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Nephrology Dialysis Transplantation 28 (Supplement 1): i322–i324, 2013
doi:10.1093/ndt/gft127
HORMONES
MP074
ENDOGENOUS OUABAIN AND BLOOD PRESSURE
VARIABILITY EVOKED BY LOW SALT INTAKE IN ESSENTIAL
HYPERTENSION
Guido Gatti1, Chiara Lanzani1, Elisabetta Messaggio1, Nunzia Casamassima1,
John Hamlyn2, Marco Simonini1 and Paolo Manunta1
1
OU Nephrology and Dialysis / Chair of Nephrology San Raffaele Scientific Institute
/ Università Vita Salute San Raffaele Milan Italy, 2Physiology Department University
of Maryland, School of Medicine Baltimore MD United States
Introduction and Aims: A series of experimental and clinical data supports the notion
that Endogenous Ouabain (EO) may affect blood pressure (BP), plasma sodium
concentration, and renal Na excretion. The plasma sodium concentration directly
affects BP but the pressor mechanism for elevated BP following an increased salt intake
is unclear. A direct relation between plasma EO and plasma Na has been reported.
Further, the BP response to a low salt intake is heterogeneous, with BP rising in some
patients.
Methods: Here we investigated the response of EO, plasma Na and BP to a low salt
intake (<100 mEq/day, 15 days) in a cohort of 79 naïve hypertensive patients (EH).
Results: The BP response to the low salt intake showed high systolic and diastolic BP
variability (range -62.4 to +40 mmHg, respectively). The changes in mean diastolic BP
were directly related to the change in plasma EO (r=0.27, p=0.02). Patients were then
segregated into quartile sub-groups according to DBP changes. Those with the greatest
BP fall were in the 1st quartile, while those patients that showed an increase in DBP
after low salt intake, i.e., reverse salt sensitivity (RSS), were in the 4th quartile (Figure A
panel). RSS showed a greater decrease in plasma [Na+] (-2.2±0.6 vs + 0,23±0.54 mEq/
L, B panel) and simultaneous increases in plasma EO (C panel). Circulating EO was
inversely related to plasma [Na+] (r=-0.316, p=0.005, n=78). Neither plasma
aldosterone nor renin were related to RSS.
Conclusions: Our findings show that in EH: 1) a low salt diet lowers BP in the vast
majority of patients while raising plasma EO and BP primarily in RSS patients. 2)
While EO upregulates renal Na-K ATPase activity,and might be a useful mechanism
minimizing sodium loss, the elevation of EO in RSS patients suggests it may account
for the paradox that reduced salt intake may increase the risk for cardiovascular and
renal disease in some individuals.
Introduction and Aims: Adiponectin (ADPN) is an adipokine with anti-atherogenic,
anti-inflammatory and insulin-sensitizing properties. To date is reported that the
adipocyte is the predominant cell type responsible for secretion of ADPN and that the
chronic inflammatory status characterizing obese patients is responsible for a reduction
of ADPN circulating levels. In vivo studies demonstrated that the hypoadiponectinemia
induces microalbuminuria through a direct podocytes dysfunction. However clinical
studies demonstrated that patients with overt proteinuria had higher circulating ADPN
levels compared to normoalbuminuric controls. Unexpectedly, similar ADPN levels
were observed in obese proteinuric patients. To date, despite all these evidences, the
mechanisms linking overt proteinuria and hyperadiponectinemia are not yet clarified.
The aim of our study was to investigate whether epithelial tubular renal cells express
and secrete adiponectin and, principally, whether renal cells in basal conditions and
upon an inflammatory stimulus secrete this adipokine contributing to ADPN
circulating levels.
Methods: In human proximal tubular epithelial cells, HK-2, ADPN mRNA was
evaluated by real time PCR-assay while protein expression levels by Western blot
analysis and immunofluorescence assay. Moreover, renal ADPN distribution was
assessed by immunohistochemical analysis of kidney biopsies from healthy subject and
from two patients affected by rapidly progressive and membranous glomerulonephrytis
respectively. Finally, by ELISA assay, we measured ADPN concentrations in culture
media of HK-2 cells treated with lipopolysaccharide (LPS) 10 µg/ml.
