in increased urinary iodine concentration (UIC), serum total iodine concentration (STIC) and serum non-protein-bound iodine concentration (SNBIC) in both maternal and offspring rats, along with significantly increased FT3 and its target gene expression of KLF9. In maternal rats of both 5 HI and 10 HI groups, systolic blood pressure (SBP) was significantly higher, the increased SBP was significantly correlated with the increased UIC (r = 0.968, p = 0.002; r = 0.844, p = 0.035), KLF9 (r = 0.935, p = 0.006; r = 0.954, p = 0.003) and the decreased Txnrd2 (r = −0.909, p = 0.012; r = −0.912, p = 0.011). In maternal rats of 10 HI group, cardiac hyperfunction with increased LVEF, LVFS and decreased LVESD were observed. The increased LVEF and decreased LVESD were significantly correlated with UIC, STIC and SNBIC (r = 0.976, p = 0.001; r = 0.945, p = 0.005; r = 0.953, p = 0.003; r = −0.917, p = 0.01; r = −0.859, p = 0.028; r = −0.847, p = 0.033), LVEF, LVFS and LVESD were significant correlated with KLF9 (r = 0.950, p = 0.004; r = 0.963, p = 0.002; r = −0.990, p = 0.0002) and Txnrd2 expression (r = −0.979, p = 0.001; r = −0.915, p = 0.01; r = 0.933, p = 0.007), and the decreased LVESD was correlated with decreased epoxyeicosatrienoic acid (EET) metabolites: 5,6-EET, 8,9-DHET and 11,12-DHET (r = 0.999, p = 0.034; r = 1.000, p = 0.017; r = 1.000, p = 0.017). While in offspring rats, no significant change in SBP and cardiac function was found. STIC and SNBIC were much lower than those in maternal rats, and eicosapentaenoic acid (EPA) metabolites (9-HEPE, 15-HEPE and 14,15 DiHETE) were significantly increased.ConclusionIn addition to thyroid hormones, STIC, SNBIC, KLF9, Txnrd2, EET and EPA metabolites might be promising biomarkers in high iodide intake-induced thyroid and cardiovascular function.     

Biceps femoris and semitendinosus tendon/aponeurosis strain during passive and active (isometric) conditions

The purpose of this study was to quantify strain and elongation of the long head of the biceps femoris (BFlh) and the semitendinosus (ST) tendon/aponeurosis. Forty participants performed passive knee extension trials from 90° of knee flexion to full extension (0°) followed by ramp isometric contractions of the knee flexors at 0°, 45° and 90° of knee flexion. Two ultrasound probes were used to visualize the displacement of BFlh and ST tendon/aponeurosis. Three-way analysis of variance designs indicated that: (a) Tendon/aponeurosis (passive) elongation and strain were higher for the BFlh than the ST as the knee was passively extended (p < 0.05), (b) contraction at each angular position was accompanied by a smaller BFlh tendon/aponeurosis (active) strain and elongation than the ST at higher levels of effort (p < 0.05) and (c) combined (passive and active) strain was significantly higher for the BFlh than ST during ramp contraction at 0° but the opposite was observed for the 45° and 90° flexion angle tests (p < 0.05). Passive elongation of tendon/aponeurosis has an important effect on the tendon/aponeurosis behavior of the hamstrings and may contribute to a different loading of muscle fibers and tendinous tissue between BFlh and ST.     

The Added and Interpretative Value of CGM-Derived Parameters in Type 1 Diabetes Depends on the Level of Glycemic Control

