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This study aimed to compare phase angle (PhA) and bioelectrical impedance vector analysis (BIVA) values between adult patients with congenital adrenal hyperplasia caused by 21-hydroxylase deficiency (CAH21OHD) and a control group. A total of 22 patients (15 women, 22.9 ± 3.7 years) were compared with 17 controls (11 women, 27.0 ± 2.5 years). Body composition was determined by dual-energy X-ray absorptiometry. Bioelectrical impedance was used to calculate PhA, and BIVA was performed using specific software. Student’s t-test and analysis of covariance were used to compare groups. Hedges’ G and partial n2 were calculated for the effect estimates. Hotelling’s t2 test was used to compare the mean impedance vectors between the groups. The Mahalanobis test was used to determine the distance between confidence ellipses. Patients with CAH21OHD had a higher fat mass percentage than that of the control group (both sexes). There was no significant difference in PhA values between groups (CAH21OHD vs. control) in females (6.9° vs. 6.3°, p = 0.092) and males (8.2° vs. 8.1°, p = 0.849), after adjusting for covariates (age and height). BIVA analysis showed a significant difference in the mean impedance vectors between the female groups (T2 = 15.9, D = 1.58, p = 0.003) owing to the higher reactance/height (Δ = 8.5; p < 0.001) of the patients. The PhA did not significantly differ between the groups. Female patients had significantly higher reactance values. However, further studies are needed to determine the usefulness of bioimpedance parameters in evaluating the hydration status and cellular integrity of patients with CAH21OHD.

It is of great importance to investigate any potential detrimental effect on bone health in young adults with 21-hydroxylase enzyme deficiency undergoing glucocorticoid replacement therapy. This study demonstrated normal bone health in well-controlled patients. Additionally, glucocorticoid dose may play an important role in the mineral density of femoral neck region. To compare regional bone mineral densities (BMDs) and bone statuses of young adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase enzyme (21OHase) deficiency with a control group. The duration and dose of glucocorticoid therapy and relative skeletal muscle index (an indicator of sarcopenia) were also analyzed as parameters to predict bone health. This case–control study included 23 patients (7 male and 16 female) and 20 controls (8 male and 12 female) matched by age range (18 to 31 years). Dual energy X-ray absorptiometry and phalangeal quantitative ultrasound (QUS) were used to estimate BMD and bone status, respectively. No difference was observed between patients and controls (of both sexes) in absolute values of BMD and Z-scores for the total body, lumbar spine, and femoral neck; or the bone status (estimated by phalangeal QUS). Multiple linear regression analysis demonstrated that relative skeletal muscle index independently correlated with BMD of the entire body (β: 0.67, P = 0.007), the lumbar spine (β: 0.73, P = 0.005), and the femoral neck (β: 0.67, P = 0.007). However, the dose of glucocorticoids (β: − 0.38, P = 0.028) independently correlated with BMD in the femoral neck region alone. No signs of change in bone health were observed in patients with CAH when compared to the reference group. Additionally, a marker of sarcopenia was demonstrated to have a role in mineral density mechanisms in all analyzed bone sites. Only the femoral neck BMD seemed to be significantly dependent on glucocorticoid dose.

O objetivo deste estudo foi analisar o comportamento da pressão arterial (PA) em adolescentes com excesso de peso após uma sessão de high intensity interval training (HIIT) na esteira ergométrica. Trata-se de uma pesquisa com delineamento cross-over aleatorizado, a amostra foi formada por 11 adolescentes do sexo masculino, 81,81% com obesidade e idade entre 15 e 18 anos. Os voluntários realizaram dois protocolos experimentais: controle e HIT. O protocolo HIIT foi constituído de cinco séries de 85 a 95% do VO2pico por um minuto, intercalados por três minutos de recuperação de 40 a 50% do VO2pico. Antes e após os protocolos, os parâmetros hemodinâmicos foram obtidas por meio de um monitor automático (SpaceLabs 90207), programado para realizar medidas a cada 20 minutos no período das 12:00 às 22:00 horas. Foi observado diferença signifi cativa entre as médias da pressão sistólica nos protocolos controle e HIIT somente na primeira hora após o fi nal do exercício (131,90±7,93 vs 124,18±7,56 mmHg). A comparação entre os protocolos e as medidas hemodinâmicas pré-sessão e média pós-sessão (10 horas) demonstrou que o HIIT promoveu uma redução signifi cativa na pressão arterial média em comparação a pré-sessão. Em conclusão, o protocolo HIIT empregado promoveu efeito hipotensor de baixa magnitude sobre as medidas hemodinâmicas pós-exercício no que diz respeito a PAS.

