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Insulin and Weight Status in Adolescents: Independent Effects of Intensity of Physical Activity and Peak Aerobic Power

Daniela A. Rubin, Robert G. McMurray, and Joanne S. Harrell

Differences in insulin concentrations between normal weight or overweight adolescents (n = 437) were determined depending on their habitual physical activity (PA) and aerobic power (pVO2max). Tertiles were computed for PA (survey) and pVO2max (submaximal predicted cycle test). Independent of their weight, adolescents in the upper 2 tertiles for vigorous PA had lower insulin concentrations than those in the bottom tertile (p < .05). Adolescents in the top tertile for pVO2max expressed per kg fat-free mass also had lower insulin concentrations than those in the medium and bottom tertiles (p = .002). In youth, vigorous physical activity and aerobic power are associated with fasting insulin independent of weight status.

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Ventilatory Responses During Submaximal Exercise in Children With Prader–Willi Syndrome

Adam M. Hyde, Robert G. McMurray, Frank A. Chavoya, and Daniela A. Rubin

Purpose: Prader–Willi syndrome (PWS) is a genetic neurobehavioral disorder presenting hypothalamic dysfunction and adiposity. At rest, PWS exhibits hypoventilation with hypercapnia. We characterized ventilatory responses in children with PWS during exercise. Methods: Participants were children aged 7–12 years with PWS (n = 8) and without PWS with normal weight (NW; n = 9, body mass index ≤ 85th percentile) or obesity (n = 9, body mass index ≥ 95th percentile). Participants completed three 5-minute ambulatory bouts at 3.2, 4.0, and 4.8 km/h. Oxygen uptake, carbon dioxide output, ventilation, breathing frequency, and tidal volume were recorded. Results: PWS had slightly higher oxygen uptake (L/min) at 3.2 km/h [0.65 (0.46–1.01) vs 0.49 (0.34–0.83)] and at 4.8 km/h [0.89 (0.62–1.20) vs 0.63 (0.45–0.97)] than NW. PWS had higher ventilation (L/min) at 3.2 km/h [16.2 (13.0–26.5) vs 11.5 (8.4–17.5)], at 4.0 km/h [16.4 (13.9–27.9) vs 12.7 (10.3–19.5)], and at 4.8 km/h [19.7 (17.4–31.8) vs 15.2 (9.5–21.6)] than NW. PWS had greater breathing frequency (breaths/min) at 3.2 km/h [38 (29–53) vs 29 (22–35)], at 4.0 km/h [39 (29–58) vs 29 (23–39)], and at 4.8 km/h [39 (33–58) vs 32 (23–42)], but similar tidal volume and ventilation/carbon dioxide output to NW. Conclusion: PWS did not show impaired ventilatory responses to exercise. Hyperventilation in PWS may relate to excessive neural stimulation and metabolic cost.

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Hormonal and Metabolic Responses to a Resistance Exercise Protocol in Lean Children, Obese Children, and Lean Adults

Daniela A. Rubin, Diobel M. Castner, Hoang Pham, Jason Ng, Eric Adams, and Daniel A. Judelson

During childhood, varying exercise modalities are recommended to stimulate normal growth, development, and health. This project investigated hormonal and metabolic responses triggered by a resistance exercise protocol in lean children (age: 9.3 ± 1.4 y, body fat: 18.3 ± 4.9%), obese children (age: 9.6 ± 1.3 y, body fat: 40.3 ± 5.2%) and lean adults (age: 23.3 ± 2.4 y, body fat: 12.7 ± 2.9%). The protocol consisted of stepping onto a raised platform (height = 20% of stature) while wearing a weighted vest (resistance = 50% of lean body mass). Participants completed 6 sets of 10 repetitions per leg with a 1-min rest period between sets. Blood samples were obtained at rest preexercise, immediately postexercise and 2 times throughout the 1-hr recovery to analyze possible changes in hormones and metabolites. Children-adult differences included a larger exercise-induced norepinephrine increase in adults vs. children and a decrease in glucagon in children but not adults. Similarities between adults and children were observed for GH-IGF-1 axis responses. Metabolically, children presented with lower glycolytic and increased fat metabolism after exercise than adults did. Obesity in childhood negatively influenced GH, insulin, and glucose concentrations. While adults occasionally differed from children, amount of activated lean mass, not maturation, likely drove these dissimilarities.