ObjectiveIn type 1 diabetes mellitus (T1DM) management, continuous glucose monitoring (CGM)-derived parameters can provide additional insights, with time in range (TIR) and other parameters reflecting glycemic control and variability being put forward. This study aimed to examine the added and interpretative value of the CGM-derived indices TIR and coefficient of variation (CV%) in T1DM patients stratified according to their level of glycemic control by means of HbA1C.MethodsT1DM patients with a minimum disease duration of 10 years and without known macrovascular disease were enrolled. Patients were equipped with a blinded CGM device for 7 days. TIR and time spent in hypoglycemia and hyperglycemia were determined, and CV% was used as a parameter for glycemic variability. Pearson (r) and Spearman correlations (r_s) and a regression analysis were used to examine associations.ResultsNinety-five patients (age: 45 ± 10 years; HbA1C level: 7.7% ± 0.8% [61 ± 7 mmol/mol]) were included (mean blood glucose [MBG]: 159 ± 31 mg/dL; TIR: 55.8% ± 14.9%; CV%: 43.5% ± 7.8%) and labeled as having good (HbA1C level ≤7% [≤53 mmol/mol]; n = 20), moderate (7%-8%; n = 44), or poor (>8% [>64 mmol/mol]; n = 31) glycemic control. HbA1C was significantly associated with MBG (r_s = 0.48, P < .001) and time spent in hyperglycemia (total: r_s = 0.52; level 2: r = 0.46; P < .001) but not with time spent in hypoglycemia and CV%, even after an analysis of the HbA1C subgroups. Similarly, TIR was negatively associated with HbA1C (r = −0.53; P < .001), MBG (r_s = −0.81; P < .001), and time spent in hyperglycemia (total: r_s = −0.90; level 2: r_s = −0.84; P < .001) but not with time in hypoglycemia. The subgroup analyses, however, showed that TIR was associated with shorter time spent in level-2 hypoglycemia in patients with good (r_s = −0.60; P = .007) and moderate (r_s = −0.25; P = .047) glycemic control. In contrast, CV% was strongly positively associated with time in hypoglycemia (total: r_s = 0.78; level 2: r_s = 0.76; P < .001) but not with TIR or time in hyperglycemia in the entire cohort, although the subgroup analyses showed that TIR was negatively associated with CV% in patients with good glycemic control (r = −0.81, P < .001) and positively associated in patients with poor glycemic control (r = +0.47; P < .01).ConclusionThe CGM-derived metrics TIR and CV% are related to clinically important situations, TIR being strongly dependent on hyperglycemia and CV% being reflective of hypoglycemic risk. However, the interpretation and applicability of TIR and CV% and their relationship depends on the level of glycemic control of the individual patient, with CV% generally adding less clinically relevant information in those with poor control. This illustrates the need for further research and evaluation of composite measures of glycemic control in T1DM.     

Does dietary arsenic and mercury affect cutaneous bleeding time and blood lipids in humans?

Fish species may contain considerable amounts of trace elements, such as selenium (Se), arsenic (As), and mercury (Hg). The present study investigated the relationships between dietary intake of these elements and cutaneous bleeding time and blood lipids in 32 healthy volunteers. For 6 wk, one group (n=11) consumed approx 250 g Se-rich fish daily, providing them with an average Se intake of 115±31 μg Se/d, Hg intake of 18±8 μg/d, and As intake of 806±405 μg/d, all values analyzed in 4-d duplicate food collections. To study the effect of Se alone, one group (n=11) included Se-rich bread in their normal diet, giving them a Se intake (135±25 μg/d) that was comparable to the fish group. A control group (n=10) ate their normal diet, providing 77±25 gmg Se/d, 3.1±2.5 μg Hg/d, and 101±33 μg As/d. The dietary As load strongly correlated both with bleeding times and changes in bleeding times (r=0.48,p<0.01 andr=0.54,p<0.002, respectively). Dietary Hg showed a positive correlation with LDL-cholesterol (r=0.55,p<0.01), whereas dietary Hg in the fish group showed a strong negative relationship with HDL-cholesterol (r=?0.76,p<0.01). Selenium seemed to have only a modest effect on bleeding time. Our results suggest that mercury and arsenic from fish may be factors contributing to or modifying some of the known effects of fish ingestion.     

The effects of upper limb posture and a sub-maximal gripping task on corticospinal excitability to muscles of the forearm

Variations in handgrip force influences shoulder muscle activity, and this effect is dependent upon upper limb position. Previous work suggests that neural coupling between proximal and distal muscles with changes in joint position is a possible mechanism but these studies tend to use artificially constrained postures that do not reflect activities of daily living. The purpose of this study was to examine the effects of upper limb posture on corticospinal excitability to the forearm muscles during workplace relevant arm positions. Motor evoked potentials (MEPs) were elicited in four forearm muscles via transcranial magnetic stimulation at six arm positions (45°, 90° and 120° of humeral elevation in both the flexion and abduction planes). MEPs were delivered as stimulus–response curves (SRCs) at rest and at constant intensity during two gripping tasks. Boltzmann plateau levels were smaller for the flexor carpi radialis in flexion at 45° versus 90° (p = 0.0008). Extensor carpi radialis had a greater plateau during flexion than abduction (p = 0.0042). Corticospinal excitability to the forearm muscles were influenced by upper limb posture during both the resting and gripping conditions. This provides further evidence that upper limb movements are controlled as a whole rather than segmentally and is relevant for workplace design considerations.     

