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Background: We investigated the temporal causal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) progression with the risk of dysglycemia, insulin resistance, and dyslipidemia.Methods: We included 3862, 17.7-year-old, participants from the Avon Longitudinal Study of Parents and Children, followed up for 7 years. cfPWV, cIMT, and fasting plasma samples were repeatedly measured. We computed homeostatic model assessment (HOMA) of insulin resistance and percent pancreatic beta-cell function. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models.Results: A higher cfPWV at 17.7 years was associated with higher insulin at age 24.5 years (odds ratio, 1.25 [CI, 1.08-1.44]; P=0.003), which slightly attenuated after covariates adjustment. Higher cIMT at 17.7 years was associated with lower insulin (odds ratio, 0.06 [0.01-0.95]; P=0.046) at 24.5 years, after covariate adjustments. In mixed-effect models, the 7-year progression in cfPWV (predictor) was directly associated with the increase in triglyceride (outcome). cIMT progression was associated with the 7-year increase in LDL (low-density lipoprotein), triglyceride, and glucose. In cross-lagged models, higher cfPWV at 17.7 years was associated with higher insulin (β=0.06, SE, 0.12, P=0.014), HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years. However, insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 17.7 years were not associated with cfPWV at 24.5 years. Higher cIMT at 17.7 years was associated with reduced insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years, but not vice versa. Higher glucose at 17.7 years was associated with higher cfPWV and cIMT at 24.5 years only.Conclusions: Arterial stiffness in adolescence may be a causal risk factor for hyperinsulinemia and insulin resistance in young adulthood. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine whether estimated cardiorespiratory fitness (CRF), fat mass (FM), lean mass (LM), and adiponectin bidirectionally associate with arterial function and structure and if CRF mediates the relationship between cardiometabolic health and arterial outcomes in 9- to 11-yr-old children drawn from the Avon Longitudinal Study of Parents and Children birth cohort, United Kingdom. Methods : Brachial artery flow-mediated dilation (FMD), distensibility coefficient (DC), and carotid-radial pulse wave velocity (PWV) were measured by ultrasonography; CRF was measured during the submaximal ergometer test; total FM, trunk FM, and LM were measured by dual-energy x-ray absorptiometry; plasma adiponectin was measured by enzyme assay; and cardiometabolic health was computed based on the International Diabetes Federation criteria for diagnosing metabolic syndrome. We tested bidirectionality by including CRF, FM, LM, and adiponectin as exposures and FMD, DC, and PWV as outcomes, alternatively. Results : Among 5566 participants (2816 (51%) girls; median age, 9.75 yr), CRF per body mass0.21 was directly related to DC ([beta] (95% confidence interval) = 0.004 (<0.0001 to 0.008); P = 0.046), whereas CRF per LM0.54 was inversely associated with PWV (- 0.034 (-0.063 to -0.003); 0.032) after adjusting for covariates. These associations remained in bidirectional analyses. Total FM, trunk FM, and LM were bidirectionally and positively associated with FMD and DC. Total FM and trunk FM but not LM had bidirectional and inverse associations with PWV. Adiponectin was not related to FMD, DC, or PWV. CRF partially mediated the associations of cardiometabolic health with FMD (1.5% mediation), DC (12.1% mediation), and PWV (3.5% mediation). Conclusions : Associations of poor cardiometabolic health with adverse arterial structure and function in childhood may be mitigated by increasing CRF. Higher CRF was associated with better arterial structure whereas higher total FM and trunk FM were associated with better arterial function and structure. In the reverse analysis, healthy arterial structure and function were independently associated with increased total FM and trunk FM, suggesting an "arterial paradox." [ABSTRACT FROM AUTHOR]

