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Alcoholic liver cirrhosis (ALC) is accompanied by sarcopenia. The aim of this study was to investigate the acute effects of balanced parenteral nutrition (PN) on skeletal muscle protein turnover in ALC. Eight male patients with ALC and seven age- and sex-matched healthy controls were studied for three hours of fasting followed by three hours of intravenous PN (SmofKabiven 1206 mL: Amino acid 38 g, carbohydrates 85 g, fat 34 g) 4 ml/kg/hour. We measured leg blood flow, sampled paired femoral arterio-venous concentrations and quadriceps muscle biopsies while providing a primed continuous infusion of [ring-2D5]-phenylalanine to quantify muscle protein synthesis and breakdown. Patients with ALC exhibited shorter 6-min walking distance (ALC: 487 ± 38 vs. controls: 722 ± 14 m, p<0.05), lower hand-grip strength (ALC: 34 ± 2 vs. controls: 52 ± 2 kg, p<0.05), and CT-verified leg muscle loss (ALC: 5922 ± 246 vs. controls: 8110 ± 345 mm2, p<0.05). Net leg muscle phenylalanine uptake changed from negative (muscle loss) during fasting to positive (muscle gain) in response to PN (ALC: -0.18 ± +0.01 vs. 0.24 ± 0.03 µmol/kg muscle*min-1; p <0.001 and controls: -0.15 ± 0.01 vs. 0.09 ± 0.01 µmol/kg muscle*min-1; p <0.001), but with higher net muscle phenylalanine uptake in ALC than controls (p <0.001). Insulin concentrations were substantially higher in ALC patients during PN. Our results suggest a higher net muscle phenylalanine uptake during a single infusion of PN in stable ALC patients with sarcopenia compared with healthy controls., Alcoholic liver cirrhosis (ALC) is accompanied by sarcopenia. The aim of this study was to investigate the acute effects of balanced parenteral nutrition (PN) on skeletal muscle protein turnover in ALC. Eight male patients with ALC and seven age- and sex-matched healthy controls were studied for three hours of fasting followed by three hours of intravenous PN (SmofKabiven 1206 mL: Amino acid 38 g, carbohydrates 85 g, fat 34 g) 4 ml/kg/hour. We measured leg blood flow, sampled paired femoral arterio-venous concentrations and quadriceps muscle biopsies while providing a primed continuous infusion of [ring-2D5]-phenylalanine to quantify muscle protein synthesis and breakdown. Patients with ALC exhibited shorter 6-min walking distance (ALC: 487 ± 38 vs. controls: 722 ± 14 m, p<0.05), lower hand-grip strength (ALC: 34 ± 2 vs. controls: 52 ± 2 kg, p<0.05), and CT-verified leg muscle loss (ALC: 5922 ± 246 vs. controls: 8110 ± 345 mm2, p<0.05). Net leg muscle phenylalanine uptake changed from negative (muscle loss) during fasting to positive (muscle gain) in response to PN (ALC: -0.18 ± +0.01 vs. 0.24 ± 0.03 µmol/kg muscle*min-1; p <0.001 and controls: -0.15 ± 0.01 vs. 0.09 ± 0.01 µmol/kg muscle*min-1; p <0.001), but with higher net muscle phenylalanine uptake in ALC than controls (p <0.001). Insulin concentrations were substantially higher in ALC patients during PN. Our results suggest a higher net muscle phenylalanine uptake during a single infusion of PN in stable ALC patients with sarcopenia compared with healthy controls.

Type 2 diabetes is associated with microvascular dysfunction, but little is known about how capillary ultrastructure is affected by exercise training. To investigate the effect of two types of exercise training on skeletal muscle capillary ultrastructure and capillarization in individuals with type 2 diabetes, 21 individuals with type 2 diabetes were allocated (randomized controlled trial) to 11 weeks of aerobic exercise training consisting of either moderate-intensity endurance training (END; n=10), or low-volume high-intensity interval training (HIIT; n=11). Skeletal muscle biopsies (m vastus lateralis) were obtained before and after the training intervention. At baseline, there was no difference in capillarization, capillary structure and exercise hyperaemia between the two groups. After the training intervention, capillary-to-fiber ratio increased by 8±3% in the END group (P<0.05) and was unchanged in the HIIT group with no difference between groups. Endothelium thickness increased (P<0.05), basement membrane thickness decreased (P<0.05) and the capillary lumen tended (P=0.07) to increase in the END group, whereas these structural indicators were unchanged after HIIT. In contrast, skeletal muscle endothelial nitric oxide synthase (eNOS) increased after HIIT (P<0.05), but not END, whereas there was no change in vascular endothelial growth factor (VEGF), superoxide dismutase (SOD)-2 or NADPH oxidase after both training protocols. In contrast to END training, HIIT did not alter capillarization or capillary structure in individuals with type 2 diabetes. In conclusion, HIIT appears to be a less effective strategy to treat capillary rarefaction and reduce basement thickening in type 2 diabetes.

PURPOSE: Cardiorespiratory fitness is positively related to heart failure (HF) prognosis, but lack of time and low energy are barriers for adherence to exercise. We, therefore, compared the effect of low-volume time-based resistance exercise training (TRE) with aerobic moderate-intensity cycling (AMC) on maximal and submaximal exercise capacity, health-related quality of life, and vascular function.METHODS: Twenty-eight HF patients (New York Heart Association class I-II) performed AMC (n = 14) or TRE (n = 14). Maximal and submaximal exercise capacity, health-related quality of life, and vascular function were evaluated before and after a 6-wk training intervention with 3 training sessions per week. The AMC group and the TRE group trained for 45 and 25 min per training session, respectively. During the training sessions, the TRE and AMC groups trained at 60 ± 4% and 59 ± 2% (mean ± standard deviation) of (Equation is included in full-text article.)O2peak, respectively.RESULTS: The energy expenditure was significantly greater in AMC than in TRE (P < .05). The (Equation is included in full-text article.)O2peak and Wattpeak increased in AMC group (P < .001) and TRE group (P = .001), with no differences between groups. Six-minute walk distance also increased in both groups (AMC, P = .006 and TRE, P = .036), with no difference between groups. Health-related quality of life improved equally in the 2 groups, whereas vascular function did not change in either group.CONCLUSION: These results demonstrate that AMC and TRE equally improved exercise capacity and health-related quality of life in lower New York Heart Association-stage HF patients, despite less time required as well as lower energy expenditure during TRE than during AMC. Therefore, TRE might represent a time-efficient exercise modality for improving adherence to exercise in patients with class I-II HF.