We aimed to compare detailed fat distribution and lipid profile between young adults with congenital adrenal hyperplasia due to 21-hydroxylase enzyme deficiency and a control group. We also verified independent associations of treatment duration and daily hydrocortisone dose equivalent (HDE) with lipid profile within patients. This case-control study included 23 patients (7 male and 16 female) matched by an age range of young adults (18-31 years) with 20 control subjects (8 male and 12 female). Dual energy X-ray absorptiometry was used to measure the fat distribution. Male patients demonstrated elevated indices of fat mass for total (7.7 ± 2.1 vs. 4.5 ± 1.3 kg/m2 , p = 0.003), trunk (4.0 ± 1.2 vs. 2.2 ± 0.8 kg/m2 , p = 0.005), android (0.63 ± 0.24 vs. 0.32 ± 0.15 kg/m2 , p = 0.008), gynoid (1.34 ± 0.43 vs. 0.74 ± 0.24 kg/m2 , p = 0.005), arm (0.65 ± 0.16 vs. 0.39 ± 0.10 kg/m2 , p = 0.009), and leg regions (2.7 ± 0.8 vs. 1.6 ± 0.4 kg/m2 , p = 0.005) than the control group, but not in females. However, female patients demonstrated elevated ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (1.90 ± 0.46 vs. 1.39 ± 0.47, p = 0.009) than the control group, but not in males. Total fat mass was inversely correlated with total testosterone (r = -0.64, p = 0.014) and positively correlated with leptin in males (r = 0.75, p = 0.002). An elevated daily HDE (s = 0.43, p = 0.038 and s = 0.47, p = 0.033) and trunk to total fat mass ratio (s = 0.46, p = 0.025, and s = 0.45, p = 0.037) were independently correlated with impaired lipid profile markers. Although there is no altered lipid profile, male patients demonstrated an increased fat distribution. However, female patients presented with an impaired lipid profile marker but demonstrated close values of normal fat distribution. Interestingly, the dose of glucocorticoid therapy can have some role in the lipid mechanisms.

The practice of sports during the growth phase has a positive influence on bone mineral accrual. However, the effects of different sports are still not fully understood. The aim of this study was to evaluate the bone geometry in adolescent handball players. This is a cross-sectional study in which 53 female adolescents (12-17 years old) were divided into two groups: handball players (HG: n = 26), who must have had at least six months of participation in official competitions, and a control group (CG: n = 27). Bone geometry properties, such as cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), section modulus (Z), and femoral strength index (FSI) were measured using DXA. Tanner's sexual maturity, menarche, peak height velocity, sun exposure, and calcium intake were assessed. An unpaired Student's

The phase angle is used to evaluate nutritional status and is an indicator of cellular health. Cardiorespiratory fitness and body composition are strong indicators of health during adolescence. We aimed to evaluate if body composition and cardiorespiratory fitness have an association with phase angle among adolescents. 203 girls and 220 boys (12.8±1.3 years) were evaluated. Peak height velocity, percentage fat mass, fat-free mass, cardiorespiratory fitness, and phase angle measurements were collected. Linear regression adjusted by peak height velocity was used to verify if predictor variables were associated with phase angle among adolescents. Phase angle showed correlation with fat-free mass (girls: r=0.42 and boys: r=0.37); with percent fat mass (girls: r=0.23); and with cardiorespiratory fitness (boys: r=0.19). Linear regression showed that percentage fat mass (in girls) and cardiorespiratory fitness (in boys) had an effect of 11 and 17% in phase angle, respectively, while fat-free mass had an effect of 22 and 26% in phase angle for girls and boys, respectively. Changes in phase angle seem to be more associated with the percentage fat mass in girls, cardiorespiratory fitness in boys, and fat-free mass in both when controlled by peak height velocity.

Made available in DSpace on 2022-04-28T19:50:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-02-01 The military are selected on the basis of physical standards and are regularly involved in strong physical activities, also related to particular sports training. The aims of the study were to analyze the effect of a 7-month military training program on body composition variables and the suitability of specific ‘bioelectrical impedance vector analysis’ (spBIVA), compared to DXA, to detect the changes in body composition. A sample of 270 male Brazilian cadets (19.1 ± 1.1 years), com-posed of a group practicing military physical training routine only (MT = 155) and a group involved in a specific sport training (SMT = 115), were measured by body composition assessments (evaluated by means of DXA and spBIVA) at the beginning and the end of the military routine year. The effect of training on body composition was similar in SMT and MT groups, with an increase in LST. DXA and spBIVA were correlated, with specific resistance (Rsp) and reactance (Xcsp) positively related to fat mass (FM), FM%, LST, and lean soft tissue index (LSTI), and phase angle positively related to LST and LSTI. Body composition variations due to physical training were recognized by spBIVA: the increase in muscle mass was indicated by the phase angle and Xcsp increase, and the stability of FM% was consistent with the unchanged values of Rsp. Military training produced an increase in muscle mass, but no change in FM%, independently of the sample characteristics at baseline and the practice of additional sports. SpBIVA is a suitable technique for the assessment of body composition in military people. Skeletal Muscle Assessment Laboratory (LABSIM) School of Technology and Science São Paulo State University (UNESP), SP Growth and Development Laboratory Center for Investigation in Pediatrics (CIPED) School of Medical Sciences University of Campinas (UNICAMP), SP Department of Life and Environmental Sciences University of Cagliari Skeletal Muscle Assessment Laboratory (LABSIM) School of Technology and Science São Paulo State University (UNESP), SP

Introduction Physical activity (PA) has a great influence on bone mineral density (BMD) and bone mineral content (BMC), however longitudinal studies that seek to relate bone mass to physical activity are scarce and have a small sample size. The aim of this study was to evaluate and compare the effect of 7 months of military physical training (MPT), impact sports (IS), and swimming in the bone mass of young military adults. Materials and Methods A prospective study was conducted with 213 military school students (male and aged 19.2 ± 1.2 years) divided into three groups: MPT (n = 144), IS (n = 56), and Swimming (n = 13). Dual-energy X-ray absorptiometry was used to determine body composition (percentage of fat, fat mass, and fat-free mass) and bone mass (BMD, BMD Z-Score, total BMC, arm BMC, leg BMC, and trunk BMC), at the beginning of the military service and after 7 months of training. Results It was observed a significant increase in BMD, BMD Z-Score, total BMC and BMC of all segments analyzed for all groups (p < 0.01). There was a significantly greater variation in BMD of the IS group in relation to the MPT group (p < 0.01), and in the arm BMC of the MPT group in relation to the IS group (p < 0.05). Conclusion After 7 months of training, there were significant increases in BMC and BMD of all the groups evaluated. The bone response was associated with the muscular group used in the physical exercise and the IS group showed greater gain in BMD.

Patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH21OHD) have increased fat mass and metabolic alterations. The bioelectrical impedance phase angle (PhA) is an indicator of cellular integrity in several diseases. This study aimed to determine the influence of adiposity levels, sex, CAH21OHD, pubertal development, body composition, and treatment on the PhA of patients with CAH21OHD.Forty girls and 30 boys with CAH21OHD aged 15.3 ± 5.8 years were evaluated. Sexual maturation was assessed by a pediatrician. The PhA was assessed using bioelectrical impedance, percentage of fat mass (% FM), and lean soft tissue (LST) with dual-energy X-ray absorptiometry. Adiposity levels were compared using % FM tertiles and body mass index (BMI). Glucocorticoid dosage was converted using hydrocortisone dose equivalent (HDE).No differences were found in the PhA values among the clinical form (LST determined the PhA variations in girls and the postpubertal group. Age and BMI were determinants in boys and the pre- and pubertal groups, respectively.

BACKGROUND: Because normal male sexual differentiation is more complex than normal female sexual differentiation, there are more cases of disorders of sex development (DSDs) with 46,XY karyotype that have unclear etiology. However, Leydig and Sertoli cell markers are rarely used in distinguishing such individuals. OBJECTIVES: To evaluate the function of Leydig and Sertoli cells in individuals with genital ambiguity, 46,XY karyotype, palpable gonads and normal testosterone secretion. STUDY DESIGN AND SETTING: Case-control study with 77 patients, including eight with partial androgen insensitivity syndrome, eight with 5α-reductase deficiency type 2 (5ARD2) and 19 with idiopathic 46,XY DSD, and 42 healthy controls, from the Interdisciplinary Study Group for Sex Determination and Differentiation (GIEDDS), at the State University of Campinas (UNICAMP), Campinas, Brazil. METHODS: Baseline levels of gonadotropins, anti-Müllerian hormone (AMH), inhibin B, insulin-like 3 (INSL3), testosterone and dihydrotestosterone in cases, and AMH, inhibin B, and INSL3 levels in controls, were assessed. RESULTS: There was no significant difference in age between cases and controls (P = 0.595). AMH and inhibin B levels were significantly lower in cases than in controls (P = 0.031 and P < 0.001, respectively). INSL3 levels were significantly higher in cases than in controls (P = 0.003). Inhibin B levels were lower in 5ARD2 patients (P = 0.045) and idiopathic patients (P = 0.001), in separate comparisons with the controls. CONCLUSION: According to our findings, we can speculate that inhibin B levels may be used to differentiate among DSD cases.

Background The association of congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase enzyme (21OHase) deficiency, duration of treatment and dosage with cardiovascular dysfunction in young adults remains unclear. We aimed to evaluate myocardial function, vascular structures and epicardial fat thickness in young adults with CAH as a result of 21OHase deficiency. Correlations between the duration and dose of glucocorticoid therapy and cardiovascular parameters were analysed. Methods This case-control study of young adults (18-31 years old) included 20 patients (5 men and 15 women) and 16 control subjects (8 men and 8 women). Echocardiographic analysis was performed using high-resolution ultrasound. Results No ultrasonographic changes in any indices of myocardial function, vascular structures and epicardial fat thickness were found in patients, except for an impaired left ventricular end-diastolic diameter in female patients (28.1 ± 1.6 vs 26.0 ± 2.4 mm/m2 , P = .021), compared with those in individuals in the control group. Nevertheless, the individual patient values were within the normal range. Multiple linear regression analysis in female patients demonstrated that an elevated daily dose of glucocorticoids correlated with increased indices of left ventricular posterior wall thickness (Partial r = 0.68, P = .007), left ventricular end-diastolic diameter (Partial r = 0.62, P = .017), aortic diameter (Partial r = 0.60, P = .022) and left carotid artery intima-media thickness (Partial r = 0.61, P = .021), independently of treatment duration. Conclusion No signs of cardiovascular dysfunction were observed in any patient. The daily dose of glucocorticoids may play a role in the mechanisms of some markers of cardiac hypertrophy, left ventricular and aortic dilation and subclinical atherosclerosis.

Made available in DSpace on 2021-06-25T12:28:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-12-01 Ministry of Education Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) The purpose of the present study was to compare the effects of three resistance exercise orders on muscular strength, body composition, and functional fitness in trained older women. Forty-five women (aged >= 60 years), after performing 12 weeks of a pre-conditioning resistance-training program were randomly assigned in one of the following groups that performed the exercises in the following orders: multi-joint to single-joint order (MJ-SJ, n=15), single-joint to multi-joint order (SJ-MJ, n=15), and alternating between upper and lower body order (ALT, n=15). Specific training intervention lasted 12 weeks (3x/week) and was composed of eight exercises performed in three sets of 15/10/5 repetitions, with increasing load through the sets. Muscular strength was estimated by one-repetition maximum tests; body composition was assessed by whole-body dual-energy x-ray absorptiometry, and functional fitness was analyzed with a sequence of four motor tests. All groups improved similarly in muscular strength (Cohen's effect size: MJ-SJ=0.45; SJ-MJ=0.48; ALT=0.45), skeletal muscle mass (MJ-SJ=0.08; SJ-MJ=0.07; ALT=0.09), and functional test performance (MJ-SJ=0.38; SJ-MJ=0.20; ALT=0.31), but no change was observed for body fat ( P >0.05). The results suggest that 12 weeks of resistance training induce positive changes in muscle morphofunctionality, regardless of the exercise order employed in trained older women. Univ Estadual Londrina, Phys Educ & Sport Ctr, Metab Nutr & Exercise Lab, Londrina, PR, Brazil Univ Northern Parana, Ctr Res Hlth Sci, Londrina, PR, Brazil Univ Estadual Campinas, Dept Pediat, Campinas, SP, Brazil Sao Paulo State Univ, Sch Sci & Technol, Prudente, SP, Brazil Univ Lisbon, Fac Motricidade Humana, CIPER, Exercise & Hlth Lab, Lisbon, Portugal Sao Paulo State Univ, Sch Sci & Technol, Prudente, SP, Brazil CNPq: 309455/2013-8