We examined the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) with the risk of overweight/obesity and elevated blood pressure (BP)/hypertension. We studied 3862 adolescents aged 17.7 years from the Avon Longitudinal Study of Parents and Children, followed-up for 7 years. cfPWV and cIMT were measured by ultrasound. Total and trunk fat mass and lean mass were assessed by dual-energy X-ray absorptiometry. Body mass index and BP were measured. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models, with covariate adjustments. Among 1719 male and 2143 female participants, higher cfPWV at 17.7 years was associated with the risk of elevated systolic BP/hypertension (odds ratio, 1.20 [1.02-1.41]; P=0.026), elevated diastolic BP/hypertension (1.77 [1.32-2.38]; P<0.0001), body mass index-overweight/obesity (1.19 [1.01-1.41]; P=0.041), and trunk fat mass overweight/obesity (1.24 [1.03-1.49]; P=0.023) at 24.5 years. Higher cIMT at 17.7 years had no associations with obesity and elevated BP at follow-up. cfPWV progression was directly associated with 7-year increase in systolic BP (effect estimate 16 mm Hg [9-24]; P<0.0001) and diastolic BP (28 mm Hg [23-34]; P<0.0001). cIMT progression was directly associated with the 7-year increase of all adiposity measures and diastolic BP. In the temporal analysis, baseline cfPWV was directly associated with follow-up systolic and diastolic BP, however, baseline BP was unassociated with follow-up cfPWV. cfPWV but not cIMT was bidirectionally associated with adiposity. Obesity and hypertension prevention from adolescence may require developing novel approaches to mitigate arterial stiffness. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Purpose: Sports have different effects on bone development and effective interventions to improve bone health of adolescent athletes are needed. The purpose of the study was to investigate the effect of a 9-month jumping intervention on bone geometry and metabolism in adolescent male athletes. Methods: Ninety-three adolescent (14.1 yr old) male swimmers (SWI), footballers (FOO), and cyclists (CYC) were randomized to intervention and sport (INT-SWI = 19, INT-FOO = 15, and INT-CYC = 14) or sport only (CON-SWI = 18, CON-FOO = 15, and CON-CYC = 12) groups. Cross-sectional area, cross-sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck were assessed using hip structural analysis and trabecular texture of the lumbar spine using trabecular bone score. Bone mineral content (BMC) at femoral neck and lumbar spine was assessed using dual-energy x-ray absorptiometry. Serum N-terminal propeptide of procollagen type I, isomer of the carboxy-terminal telopeptide of type 1 collagen, total serum calcium, and 25-hydroxyvitamin D were analyzed. Results: INT-CYC acquired significantly higher lumbar spine BMC (4.6%) and femoral neck BMC (9.8%) than CON-CYC. INT-CYC acquired significantly higher cross-sectional area (11.0%), CSMI (10.1%), and trabecular bone score (4.4%) than CON-CYC. INT-SWI acquired significantly higher femoral neck BMC (6.0%) and CSMI (10.9%) than CON-SWI. There were no significant differences between INT-FOO and CON-FOO in any bone outcomes. N-terminal propeptide of procollagen type I significantly decreased in CON-SWI, INT-FOO, CON-FOO, and CON-CYC. Carboxy-terminal telopeptide of type 1 collagen significantly decreased in CON-SWI and CON-CYC. The 25-hydroxyvitamin D significantly increased in INT-CYC, CON-CYC, INT-FOO, and CON-FOO. Conclusions: A 9-month jumping intervention improved bone outcomes in adolescent swimmers and cyclists, but not in footballers. This intervention might be used by sports clubs to improve bone health of adolescent athletes. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe the relationship between body size and oxygen uptake efficiency slope (OUES) in pediatric patients with cystic fibrosis (CF) and healthy controls (CON), to identify appropriate scaling procedures to adjust the influence of body size upon OUES. Methods: The OUES was derived using maximal and submaximal points from cardiopulmonary exercise testing in 72 children (36 CF and 36 CON). OUES was subsequently scaled for stature, body mass (BM), and body surface area (BSA) using ratio-standard (Y/X) and allometric (Y/Xb) methods. Pearson's correlation coefficients were used to determine the relationship between body size and OUES. Results: When scaled using the ratio-standard method, OUES had a significant positive relationship with stature (r = 0.54, P G 0.001) and BSA (r = 0.25, P = 0.031) and significant negative relationship with BM (r = -0.38, P = 0.016) in the CF group. Combined allometric exponents (b) for CF and CON were stature 3.00, BM 0.86, and BSA 1.40. A significant negative correlation was found between OUES and stature in the CF group when scaled allometrically (r = -0.37, P = 0.027). Nonsignificant (P > 0.05) correlations for the whole group were found between OUES and allometrically scaled BM (CF r = -0.25, CON, r = 0.15) and BSA (CF r = -0.27, CON r = 0.13). Conclusions: Only allometric scaling of either BM or BSA, and not ratio-standard scaling, successfully eliminates the influence of body size upon OUES. Therefore, this enables a more direct comparison of the OUES between patients with CF and healthy controls. [ABSTRACT FROM AUTHOR]

