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Causal Associations and Potential Mediating Factors between Sarcopenia-Related Traits and Heart Failure Risk: A Mendelian Randomization Study.

INTRODUCTION: In this two-sample, two-step Mendelian randomization (MR) study, we aimed to elucidate the causal associations between sarcopenia-related characteristics and heart failure (HF) risk, and to identify the factors mediating these associations, with a particular focus on the mediating roles of obesity and sedentary habits. METHODS: Genetic instruments for appendicular lean mass (ALM), hand grip strength (HGS), walking pace (WP), and potential mediators were extracted from genome-wide association studies. Inverse-variance weighting (IVW) was used as the primary analytical method, supplemented by MR-Egger regression, weighted median, and weighted mode analyses. Sensitivity analyses including Cochran's Q test and MR-Egger intercept method were performed to assess heterogeneity and pleiotropy. Bidirectional MR was conducted to exclude reverse causation. RESULTS: IVW revealed that a faster genetically predicted WP was associated with lower HF risk (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.33-0.60, p = 5.806 × 10-7). The mediation analysis indicated that body mass index (BMI) accounted for 32% of this effect, while time spent watching television accounted for 14%. Elevated ALM showed a slight but significant positive association with HF risk (OR 1.06, 95% CI 1.03-1.09, p = 5.437 × 10-4). However, multivariable MR adjusting for BMI completely attenuated this association (p = 0.693), suggesting ALM reflects overall body composition rather than isolated muscle mass. No significant associations were found between HGS and HF. Bidirectional MR showed no robust reverse effects. CONCLUSIONS: These findings suggest that genetically predicted increased WP exerts beneficial effects against HF, partially mediated by obesity and sedentary habits. Targeting weight management and anti-sedentary interventions may mitigate HF risk in individuals with sarcopenia-related characteristics.

Heart failure

Maximal oxygen intake and body composition of female dancers.

Complete paucity of any data regarding the influence of habitual dance on cardiovascular-pulmonary fitness and body composition of female dancers prompted this study in which 12 female dancers and 12 sedentary female students of the same age range participated as subjects. Maximal oxygen intake was determined on the treadmill, body composition was calculated from skinfolds and vital signs were determined besides measurements of height and weight. Dancers had significantly lower weight, lower resting heart rate, and lower diastolic blood pressure. Systolic blood pressure was also lower in dancers but the difference between the means did not reach statistical significance. Maximal oxygen intake was higher in dancers when expressed in relative terms. Dancers had also significantly lower total body fat. In conclusion, it seems tha, dance with all the variations, should be encouraged in schools as a suitable behavioral modifier of sedentary habits and for maintenance of physical fitness and ideal weight.

Adult

Genetic analysis of Schistosoma mansoni in a low-transmission area in Brazil suggests population sharing between wild-hosts and humans and geographical isolation.

BACKGROUND: The fluke Schistosoma mansoni is the causative agent of intestinal schistosomiasis, a neglected tropical disease, and remains prevalent in certain regions of Brazil. In the municipality of Sumidouro, state of Rio de Janeiro, Brazil, a low-endemic area for S. mansoni, water rats (Nectomys squamipes) are naturally infected by this trematode. The S. mansoni populations infecting humans and water-rats in Sumidouro exhibit distinct patterns of cercarial emergence (chronotypes) and phenotypic differences between hosts. Previous studies have shown that the adaptation of S. mansoni populations to human hosts (diurnal chronotype) and water rats (nocturnal chronotype) could result in prezygotic isolation. To test this hypothesis, we employed the mitochondrial cytochrome c oxidase subunit 1 gene (MT-CO1) and microsatellite loci as genetic markers. PRINCIPAL FINDINGS: We assessed the population structure between the definitive host species and geographically distant isolates collected from two endemic localities (Pamparrão-PAM and Encanto-Soledade-ENC-SOL) in Sumidouro. Additionally, we evaluated the phylogenetic relationships between S. mansoni from Sumidouro and those from other countries. Five haplotypes of the MT-CO1 gene were identified, with haplotypes 3 and 4 exclusive to ENC-SOL, and haplotypes 1, 2, and 3 were shared between humans and water rats. Haplotype 1 was also shared with other Brazilian localities, South American countries and a single locality in West Africa. The remaining haplotypes were exclusive to Sumidouro, indicating local genetic diversity. Population structure analysis revealed no genetic differentiation associated with host species but rather geographical structuring, probably due to the sedentary habits of rodents and the limited movement of humans between localities. This finding indicates that S. mansoni populations with different chronotypes are not genetically isolated and that significant gene flow occurs between them. CONCLUSIONS: In conclusion, our findings confirm that wild rodents contribute to the maintenance of the S. mansoni life cycle in Sumidouro and can serve as indicators of local transmission hotspots.