Context Congenital adrenal hyperplasia (CAH) patients have potential normal longevity. However, a greater risk for cardiovascular disease has been reported. Insulin resistance and hyperinsulinemia have been described in CAH patients, whereas the prevalence of overt type 2 diabetes is not higher in CAH than in normal population. Objective To examine the contributions of insulin secretion and of hepatic insulin clearance to compensatory hyperinsulinemia in young insulin-resistant adults with classic CAH due to 21-hydroxylase deficiency (21-OHD). Design Cross-sectional. Setting University outpatient clinics. Methods Fifty-one participants: 21 controls, and 30 CAH (15 virilizing and 15 salt-wasting phenotypes), female/male (33/18), age (mean [SD]): 24.0 (3.6) years, body mass index: 24.6 (4.9)kg/m2 with normal glucose tolerance, were submitted to a hyperglycemic clamp study. Main Outcome Measures Insulin sensitivity, beta cell function, and hepatic insulin clearance using appropriate modeling. Results We found an increased insulin resistance in 21-OHD. The systemic hyperinsulinemia (posthepatic insulin delivery) was elevated in CAH patients. No increases were observed in insulin secretory rate (beta cell function) in the first phase or during the hyperglycemic clamp. The increase in insulin concentrations was totally due to a ~33% reduction in insulin clearance. Conclusion 21-OHD nonobese subjects have reduced insulin sensitivity and beta cell response unable to compensate for the insulin resistance, probably due to overexposure to glucocorticoids. Compensatory hyperinsulinemia is most related with reduced hepatic insulin clearance. The exclusive adaptation of the liver acts as a gating mechanism to regulate the access of insulin to insulin-sensitive tissues to maintain glucose homeostasis.

Optimizing bone mass gain during childhood and adolescence may help prevent bone diseases in advanced ages. The aim of this study was to verify the bone mineral density (BMD) and bone mineral content (BMC) in female adolescent’s handball players. This is a cross-sectional study where 68 female adolescents (12–17 years) were allocated into two groups: handball players (n = 29) (HG) and control group (n = 39) (CG). BMC and BMD from total body (TB), total body less head (TBLH), lumbar spine (L1–L4), femoral neck (FN), Ward’s triangle (WT) and respectively Z-scores were measured using dual-energy X-ray absorptiometry (DXA). Sexual maturity, menarche, PHV, time of sun exposure, physical activity level and Calcium and vitamin D intake were assessed. The HG showed significantly higher BMC, BMD as well Z-scores values (p≤0.05) of total body, TBLH, femoral neck, hip and lumbar spine than the CG. When the values were adjusted for lean soft tissue (LST) the HG showed significantly higher BMC of femoral neck (p≤0.05), as well as BMD of TBLH and femoral neck (p≤0.05) and Z-score values all bone sites except hip, than the CG. We conclude that handball players have significantly higher bone mass values compared to group of girls of the same age. Resumo Otimizar o ganho da massa óssea durante a infância e adolescência pode auxiliar na prevenção de doenças ósseas em idades mais avançadas. Objetivou-se verificar a densidade mineral óssea (DMO) e conteúdo mineral ósseo (CMO) em adolescentes do sexo feminino. Foi realizado um estudo transversal com 68 meninas adolescentes (12 a 17 anos), divididas em dois grupos: jogadoras de handebol (HG: n=29) e grupo controle (CG: n=39). DMO e CMO de corpo inteiro (TB), corpo total menos cabeça (TBLH), coluna lombar (L1-L4), colo do fêmur (FN) e triângulo de Ward’s (WT) e respectivos escore Z foram medidos usando a absorciometria por dupla emissão de raios-x (DXA). Também foi avaliada a maturidade sexual, menarca, PVC e ingestão de cálcio e vitamina D. As jogadoras de handebol mostraram valores de CMO, DMO e respectivos escores Z do corpo inteiro, TBLH, fêmur, quadril e coluna lombar significativamente maiores quando comparados ao grupo controle. Quando ajustados para a massa isenta de gordura o grupo HG apresentou valores maiores para o CMO do fêmur e DMO do fêmur e TBLH; e nos valores de escore Z de todos os sítios ósseos, exceto o quadril, quando comparadas ao CG. Concluímos que as jogadoras de handebol têm valores de massa óssea significativamente maiores comparadas ao grupo de meninas da mesma idade.

