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Context: The Human Body Posturizer (HBP) is an exoskeleton used in the neurorehabilitation. The HBP may improve motor control by stimulating the pre-frontal cortex, a brain region involved also in the inhibitory modulation of the amygdala whose hyperactivity is involved in the mechanisms of depression.Objective: The aim of the study was to investigate in institutionalized elderly patients the effects on depression of a physical training with the use of the HBP compared to a traditional training.Design: Randomized controlled trial.Participants: 20 institutionalized patients (mean age = 88, ds = ± 5, 3 males) with moderate depression levels.Intervention: The participants were randomly assigned to: a) HBP Group, which carried out physical training using the HBP; b) Excercise Group, which carried out a training without the use of the orthosis. The training was conducted for 6 months (3 sessions each week), with the same kind of exercises with or without the HBP according to the assignment group.Measurements: Participants were evaluated at baseline using the Tinetti balance and Gait scale, the Mini Mental State Examination and the Geriatric Handicap Scale. The Geriatric Depression Scale was administered to the participants before and after the period of training. RESULTS: The two groups were homogeneous for age, baseline motor ability (risk falls), handicap score, cognitive functioning and depression levels. After 6 months of exercise training a significant reduction in depression levels was reported only in the HBP Group (p <.01).Conclusions: A positive effect of the HBP in the modulation of mood in institutionalized elderly subjects was found. It is possible to hypothesis that a traditional training without the HBP may require more time to achieve significant results. Clinical implications will be discussed. [ABSTRACT FROM AUTHOR]

Objective:Increased thyroid-stimulating hormone (TSH) and FT3 levels are often found in clinically euthyroid obese individuals. Information on thyroid gene expression in human adipose tissue is scarce. The objective of this study was to measure the expression of the TSH receptor (TSHR) and the thyroid hormone receptor (TRα1) genes in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in obese individuals and to test the effect of weight loss on these genes.Study Design and Participants:This study is a prospective study involving 107 obese (body mass index (BMI)=46±8 kg m−2, 52 with type 2 diabetes or impaired glucose tolerance) and 12 lean nondiabetic participants. A total of 27 obese patients were restudied 1 year after gastric bypass surgery. Total RNA was extracted from SAT and VAT obtained at baseline from all participants, and from SAT in obese patients post surgery.Results:Circulating TSH and FT3 levels were 170 and 36%, respectively, higher in obese patients than in controls. In SAT, TSHR and TRα1 were reduced in the obese by 67 and 33%, respectively, regardless of glucose tolerance. A similar trend was found in VAT. Post surgery, a BMI decrease of 33% was associated with a decrease in TSH and FT3 levels and with a 150 and 70% increase in SAT of TSHR and TRα1, respectively.Conclusion:In both subcutaneous and visceral fat, the thyroid gene expression (especially TSHR) is reduced in obesity. The reversal of these changes with major weight loss and the reciprocal changes in plasma TSH and FT3 levels suggest a role for adipocytes in the regulation of TSH and thyroid hormones. [ABSTRACT FROM AUTHOR]

Objective:To investigate whether adiponectin receptor genes (AdipoR1 and AdipoR2) expression in human subcutaneous (SAT) and visceral (VAT) adipose tissue in severely obese patients with or without diabetes is related to adiponectin gene (APM1) expression and in vivo metabolic parameters.Design:Cross-sectional, clinical research study.Subjects:Total RNA was extracted from SAT and VAT tissue obtained during surgery from 13 lean controls, 30 obese diabetic patients, 19 obese glucose-intolerant patients and 54 obese subjects with normal glucose tolerance.Measurements:Tissue expression of APM1, AdipoR1 and AdipoR2, tissue concentration of adiponectin (ApN), and metabolic variables.Results:APM1 expression was higher in SAT than VAT (1.06±0.76 vs 0.69±0.52, P<0.0001) as was AdipoR1 (1.17±0.70 vs 0.66±0.38, P<0.0001) and AdipoR2 (7.02±6.19 vs 0.75±0.64, P<0.0001). In SAT, APM1 and AdipoR1 expression tended to be lower – by 0.38±0.22 and 0.35±0.22, respectively – and AdipoR2 expression was markedly depressed – by 4.82±1.93 – in association with obesity, whereas presence of diabetes had no additional effect. In VAT, APM1 and AdipoR1 expressions were also reduced – by 0.36±0.16 and 0.30±0.11, respectively – in association with obesity. Within both SAT and VAT, expression levels of APM1, AdipoR1 and AdipoR2 were all positively interrelated. Tissue ApN concentrations in SAT were similar across groups, whereas ApN levels in VAT were substantially lower in association with obesity (by an average of 63±12 ng/mg total protein, P<0.0001). In multivariate models adjusting for sex, age and obesity, serum triglyceride concentrations were reciprocally related to APM1 (r=−0.27, P<0.02), AdipoR1 (r=−0.37, P<0.002 and AdipoR2 expression (r=−0.37, P<0.002) in VAT. Likewise, plasma insulin concentrations were inversely related only to APM1 in VAT (r=−0.25, P<0.03).Conclusions:Severe obesity is associated with suppressed expression of both ApN and its receptors in both SAT and VAT, the expression levels in VAT are specifically linked with hyperinsulinemia and dyslipidemia.International Journal of Obesity (2007) 31, 1843–1848; doi:10.1038/sj.ijo.0803676; published online 3 July 2007 [ABSTRACT FROM AUTHOR]

A correction to the article "Expression of thyrotropin and thyroid hormone receptors in the adipose tissue of patients with morbid obesity and/or type 2 diabetes: Effects of weight loss," that was published in a previous issue of the journal is presented.