Animals

Effects of exercise training on plasminogen activator inhibitor activity.

Plasminogen activator inhibitor (PAI) activity, an important regulator within the fibrinolytic system, has been shown to be a risk indicator for venous and arterial thrombosis. The present study aimed to test the effects of exercise training on PAI activity, and to link possible changes in PAI activity to changes in cardiovascular fitness, body composition, and the lipid profile. Four groups of previously sedentary subjects were studied thrice in an 8-month period. A long-term training group (N = 11) trained during the entire 8-month period. A detraining group (N = 14) trained for 4 months and then reverted to sedentary habits. A postponed training group (N = 16) trained only during the second 4-month period, and a no-training control group (N = 9) remained untrained throughout the entire 8-month period. PAI activity always decreased in response to training, but the training effects were small and spontaneous seasonal shifts in PAI activity of the control groups clouded their interpretation. Furthermore, detraining failed to influence PAI activity and training-induced changes in PAI activity were not related to simultaneous changes in maximal oxygen consumption, diastolic blood pressure, triglycerides, or percentage body fat, and inconsistently related to the training-induced changes in LDL-cholesterol and HDL-cholesterol. The occurrence of simultaneous changes in body fat, blood pressure, and the lipid profile underscores the potential of regular exercise to protect against cardiovascular disease. Whether these beneficial effects are accompanied by changes in the fibrinolytic system remains to be proven.

Adult

[Long-term results of the treatment of arteritis with intra-arterial injections using Reboul's technique].

We have made a non-selective search for patients undergoing treatment for more than five years for an arterial deficiency of the lower limbs. Most of the patients studied suffered from intermittent claudications for which surgical treatment was impossible (distal lesions, diabetes, coronaritis) or had failed (sympathectomy, recurrences). Faced with the inefficiency of vasodilators, and in addition to strict medical treatment of the risks factors of arterio-sclerosis disease (tobacco, obesity, hypercholesterol, sedentary habits), we treated these patients using intra-arterial injections according to the method of Reboul. Our patients generally received one injection per week of xylocaine-priscol-pronestyl. Once an improvement appeared, these injections were spaced out so as to become semi-annual. We grouped 67 patients suffering from intermittent claudications and 5 patients suffering from arteritis ulcers. We studied the results obtained from this so-called palliative treatment (the claudication going from an average 201 meters to 3,395 meters after five years and cure of the ulcers).

Aged

Coronary risk factors in middle-aged men as related to smoking, coffee intake and physical activity.

The relationship between lifestyle and coronary risk factors in blood was investigated in 165 middle-aged men. Plasma fibrinogen, serum triacylglycerols (TG), and apolipoprotein B (apo B) were higher, and high density lipoprotein cholesterol (HDLc) lower in smokers (n = 69) than in non-smokers (n = 96). By linear regression analysis there was a significant positive association between degree of smoking and either total cholesterol (TC), apo B, or plasma fibrinogen, whereas smoking was inversely related to HDLc. Smoking and coffee intake were positively correlated with an atherogenic index, reflecting the balance between low and high density lipoproteins. Sedentary men (n = 59) had higher mean TC, apo B, and atherogenic index than physically active men (n = 104). Smokers used salt more often than non-smokers. Physically active men used vegetables more often than sedentary men. Combining several habits into a "bad habit" score gave a high level of significance for its association with TC, apo B, and the atherogenic index. The results indicate that lifestyle may influence several blood factors involved in atherosclerosis development.

Adult

The descriptive epidemiology of a sedentary lifestyle in adult Australians.

Regular exercise is important for the maintenance of good health, but many people do very little exercise. There are public health concerns about activating the sedentary and, from an epidemiological measurement perspective, there are advantages in assessing physical inactivity. Using pooled data from 17,053 participants in Australian population surveys, we identified 5078 people (29.7%) who could be classified as sedentary in their recreational exercise habits. Logistic regression analyses found the inactive to be more likely to be older, less well educated, and to have lower incomes. The main reasons given for not exercising were no time (33%), being physically unable (23%), and not wanting to exercise (13%): these were more likely to be reported by those who were older, and who had lower incomes; the only exception was that being 55 years or older was not associated with having less time. Women were more likely to report being physically unable to exercise. Lower income was associated with being physically unable, and with not wanting to exercise. Those with children, while wanting to exercise, were more likely to report having no time. The greatest health benefits will result from the sedentary becoming more active, and inexpensive and convenient activities such as walking need to be emphasized.

Adult

[Clinical characteristics of pain in chronic venous insufficiency].