This study examined the effect of pubertal development on Amplitude Dependent Speed of Sound (AD-SoS), accounting for the growth in stature among adolescents. A mixed-longitudinal design with 3 assessments across a 15-mo period in 439 adolescents (girls: 215; boys: 224) aged 9–16 y was used. Bayesian multilevel models were used to describe gender-specific AD-SoS variations among participants during pubertal years. Substantial increments in AD-SoS during pubertal years were observed in both genders. AD-SoS changes were positively related to stature, and the rate of stature growth per year. Quantitative ultrasonography was sensible to describe age-related changes of bone mass during pubertal development. It seemed clinically reliable to use AD-SoS in the study of bone growth and development.

RESUMO Objetivo: Avaliar a massa óssea pela ultrassonografia quantitativa de falanges em jovens praticantes de karatê em relação a um grupo controle. Métodos: Amostra constituída por 162 praticantes de karatê (52 meninas) e 326 controles escolares (110 meninas) saudáveis, de 6 a 16 anos de idade, do oeste do Paraná. Foram avaliados peso, estatura, índice de massa corporal (IMC), Amplitude Dependent Speed of Sound (AD-SoS) e Bone Time Transmission (BTT), e os valores de IMC, AD-SoS e BTT transformados em escore Z. Aplicaram-se testes de Mann-Whitney, qui-quadrado ou Exato de Fisher e regressão linear múltipla, sendo significante p≤0,05. Resultados: Para ambos os sexos, os praticantes de karatê apresentaram valores superiores do escore Z do BTT comparados aos controles. Quanto à AD-SoS, as meninas do grupo de controle apresentaram valor absoluto e de escore Z superiores aos apresentados pelas praticantes de karatê do mesmo sexo. Ao avaliar a frequência relativa e absoluta de acordo com o escore Z do BTT em ambos os grupos, os meninos praticantes de karatê apresentaram maior frequência de massa óssea adequada. Nas meninas praticantes de karatê, a idade apresentou poder de explicação de 42% na variação da AD-SoS e o peso de 45% na variação do BTT. Nos meninos praticantes de karatê, a idade apresentou poder de explicação de 26% na variação da AD-SoS e a estatura 36% na variação do BTT. Conclusões: Nesse grupo de crianças e adolescentes, independentemente do sexo, os praticantes de karatê apresentaram maior massa óssea em relação ao grupo controle, sendo o BTT mais sensível para essa avaliação. ABSTRACT Objective: To evaluate bone mass by quantitative ultrasound of the phalanges in young karate practitioners compared to a control group. Methods: Sample composed of 162 karate practitioners (52 females) and 326 healthy controls (110 females) aged 6 to 16 years old, in Western Paraná (Southern Brazil). Weight, height, BMI, amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were evaluated. BMI, AD-SoS and BTT values were converted to Z scores. Mann-Whitney, chi-square or Fisher Exact tests and multiple linear regression were applied, with significance level set at p≤0.05. Results: Both genders showed higher values of BTT as Z scores when compared to control group. Females from the control group had higher AD-SoS values (m/s and Z score) compared to female karate practitioners. When relative and absolute frequencies were assessed according to BTT Z score in both groups, male karate practitioners’ bone mass was shown to be adequate more frequently. In female practitioners, age and weight were independent predictors of AD-SoS (R2=0.42) and BTT (R2=0.45), respectively. Among male karate practitioners, age was related to 26% of AD-SoS variances and height was responsible for 36% of BTT variances. Conclusions: Children and adolescents who practice karate were shown to have more bone mass in comparison to the control group, regardless of gender. BTT was more sensitive for this evaluation.

Objectives The model most suitable for estimating resting energy expenditure (REE) using dual-energy X-ray absorptiometry (DXA) metabolic maps is not known; moreover, the applicability in individuals with different body sizes also is uncertain. The aim of this study was to test the accuracy of REE estimation from models of DXA metabolic maps with four, five, and six tissue-organ components in young men, stratified by body size. Methods We studied 52 young men between the ages of 18 and 29 y. Participants were clustered to small (SW; n = 32) and large (LW; n = 20) weight, and small (SWH; n = 25) and large (LWH; n = 27) weight–height. REE was measured by indirect calorimetry (REE m ), and predicted from DXA metabolic maps with four (REE c1 ), five (REE c2 ) and six (REE c3 ) tissue-organ components. Results REE c1 , REE c2 , and REE c3 explained 54% ( P P P m variance in all participants, respectively. However, REE c2 showed mean difference between REE m ( P c3 showed trends in estimating the REE ( P c1 showed limits of agreement (95%) of −248.3 to 285.8 kcal/d, 18.7 ± 136.3 kcal/d of bias, and no trends in the Bland–Altman analysis. The relationship between all predicted models and measured REE decreased in LW and LWH. Conclusions REE c1 can be considered the best accurate model of REE estimation in Brazilian young men, providing the REE and metabolically active tissue-organ of four components. Caution should be exercised with the use of DXA metabolic maps in populations with greater weight and greater weight–height.