Purpose: Exercise is an effective approach for developing bone mass and adolescence is a key period to optimize bone health. However, sports specific training may have different effects on bone outcomes. This study examined the differences on bone outcomes between osteogenic (football) and non-osteogenic (swimming and cycling) sports and a control group in adolescent males. Methods: One hundred twenty one males (13.1±0.1 years) were measured: 41 swimmers, 37 footballers, 29 cyclists and 14 controls. Dual energy X-ray absorptiometry measured bone mineral density (BMD) and content (BMC) at lumbar spine, right and left hip and total body. Hip structural analysis evaluated bone geometry at the femoral neck. Quantitative ultrasound evaluated bone stiffness at both feet. Results: Footballers had significantly higher BMD at total body less head (7-9 %), total hip (12-21 %) and legs (7-11 %) compared to all groups and significantly higher BMD at the femoral neck than controls (14 %). Cyclists had higher BMD at the trochanter (10 %) and BMC at the arms (10 %) compared to controls. Geometrical analysis showed that footballers had significantly higher cross-sectional area (8-19 %) compared to all groups, cross-sectional moment of inertia (17 %) compared to controls and section modulus compared to cyclists (11 %) and controls (21 %). Footballers had significantly higher bone stiffness compared to all groups (10-20 %) at the dominant foot and (12-13 %) at the non-dominant foot compared to swimmers and controls. Conclusions: Adolescent male footballers exhibited higher bone density, geometry and stiffness compared to swimmers, cyclists and controls. Although swimmers and cyclists had higher bone outcomes compared to controls, these differences were not significant. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the effects of mild-to-moderate cystic fibrosis (CF) on the pulmonary oxygen uptake (...O2) kinetics of seven pediatric patients (13.5 ± 2.8 yr) versus seven healthy matched controls (CON; 13.6 ± 2.4 yr). We hypothesized that CF would slow the ...O2 kinetic response at the onset of moderate (MOD) and very heavy (VH) intensity cycling. Methods: Changes in breath-by-breath ...O2, near-infrared spectroscopy-derived muscle deoxygenation ([HHb]) at the vastus lateralis muscle and thoracic bioelectrical impedance--derived heart rate (HR), stroke volume index, and cardiac index were measured during repeat transitions to MOD (90% of the gas exchange threshold) and VH (Δ60%) intensity cycling exercise. Results: During MOD, the phase II ...O2 τ (P = 0.84, effect size [ES] = 0.11) and the overall mean response time (MRT) (P = 0.52, ES = 0.11) were not significantly slower in CF versus CON. However, during VH exercise, the phase II...O2 τ (P = 0.02, ES = 1.28) and MRT (P = 0.01, ES = 1.40) were significantly slower in CF. Cardiac function, central O2 delivery (stroke volume index and cardiac index), and muscle [HHb] kinetics were unaltered in CF. However, the arteriovenous O2 content difference (C(a-...y)O2) was reduced during VH at 30 s (P = 0.03, ES = 0.37), with a trend for reduced levels at 0 s (P = 0.07, ES = 0.25), 60 s (P = 0.05, ES = 0.28), and 120 s (P = 0.07, ES = 0.25) in CF. Furthermore, ΔC(a-...)O2 significantly correlated with the VH phase II...O2 τ (r = -0.85, P = 0.02) and MRT (r = -0.79, P = 0.03) in CF only. Conclusion: Impairments in muscle oxidative metabolism during constant work rate exercise are intensity dependent in young people with mild-to-moderate CF. Specifically, ...O2 kinetics are slowed during VH but not MOD cycling and appear to be mechanistically linked to impaired muscle O2 extraction and utilization. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to document the matching of muscle O2 delivery to O2 use in young patients with cystic fibrosis (CF) from muscle deoxygenation (HHb) dynamics during ramp exercise. Methods: Ten patients with stable, mild-to-moderate CF (12.7 ± 2.8 yr) and 10 healthy controls (CON, 12.8 ± 2.8 yr) completed a combined ramp and supramaximal cycling test to determine maximal O2 uptake (VO2max). Changes in gas exchange and ventilation, HR, andm. vastus lateralis HHb (near-infrared spectroscopy) were assessed. Δ[HHb]-work rate and Δ[HHb]-VO2 profiles were normalized and fit using a sigmoid function. Results: Aerobic function was impaired in CF, indicated by very likely reduced fat-free mass-normalized VO2max (mean difference, ±90% confidence interval: −7.9 mL•kg−1•min−1, ±6.1), very likely lower VO2 gain (−1.44 mL•min−1•W−1, ±1.12), and a likely slower VO2 mean response time (11 s, ±13). An unclear effect was found upon the absolute and relative work rate (−14 W, ±44, and −0.7% peak power output, ±12.0, respectively) and the absolute and percentage (−0.10 L•min−1, ±0.43, and 3.3% VO2max, ±6.0) VO2 corresponding to 50% Δ[HHb] amplitude, respectively, between groups. However, arterial oxygen saturation (SpO2) was very likely lower in CF (−1%, ±1) and demonstrated moderate-to–very large relations with parameters of aerobic function. Conclusions: Young patients with mild-to-moderate CF present with impaired aerobic function during ramp incremental cycling exercise. Because the rate of fractional O2 extraction during ramp cycling exercise was not altered by CF, yet SpO2 was lower, the present findings support the notion of centrally mediated oxygen delivery to principally limit the aerobic function of pediatric patients with CF during ramp incremental cycling exercise. [ABSTRACT FROM AUTHOR]

PURPOSE: To determine whether pre-clinical signs of atherosclerosis such as endothelial dysfunction and arterial stiffness associates with cardiorespiratory fitness and fat mass. METHODS: We studied 5566 children and adolescents (51% girls) aged 9-11 years from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, Bristol, UK. Cardiorespiratory fitness was measured during submaximal ergometer test and allometrically scaled for lean mass; Total and trunk fat mass were assessed by dual-energy Xray absorptiometry; brachial artery endothelial function was determined using flow-mediated dilation (FMD), expressed as the percentage change in diameter from baseline after reactive hyperemia; arterial elasticity as distensibility coefficient (DC) expressed in mean percentage change in cross-sectional area relative to blood pressure (BP); arterial stiffness by carotid to radial pulse wave velocity (crPWV). We conducted multivariable linear regressions with Sidak correction and adjusted for age, sex, total fat mass or cardiorespiratory fitness/lean mass, pubertal status, brachial artery diameter, systolic BP, low-density lipoprotein cholesterol, mother's social-economic class, and time (years) between the measurement of predictors and outcomes. RESULTS: crPWV was inversely associated with cardiorespiratory fitness/lean mass-0.54 (β [95% CI]) = (-0.030 [-0.060 to -0.001]; P = 0.043). FMD and DC were unrelated to cardiorespiratory fitness. FMD (0.012 [0.008 to 0.016]) and DC (0.004 [0.002 to 0.006]) were directly associated, while crPWV (-0.050 [-0.060 to -0.039]) was inversely associated with total fat mass (P<0.0001 for all). FMD (0.016 [0.011 to 0.020]) and DC (0.005 [0.002 to 0.007]) were directly associated, while crPWV (-0.057 [-0.070 to -0.045]) was inversely associated with trunk fat mass (P<0.0001 for all). CONCLUSION: Among British children, arterial stiffness was associated with reduced cardiorespiratory fitness. Moreover, better endothelial function and arterial elasticity were associated with higher total and trunk fat mass, whereas arterial stiffness was associated with lower total and trunk fat mass. Our findings suggest an 'arterial paradox' where better arterial function relates to higher levels of adiposity, warranting further studies. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the association of age and sex on quadriceps muscle phosphate and potential of Hydrogen (pH) responses in children and adults during incremental exercise. The subjects consisting of 15 boys and 18 girls of nine to years old, eight men, and eight women have undergone quadriceps step-incremental test exhaustion inside a magnetic resonance (MR) scanner to determine the metabolic and pH responses of muscle when exercising. The results reveal that the output in a normalized power and cellular energetic state at metabolic intracellular threshold (IT) are the same in children and adults and on both sexes. The study concludes that age-and sex-related differences in muscle metabolism in children and adults depend on the exercise intensity.

Purpose of Review: Chronic obstructive pulmonary disease (COPD) and bronchiectasis are two different but related diseases that occur separately, but can coexist. In this review, we will examine the recent research regarding patients with COPD who have coexisting bronchiectasis., Recent Findings: Recent research has focused on defining distinct COPD phenotypes with the ultimate goal of changing the outcomes using tailored therapies. A frequent exacerbator phenotype has been identified. COPD patients with Pseudomonas aeruginosa are a phenotype with worse outcomes. Patients with coexisting COPD and bronchiectasis may represent a unique phenotype., Summary: Patients with coexisting COPD and bronchiectasis could represent a unique phenotype with more severe disease, worse outcomes, more isolation of potentially pathogenic microorganisms, and more frequent exacerbations, with the potential for targeted therapies.