Since the report of the 1st International Conference of Phlebology at Chambéry, devoted to venous pain, the subject has scarcely attracted attention apart from the meeting of the Benelux Society of Phlebology devoted to "pain in the legs". Pain due to superficial venous insufficiency has scarcely changed in nature for 30 years and remains one of the major presenting symptoms in phlebology. Acute or chronic, punctate or diffuse, modifications in this functional symptomatology have been accentuated, or have varied in their aspects under the influence of certain fashions or certain habits of modern life, i.e.: sedentary behaviour, underfloor heating, the use of oral contraceptives or of menopausal hormone replacement therapy. However, the distribution of the various aspects of venous pain remains in the same proportions as those described by the authors cited previously. While the etiological diagnosis must essentially eliminate all other causes: arterial, neurological, muscular, articular, it is essential not to neglect deep venous insufficiency of the gemellar veins, often responsible for a wide range of symptomatology and still all too often neglected. The pathogenesis of this pain not only involves the concept of pain receptors but also the appearance of algogenic metabolites at the site of the microcirculatory unit, to which endothelial cells are particularly sensitive during stasis. In fact, pain is the expression of disorders concerning local exchanges, whether thermal, pressure, metabolic or hemorheological. It is the alarm bell of venous insufficiency and merits the attention of the phebologist who must thus undertake active treatment before problems become irreversible.

Chronic Disease

Return to work after spinal cord injury: the potential contribution of physical fitness.

The history, physical characteristics and fitness status of 60 persons who had sustained a spinal cord injury at least 3 years previously were considered in relation to current occupation. All subjects had completed their education, 39 being gainfully employed and 21 unemployed. The general characteristics of the sample, mainly beneficiaries of the Quebec Automobile Insurance Plan, were typical of spinal cord injured individuals in North America. The working group had a significantly higher current level of education than those who were unemployed (p less than .01). In terms of physical fitness, the workers were lighter, with a lower body mass index and a higher aerobic power (p less than .05). Isokinetic testing suggested a trend toward a higher peak torque in the workers. The total work performed (Nm.kg-1) during an isokinetic endurance test (25 biphasic contraction at 180 degrees.sec-1) was significantly higher in the workers, suggesting that such muscular endurance might be even more useful than greater peak isokinetic strength during vocational activities. However, the likelihood of employment was unrelated to habitual patterns of either aerobic exercise or overall physical activity. No significant differences of physical fitness or physical activity habits were found between workers holding sedentary versus physically demanding jobs. The results verified the positive relationship between physical fitness (body composition, aerobic power, muscular endurance) and the gainful employment of paraplegics, but failed to show any significant relationship between physical fitness and the acceptance of physically demanding work by such individuals.

Adolescent

Life styles of men in barren couples and their relationship to sperm quality.

This study is based on a questionnaire which focused on the possible association between life-style factors and male fertility in a group of 252 men attending our laboratory in connection with a fertility investigation. Their answers were correlated to sperm quality. No association could be documented between sperm quality and smoking habits, coffee drinking, a moderate alcohol intake, exposure to heat (sauna, hot baths, type of underwear, sedentary activities), or physical activities in their leisure time. In contrast, the reported average ejaculation frequency was significantly positively correlated to the motility of the sperm (% progressive), and inversely related to the proportion of sperm with abnormal morphology and semen volume. This indicates that the life style of the subject has little if any impact on semen quality, at least within the limits recorded in the present study.

Alcohol Drinking

Health situation and related social conditions among 66-year-old Finnish men.

The aims of the study were to reveal the extent of physical activity, nutritional habits, smoking and alcohol consumption and the relation of these to previous occupation among recently retired men. The number of men belonging to various health risk groups was estimated on the basis of the results. About 10% had inadequate nutritional habits as judged from their food expenses and number of daily hot meals and about 20% practised physical exercise in the way which is considered necessary for the improvement of cardiovascular performance and maximal oxygen uptake. Only a small minority had been requested to undertake physical exercise. About 18% lived alone. The problems were more pronounced among the men retired from manual occupations compared with men whose main occupation had been of a sedentary nature. The results indicate that a considerable proportion of elderly men would need more advice and more adequate services in order to improve their daily living habits. Any such measures should preferably be started before retirement as the living habits adopted during the earlier periods of life seem to remain unchanged in old age. The results are based on an interview study carried out among 137 66-year-old men representing about 90% of the men of that age group living in Jyväskylä, a town of 60000 inhabitants in Central Finland.

Aged

Occupational physical activity and colon cancer risk in Turkey.