OBJECTIVE The aim of the present study was to analyze the tracking of indicators of health-related physical fitness between childhood and adulthood. METHODS The study presents a longitudinal design, with the first phase of data collection occurring annually between 2002 and 2006, and the second phase carried out in 2016. A total of 142 young adults, aged between 21 and 25 years, of both sexes participated in the study. Were evaluated body mass, stature, skinfold thickness, sit and reach test; abdominal resistance/strength test, and 20-m shuttle run test. RESULTS The intraclass correlation coefficient (ICC) indicated that all health-related physical fitness variables presented values considered moderate to high tracking (0.37-0.67; P

Objective: To characterize resting energy expenditure (REE) in patients with classic 21-hydroxylase congenital adrenal hyperplasia (21-OH CAH) using indirect calorimetry and compare it to the most commonly used REE predictive equations. Methods: This case-control study comprised 29 post-pubertal 21-OH CAH patients regularly followed at the University of Campinas. Elevated serum 17-hydroxyprogesterone and CYP21 gene molecular analysis confirmed the diagnosis. A healthy control group paired by age, gender, and body mass index was examined. Dual-energy X-ray absorptiometry (DEXA) measured body compositions. A bioimpedance analyzer determined fat-free mass, and indirect calorimetry using a metabolic cart measured REE. Results: Unlike our initial hypothesis, REE was similar between the groups (18.7 ± 3.1 kcal/kg/day in CAH vs. 20.3 ± 3.5 kcal/kg/day in controls; P = .728). No predictive equations reached the stipulated accuracy criteria, thus lacking validity in REE assessment in adults with the characteristics of the group studied. DEXA analysis revealed higher body fat and diminished nonbone lean mass in 21-OH CAH. Anthropometric and bioelectrical impedance parameters were not significantly different. Conclusion: Classic 21-OH CAH is generally followed in reference centers, which may facilitate indirect calorimetry use for REE measurement. Alternatively, considering our REE findings in adult 21-OH CAH patients, nutrition management based on 25 kcal/body weight/day (measured REE × activity factor 1.2 to 1.3) may be reasonable for current body weight maintenance in these patients. Abbreviations: 17-OHP = 17-hydroxyprogesterone; 21-OH CAH = classic 21-hydroxylase deficiency congenital adrenal hyperplasia; BMI = body mass index; REE = resting energy expenditure; VO2 = volume of oxygen; VCO2 = volume of carbon dioxide.

OBJECTIVES The aim of this study was to evaluate the association between phase angle, body composition, and blood glucose changes in healthy young males after 6 months of physical training. METHODS Volunteers, 98 healthy males (18.8 ± 0.5 years), had 6 months of progressive physical training (5 days a week, 90 minutes a day). Resistance, reactance, and phase angle were obtained by bioelectrical impedance analysis, body composition (fat mass, bone mineral content [BMC], and lean soft tissue [LST]) by dual-energy X-ray absorptiometry, and blood glucose by reflectance photometry. Measurements were made at rest and in a fasted state, both before and after the training period. RESULTS Phase angle, reactance, BMC, and LST significantly increased (0.6°, 3.8 Ω, 0.1 kg, and 1.9 kg, respectively; P

The optimum abbreviated period for measurement by indirect calorimetry (IC) to estimate the resting energy expenditure (REE), including the acclimation period, in healthy individuals has not been established. This study aimed to determine the acclimation time required to achieve the REE steady state during a 30-minute IC measurement and to define the optimum abbreviated measurement period in the steady state to estimate the REE in healthy young adults.Thirty-nine volunteers (27 men and 12 women; age, 18-31 years) were recruited. The REE was obtained by IC over 30 minutes. Friedman's test was used to compare the coefficient of variation (CV%) among all 5-minute intervals (REE5). To compare the REE values obtained during the first REE5 interval in the steady state with the REE average values of the subsequent measurements, Student paired t test, linear regression, and Bland-Altman test were used.The CV% of the first REE5 (mean ± standard deviation: 19.9% ± 13.2%) was significantly higher (P.0001) than that of all other REE5 (second REE5: 7.4% ± 3.8%; third: 7.8% ± 5.2%; fourth: 7.1% ± 3.9%; fifth: 8.0% ± 5.7%; sixth: 8.0% ± 4.5%). No significant difference was found between the second REE5 and the REE average values of the last 20 minutes. The second REE5 explained 90% of the REE average of the last 20 minutes, with the 95% limits of agreement by the Bland-Altman test ranging from -142.92 to 150.44 kcal/d.Ten minutes can be used as an abbreviated alternative for IC measurements in healthy young adults, and values of the first 5-minute interval should be discarded.

Background Musculoskeletal injuries are the main cause of premature discharge from military service and can sometimes lead to permanent disabilities. Some intrinsic risk factors are well discussed in the literature. However, the relation between body composition variables and the risk for musculoskeletal injury is not well known or recognized. Methods This prospective study evaluated 205 Brazilian military students. At the beginning of military service, health status and sports experience prior to military service were registered. Anthropometric variables were evaluated, and bone and body composition variables were measured using dual-energy X-ray absorptiometry. The occurrence of musculoskeletal injuries throughout the year was registered at the military physiotherapy service. At the end of 1 year of follow-up, risk factors were analysed by comparing the variables between the injured and non-injured students. Results No difference in previous health status was found between injured and non-injured groups, whereas sports experience prior to military service was identified as a protective factor (Odds Ratio (OR) 0.323; 95% CI: 0.108–0.968; p = 0.044). Anthropometric, bone, and body composition variables could not be identified as risk factors for musculoskeletal injuries in Brazilian military students. Conclusion Anthropometric, bone, and body composition variables could not be considered risk factors for musculoskeletal injuries in Brazilian military students.