Muscle activation history at different vertical jumps and its influence on vertical velocity

In the present study we investigated displacement, time, velocity and acceleration history of center of mass (COM) and electrical activity of knee extensors to estimate the dominance of the factors influencing the vertical velocity in squat jumps (SJs), countermovement jumps (CMJs) and drop jumps (DJs) performed with small (40°) and large (80°) range of joint motion (SROM and LROM). The maximum vertical velocity (v4) was 23.4% (CMJ) and 7.8% (DJ) greater when the jumps were performed with LROM compared with SROM (p < 0.05). These differences are considerably less than it could be expected from the greater COM and knee angular displacement and duration of active state. This small difference can be attributed to the greater deceleration during eccentric phase (CMJ:32.1%, DJ:91.5%) in SROM than that in LROM. v4 was greater for SJ in LROM than for SJ in SROM indicating the significance of the longer active state and greater activation level (p < 0.001). The difference in v4 was greater between SJ and CMJ in SROM (38.6%) than in LROM (9.0%), suggesting that elastic energy storage and re-use can be a dominant factor in the enhancement of vertical velocity of CMJ and DJ compared with SJ performed with SROM.     

Elevated plasma levels of soluble (pro)renin receptor in patients with obstructive sleep apnea syndrome: Association with polysomnographic parameters

(Pro)renin receptor ((P)RR) is a specific receptor for both renin and its precursor prorenin. (P)RR was shown to be involved in pathophysiology of cardiovascular and renal diseases. Soluble (pro)renin receptor (s(P)RR), which is generated by furin from full length (P)RR, is present in blood. The aim of the present study is to clarify the association of plasma s(P)RR levels and the severity of OSAS. Plasma levels of s(P)RR were measured by ELISA in 58 male patients diagnosed as OSAS based on polysomnography, and 14 age-matched male control subjects. Blood samples were obtained at 6:00 a.m. just after overnight polysomnography. Plasma s(P)RR levels were significantly higher in patients with OSAS (9.0 ± 2.0 ng/mL, mean ± SD) than in control subjects (7.4 ± 1.5 ng/mL) (P = 0.0026). Plasma s(P)RR levels showed a significant negative correlation with % stage rapid eye movement (REM) sleep (r = −0.377, p < 0.005), and significant positive correlations with % stage 1 (r = 0.374, p < 0.005), arousal index (r = 0.341, p < 0.01), apnea hypopnea index (AHI) (r = 0.352, p < 0.01) and desaturation index (r = 0.302, p < 0. 05). In 12 OSAS patients with AHI ≥20, plasma levels of s(P)RR were studied after 3-month treatment with nasal continuous positive airway pressure (nCPAP). Plasma s(P)RR levels were significantly decreased after the nCPAP treatment (p = 0.0016). The present study has shown for the first time elevated plasma s(P)RR levels in patients with OSAS. Plasma s(P)RR levels were associated with the severity of OSAS. Soluble (P)RR may serve as a plasma marker reflecting the severity of OSAS.     

Circulating levels of irisin in patients with anorexia nervosa and different stages of obesity – Correlation with body mass index

Irisin was recently identified as cleavage product of fibronectin type III domain containing 5 (FNDC5) and shown to increase energy expenditure in mice and humans and therefore was discussed as potential treatment option in obesity. However, the regulation of irisin under conditions of severely altered body weight such as anorexia nervosa and obesity remains to be investigated. We analyzed circulating irisin levels over a broad spectrum of body weight in 40 patients with anorexia nervosa (mean body mass index, BMI 12.6 ± 0.7 kg/m²), normal weight controls (22.6 ± 0.9 kg/m²) and obese patients with BMI of 30–40 (36.9 ± 1.2 kg/m²), 40–50 (44.9 ± 1.1 kg/m²) and >50 (70.1 ± 2.7 kg/m², n = 8/group). Correlation analyses were performed between irisin and different body indices, parameters of body composition and hormones involved in various homeostatic processes. Obese patients showed higher circulating irisin levels compared to normal weight and anorexic patients (p < 0.05) resulting in a correlation of irisin with body weight (r = 0.47, p < 0.01) and BMI (r = 0.50, p < 0.001). Plasma irisin was also positively correlated with fat mass (r = 0.48, p < 0.01), body cell mass (r = 0.45, p < 0.01) and fat free mass (r = 0.40, p < 0.05). Insulin levels were positively correlated with irisin (r = 0.45, p < 0.01), whereas circulating ghrelin, cortisol, thyroid-stimulating hormone or C-reactive protein were not (p > 0.05). These data indicate that circulating irisin is affected under conditions of altered BMI with highest levels in severely obese patients. The increase of irisin under conditions of obesity may indicate a physiological function to improve glucose tolerance which is often impaired in obese subjects.