A case-control study of 107 colon cancer cases and 486 controls from an oncological clinic in Istanbul was conducted to examine the association between occupational physical activity and colon cancer in Turkey, where incidence of this disease is low. Only two of the four activity measures showed evidence of an increased colon cancer risk for sedentary jobs (time spent sitting OR = 1.5 and occupational energy expenditure OR = 1.6); neither was statistically significant. Subjects below age 55 showed higher risk associated with sedentary jobs than did the older age group, probably due to their adoption of a more western lifestyle, including dietary habits, less activity, and other factors that may interact to increase the risk of colon cancer.

Adolescent

Sporting activities and exercise habits of the 1975 Busselton population.

Studies of the sporting activities and exercise habits of the 1975 Busselton population indicated that two out of three subjects exercised either not at all, or less than once a week, and only 7% stated they tried to get out of breath during their exertions. Those in sedentary occupations undertook more leisure exercise than those in non-sedentary occupations, with men exercising more frequently than women. Comparisons of body weights, blood pressures, serum levels of cholesterol and triglycerides, glucose levels, uric acid levels, lung function tests and electrocardiogram tracings between those who exercised four or more times per week and those who exercised less than four times per week revealed significant differences only in relation to lung function tests, which favoured the higher exercise group. This evidence suggested that the levels of activity involved in the Busselton population's sport and exercise habits were failing to provide additional protection against future coronary heart disease.

Adolescent

Moderate exercise and high-density lipoprotein-cholesterol. Observations during a cardiac rehabilitation program.

The effects of a 13-week moderate exercise program on fasting plasma insulin, lipids, and lipoprotein cholesterol concentrations were studied in 32 sedentary, middle-aged men with coronary artery disease. The preponderant component of the exercise program was walking or slow jogging. There was no significant change in the systolic blood pressure and pulse rate product response to a standard exercise load. The high-density lipoprotein-cholesterol (HDL-C) level increased, and the fasting plasma insulin concentration decreased. There were no significant changes in plasma triglycerides or low-density lipoprotein cholesterol levels. In sedentary subjects with coronary artery disease, a modest increase in activity can result in an increase in the HDL-C level and a decrease in the plasma insulin concentration. These changes occurred in the absence of variations in diet, smoking habits, adiposity, or plasma triglyceride concentrations and did not require a cardiovascular training effect.

Adult

The role of physical activity in the control of obesity.

An exercise programme is an important part of the management of the obese patient. Exercise may increase both the specific dynamic action of food and the post-exercise metabolic rate, in addition to its direct caloric cost. Moderate daily exercise aids regulation of the appetite and may reduce the voluntary caloric intake of otherwise sedentary persons. Post-prandial activity may utilize more calories; therefore an adequate breakfast and avoidance of late night eating may be effective in weight control. A better tolerated and more nutritious diet may be allowed, and lean body weight better preserved, by combining exercise with a dietary programme. Regular exercise may also reduce some of the more serious life-threatening complications of obesity and poor dietary habits, allowing greater freedom in the pursuit of other pleasures.

Adolescent

An epidemiological study of acute herniated lumbar intervertebral discs.

In an epidemiological study of acute herniated lumbar intervertebral discs in the New Haven, Connecticut (U.S.A.), area, it was found that this condition was most likely to be diagnosed among persons in the age group 30-39 years, and that the most important risk factors among the variable considered in this study were driving of motor vehicles at or away from work, sedentary occupations, suburban residence, and previous full-term pregnancies. Variables for which there was some suggestion of an association but for which the evidence was inconclusive were the male sex, high social class among females, chronic cough and chronic bronchitis, participation in baseball, golf and bowling, the spring and fall seasons, and possibly lack of physical activity other than at work. No increase in risk for this condition was related to race, social class in males, smoking habits, participation in sports other than baseball, golf and bowling, weight or body bulk, recent episodes of emotional stress, pregnancies which were not full-term, and jobs involving lifting, pushing, pulling, or carrying.

Adult

Energy expenditure, cigarette smoking, and blood pressure level as related to death from specific diseases.

In a 22-year followup of 3686 San Francisco longshoremen, the roles of physical activity, cigarette smoking habit, and systolic blood pressure level were evaluated independently in relation to risk of death from a broad range of diseases. Smoking pattern and blood pressure status were established in 1951 and job activity was assessed annually during the followup period. Lower levels of energy expenditure predicted increased risk of fatal heart attack and perhaps of stroke. Heavy cigarette smoking predicted increased risk of death from heart attack, cancer, chronic obstructive respiratory disease, and pneumonia. Higher levels of systolic blood pressure were associated with death from all cardiovascular diseases, diabetes mellitus, and cirrhosis. Tacit to these findings: sedentary living takes its toll largely through heart disease and stroke; the toxicity of cigarette smoking is associated with a broader range of diseases, including heart attack, cancer, and respiratory disease; and higher level of blood pressure related to an even broader range of cardiovascular disease than either of the other characteristics studied.

Adult