The aim of this study was to test the accuracy of different methods of resting energy expenditure (REE) data analysis using indirect calorimetry (IC) during traditional (30 min) and abbreviated (10 min) protocols.Fifteen women and 15 men (21-34 y of age) completed two consecutive 30-min IC measurements. Body composition was measured using dual-energy x-ray absorptiometry. The reference method for REE analysis was 5 min in steady state (SS) during 30 min (first 5 min discarded). REE measurements were randomized to define a reference or testing method. An interval method was defined using 25, 20, and 15 min (with first 5, 10, and 15 min discarded, respectively), during 30 min, and 5 min (first 5 min discarded) during 10-min intervals. The SS method was defined using 5 min in SS (first 5 min discarded) during 30 min, 5, 4, and 3 min in SS during 10-min (first 5 min discarded) intervals.Interval methods during 30 min and SS and interval methods during 10 min demonstrated large bias with significantly high REEs compared to the reference method (78.8-109.0 kcal/d, all P0.001). Testing methods demonstrated large upper limits of agreement between 225.2 and 322.8 kcal/d. No mean differences (P0.05), small bias (14.3 kcal/d), and narrow limits of agreement (-125.8 to 154.4 kcal/d) were observed between 5-min SS during 30 min and the reference method.All interval methods and SS methods during 10 min overestimated REE. We recommend using 5-min SS during 30 min. The measurement may be repeated until all participants achieve SS.

RESUMO Objetivo: Verificar a influência da prática de atividade física e/ou esportes na geometria óssea de crianças e adolescentes saudáveis. Fonte de dados: Foi realizada uma revisão sistemática, utilizando como referência o método Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Foram utilizadas as bases de buscas PubMed, Biblioteca Regional de Medicina/Literatura Latino-Americana e do Caribe em Ciências da Saúde (BIREME/LILACS) e Scientific Electronic Library Online (SciELO), para levantamento de artigos publicados de 2006 a 2016, e os seguintes descritores: “Bone geometry” AND (Sport* OR Exercise* OR “Physical Activity”). Síntese dos dados: Após a seleção, foram incluídos 21 artigos. A maioria dos estudos demonstrou que a prática de atividade física e/ou esportes foi benéfica do ponto de vista da geometria e densidade mineral óssea; apenas dois estudos apresentaram valores dos parâmetros ósseos dos indivíduos controles melhores do que os praticantes de natação. As atividades físicas e esportes encontrados foram: ginástica artística (n=7), ginástica rítmica (n=2), tênis (n=1), futebol (n=3), capoeira (n=1), natação (n=4), ciclismo (n=1), atividades com saltos (n=2), estudos relacionando atividade física com pico de torque isocinético (n=1), atividade física em geral, tempo presente ou passado, mensurado por questionário (n=4) e aulas adicionais de educação física (n=2). Conclusões: Dentre os esportes e atividades físicas encontradas, a ginástica, o futebol e a prática de atividade física mais intensa avaliada por questionário resultaram em geometria óssea melhor em comparação à não prática de atividade física, enquanto que a natação e exercícios de saltos não influenciaram a geometria óssea. Portanto, atividades esportivas com sobrecarga corporal, avaliadas como mais intensas e mais frequentes, exercem efeito benéfico sobre a geometria óssea. ABSTRACT Objective: To perform a systematic review on the practice of physical activity and/or sports in health and its influence on bone geometry of healthy children and adolescents. Data source: The method used as reference was the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Databases searched for articles published from 2006 to 2016, with “Bone geometry” AND (Sport* OR Exercise* OR “Physical Activity”) as descriptors, were PubMed, BIREME/LILACS and SciELO. Data syntheses: After the selection, 21 articles were included. Most studies stated that practice of physical activity and/or sports was beneficial for bone geometry and bone mineral density. Only two studies presented values of bone parameters for control individuals better than those of swimmers. Physical activities and sports studied were: gymnastics (n=7), rhythmic gymnastics (n=2), tennis (n=1), soccer (n=3), capoeira (n=1), swimming (n=4), cycling (n=0), jumping activities (n=2), studies relating physical activity with isokinetic peak torque (n=1), physical activity measured by questionnaire (n=4), and additional physical education classes (n=2). Conclusions: Among the sports and physical activities found, gymnastics, soccer, and more intense physical activity assessed by questionnaires were mentioned along with better results in bone geometry compared to the absence of physical activity, whereas swimming and jumping exercises did not influence it. Therefore, sports activities with weight bearing and those practiced more frequently and intensively are beneficial for bone geometry.

To analyze the association between a 34-week military training on body composition, physical fitness and compensatory changes in resting energy expenditure (REE) recognized as adaptive thermogenesis (AT). We also explored if regional body composition changes were related to AT.Twenty-nine male army cadets, aged 17 to 22 years were tested at baseline (T0) and after 34-weeks military training (T1). Physical training was performed 5 days/week during 90 minutes/day. Measurements included body composition by dual-energy x-ray absorptiometry; physical fitness by 3000-m running, pull-up, 50-m freestyle swimming, push-up and sit-up tests; REE measured by indirect calorimetry (REEm) and predicted from fat-free mass (FFM), fat mass (FM) and ethnicity at T0 (REEp). %AT was calculated using values at T1: 100(REEm/REEp-1); and AT (kcal/day) as %AT/100 multiplied by baseline REEm.Physical training was associated with increases of lean soft tissue (LST) (∆1.2±1.3 kg), FM (∆1.4±1.3 kg), FFM (∆1.2±1.3 kg) and physical fitness (P0.01), but no REE changes (∆59.6±168.9 kcal/day) and AT were observed (P0.05). Though a large variability was found, AT was partially explained by trunk LST (r2=0.17, P=0.027). Individuals showing a higher AT response demonstrated a higher trunk LST increase (∆0.8±0.7 kg, P0.05).The military training increased LST, FM, FFM and physical fitness. Though no mean changes in AT occurred, a large individual variability was observed with some participants increasing REE beyond the expected body composition changes, suggesting a spendthrift phenotype. Changes of trunk LST may play an important role in the AT response observed in these individuals.