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Accuracy of Three Dry-Chemistry Methods for Lipid Profiling and Risk Factor Classification

Daniela A. Rubin, Robert G. McMurray, Joanne S. Harrell, Barbara W. Carlson, and Shrikant Bangdiwala

The purpose of this project was to determine the accuracy in lipids measurement and risk factor classification using Reflotron, Cholestech, and Ektachem DT-60 dry-chemistry analyzers. Plasma and capillary venous blood from fasting subjects (n = 47) were analyzed for total cholesterol (TC), high density lipoprotein (HDL-C), and triglycerides (TG) using these analyzers and a CDC certified laboratory. Accuracy was evaluated by comparing the results of each portable analyzer against the CDC reference method. One-way ANOVAs were performed for TC, HDL-C, and TG between all portable analyzers and the reference method. Chi-square was used for risk classification (2001 NIH Guidelines). Compared to the reference method, the Ektachem and Reflotron provided significantly lower values for TC (p < .05). In addition, the Cholestech and Ektachem values for HDL-C were higher than the CDC (p < .05). The Reflotron and Cholestech provided higher values of TG than the CDC (p < .05). Chi-squares analyses for risk classification were not significant (p > .45) between analyzers. According to these results, the Ektachem and Cholestech analyzers met the current NCEP III guidelines for accuracy in measurement of TC, while only Ektachem met guidelines for TG. All 3 analyzers provided a good overall risk classification; however, values of HDL-C should be only used for screening purposes.

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Improved Motor Proficiency and Quality of Life in Youth With Prader–Willi Syndrome and Obesity 6 Months After Completing a Parent-Led, Game-Based Intervention

Daniela A. Rubin, Kathleen S. Wilson, Jared M. Tucker, Diobel M. Castner, Marilyn C. Dumont-Driscoll, and Debra J. Rose

Purpose: To determine changes and potential differences in physical activity (PA), gross motor proficiency (MP), and health parameters after a 6-month follow-up (FU) period following participation in a parent-led PA intervention in youth with or without Prader–Willi syndrome (PWS). Methods: About 42 youth with PWS and 65 youth without PWS but with obesity (body fat percentage >95th percentile for age and sex), aged 8–16 years, participated. The intervention included preplanned PA sessions containing playground and console-based video games scheduled 4 days per week for 24 weeks. Families received training and curriculum materials. PA (accelerometry), MP (Bruininks–Oseretsky Test of MP), and health-related quality of life were obtained before (PRE), after completing the intervention (POST), and at FU. Results: There were no significant changes in PA at any time point. At FU and POST, participants showed higher bilateral coordination (PRE = 9.3 [0.4], POST = 11.7 [0.5], and FU = 11.1 [0.6]); speed and agility (PRE = 9.2 [0.4], POST = 10.8 [0.4], and FU = 11.5 [0.5]); and strength (PRE = 8.0 [0.3], POST = 9.2 [0.3], and FU = 9.2 [0.3]) than at PRE. At FU (80.3 [2.1]) and POST (79.8 [1.7]), youth without PWS showed higher health-related quality of life than PRE (75.0 [1.8]). Conclusion: The improvements in MP and health-related quality of life at FU suggest long-term durability of intervention outcomes.

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Cytokine Responses to Acute Intermittent Aerobic Exercise in Children with Prader-Willi Syndrome and Nonsyndromic Obesity

Andrea T. Duran, Erik Gertz, Daniel A. Judelson, Andrea M. Haqq, Susan J. Clark, Kavin W. Tsang, and Daniela Rubin

Prader-Willi Syndrome (PWS), the best characterized form of syndromic obesity, presents with abnormally high fat mass. In children, obesity presents with low-grade systemic inflammation. This study evaluated if PWS and/or nonsyndromic obesity affected cytokine responses to intermittent aerobic exercise in children. Eleven children with PWS (11 ± 2 y, 45.4 ± 9.5% body fat), 12 children with obesity (OB) (9 ± 1 y, 39.9 ± 6.8% body fat), and 12 lean (LN) children (9 ± 1 y, 17.5 ± 4.6% body fat) participated. Children completed 10 2-min cycling bouts of vigorous intensity, separated by 1-min rest. Blood samples were collected preexercise (PRE), immediately postexercise (IP), and 15, 30, and 60 min into recovery to analyze possible changes in cytokines. In all groups, IL-6 and IL-8 concentrations were greater during recovery compared with PRE. PWS and OB exhibited higher IL-6 area under the curve (AUC) than LN (p < .01 for both). PWS demonstrated higher IL-8 AUC than LN (p < .04). IL-10, TNF-α, and IFN-γ did not change with exercise (p > .05 for all). Results indicate that children with PWS respond with increased Il-6 and IL-8 concentrations to acute exercise similarly to controls. Excess adiposity and epigenetic modifications may explain the greater integrated IL-6 and IL-8 responses in PWS compared with controls.