Introduction Bioelectrical impedance analysis (BIA) is a practical and rapid method for making a longitudinal analysis of changes in body composition. However, most BIA validation studies have been performed in a clinical population and only at one moment, or point in time (cross-sectional study). The aim of this study is to investigate the accuracy of predictive equations based on BIA with regard to the changes in fat-free mass (FFM) in Brazilian male army cadets after 7 mo of military training. The values used were determined using dual-energy X-ray absorptiometry (DXA) as a reference method. Materials and Methods The study included 310 male Brazilian Army cadets (aged 17-24 yr). FFM was measured using eight general predictive BIA equations, with one equation specifically applied to this population sample, and the values were compared with results obtained using DXA. The student's t-test, adjusted coefficient of determination (R2), standard error of estimation (SEE), Lin's approach, and the Bland-Altman test were used to determine the accuracy of the predictive BIA equations used to estimate FFM in this population and between the two moments (pre- and post-moment). Results The FFM measured using the nine predictive BIA equations, and determined using DXA at the post-moment, showed a significant increase when compared with the pre-moment (p < 0.05). All nine predictive BIA equations were able to detect FFM changes in the army cadets between the two moments in a very similar way to the reference method (DXA). However, only the one BIA equation specific to this population showed no significant differences in the FFM estimation between DXA at pre- and post-moment of military routine. All predictive BIA equations showed large limits of agreement using the Bland-Altman approach. Conclusion The eight general predictive BIA equations used in this study were not found to be valid for analyzing the FFM changes in the Brazilian male army cadets, after a period of approximately 7 mo of military training. Although the BIA equation specific to this population is dependent on the amount of FFM, it appears to be a good alternative to DXA for assessing FFM in Brazilian male army cadets.

Bioelectrical impedance spectroscopy (BIS) is an inexpensive and non-invasive technique to measure total body water (TBW), extracellular water (ECW), and intracellular water (ICW). The purpose of this study was to validate TBW, ECW and ICW assessed by BIS, using dilution techniques as the reference method (REF) in elite judo athletes. Thirty-two Portuguese elite male judo athletes were evaluated during a period of weight stability. TBW, ECW and ICW were assessed by BIS (Xitron 4000). Deuterium and bromide dilution techniques were used as the criterion method for measuring TBW and ECW, while ICW was calculated as the difference between the two. BIS explained 96%, 77% and 94% of the total variability from REFs for TBW, ECW and ICW, respectively. BIS also demonstrated high precision (ρ ≥ 0.88) and accuracy (Cb = 0.98), with a minimum concordance coefficient correlation of 0.87 for ECW. The mean bias demonstrated that BIS slightly overestimated the REF in 1.1 kg (2.3%), 0.3 kg (1.6%) and 0.8 kg (2.7%) for TBW, ECW and ICW, respectively. The 95% limits of agreement ranged from -1.2 to 3.3 kg in TBW, from -1.8 to 2.4 kg in ECW and from -1.0 to 2.6 kg in ICW. A non-significant trend was found between the difference and the mean of reference and alternative methods. These findings highlight the efficacy of BIS as a valid non-biased tool for the assessment of TBW and its compartments in elite male judo athletes, during a period of weight stability.

ObjectiveTo analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound (QUS) of the phalanges.Data sourceA systematic literature review was performed according to the PRISMA method with searches in databases Pubmed/Medline, SciELO and Bireme for the period 2001-2012, in English and Portuguese languages, using the keywords: children, teenagers, adolescent, ultrasound finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound.Data synthesis21 articles were included. Girls had, in QUS, Amplitude Dependent Speed of Sound (AD-SoS) values higher than boys during pubertal development. The values of the parameters of QUS of the phalanges and dual-energy X-ray Absorptiometry (DXA) increased with the increase of the maturational stage. Anthropometric variables such as age, weight, height, body mass index (BMI), lean mass showed positive correlations with the values of QUS of the phalanges. Physical activity has also been shown to be positively associated with increased bone mass. Factors such as ethnicity, genetics, caloric intake and socioeconomic profile have not yet shown a conclusive relationship and need a larger number of studies.ConclusionsQUS of the phalanges is a method used to evaluate the progressive acquisition of bone mass during growth and maturation of individuals in school phase, by monitoring changes that occur with increasing age and pubertal stage. There were mainly positive influences variables of sex, maturity, height, weight and BMI, with similar data when compared to the gold standard method, the DXA.

Growth curves have been developed for individuals with Down syndrome (DS) in several countries. However, in order to facilitate the preparation of clinical guidelines it is necessary to verify the eligibility of these curves. The search was conducted according to the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). It was conducted between July 2012 and June 2013 in MEDLINE/PubMed and BIREME. The inclusion and exclusion criteria were applied to identify the studies and a total of 16 relevant articles were selected. The aspects analyzed in the articles consisted of sample size, number of observations, age group, anthropometric variables, standard deviation scores (SDS), type of study, collection and analysis of data, participants, inclusion/exclusion criteria and outcomes. The mean, standard deviations (SDs) and percentiles for sex and age were used to develop the curve of weight, height, and head circumference. The individuals with DS presented growth between -0.4 and -4.0 SDS in comparison to healthy controls. The variation in these observations can be explained by genetic differences, secular trends in growth and disease status. Regarding the limitations identified, it was observed that most of the studies did not provide data concerning the number of individuals and observations, mean values and respective SDs by sex and age. In addition, most studies did not use LMS methods to evaluate asymmetry, the median and data variability. In conclusion, the results of this review demonstrated that in order to avoid false diagnoses in children and adolescents with DS new growth curves must be developed.