Results: Our analyses revealed that HK-2 cells express ADPN both in terms of mRNA
and protein. These results were confirmed by the observed cytoplasmatic HK-2 intense
immunoreactivity for ADPN antibody and by immunohistochemical analysis showing
a diffuse ADPN distribution in normal kidney tissue. We also confirmed that HK-2
cells express both best-characterized receptors for ADPN, adipoR1 and adipoR2
although, the results revealed that adipoR1 is the predominant isoform. Furthermore
we observed that tubular cells secrete ADPN in basal condition and, more interestingly,
this secretion significantly increases ( p < 0.05) upon LPS treatment in a time
dependent manner. Finally, immunohistochemical analysis of kidney biopsies obtained
from patients affected by membranous and rapidly progressive glomerulonephritis
showed a similar pattern of ADPN staining observed in healthy control.
Conclusions: Our study demonstrates, for the first time, that tubular renal cells express
and secretes ADPN, which concentration increases upon inflammatory stimulus. These
results suggest that in renal inflammatory diseases, tubular cells may contribute to the
increasing ADPN circulating levels, triggering a feedback response in order to
self-mitigate the inflammatory process.
MP076
ANTIDIURETIC EFFECTIVENESS OF DESMOPRESSIN
ENCAPSULATED IN NEWLY DESIGNED LIPOSOMAL
CARRIERS
Olga Gawrys1, Katarzyna Gawarecka2, Ewa Swiezewska2, Marek Masnyk3,
Marek Chmielewski3 and Elzbieta Kompanowska-Jezierska1
1
Mossakowski Medical Research Centre Polish Academy of Sciences Warsaw
Poland, 2Institute of Biochemistry and Biophysics Polish Academy of Sciences
Warsaw Poland, 3Institute of Organic Chemistry Polish Academy of Sciences
Warsaw Poland
MP074
MP075
ADIPONECTIN IS EXPRESSED AND SECRETED BY TUBULAR
EPITHELIAL RENAL CELLS
Anna Perri1, Donatella Vizza1, Danilo Lofaro1, Paolo Gigliotti1, Francesca Leone1,
Teresa Papalia1 and Renzo Bonofiglio1
1
Dept of Nephrology, Annunziata Hospital “Kidney and Transplantation” Research
Center Cosenza Italy
Introduction and Aims: Recently liposomal formulation lies within the interest of
many researchers. Drug carriers based on liposomes are considered to be efficient and
convenient enabling pharmacologically active substances better penetration through
biological membranes. Augmenting carrier properties by using new components seems
to be a very profitable strategy to improve therapy. Previous studies on amino-prenols,
new derivatives of polyisoprenoid alcohols, proved their lipofecting properties and
showed their lack of toxicity in rats. In this study we investigate how they affect the
bioavailability of desmopressin (dDAVP). This agonist of vasopressin acts selectively
on V2receptors, responsible for the antidiuretic effect and is deprived of its
vasoconstrictory action. Antidiuretic effectiveness of dDAVP encapsulated in new
liposomes built of dioleoyl phosphatidylethanolamine and amino-prenols (dDAVP
+LP, 60ng/kg of dDAVP in 7.5 mg/kg of lipids) was compared to dDAVP (60ng/kg)
given in classical solvent (water).Two control groups received: liposomes without
dDAVP (LP,7.5 mg/kg of lipids) and solvent for classical dDAVP (W).
Methods: In acute experiments anaesthetized and surgically prepared male
Sprague-Dawley rats received intravenous infusion of 2.5% glucose solution (36 ml/h/
kg) to induce water diuresis. After 30 minutes the corresponding solution (dDAVP+LP,
dDAVP, LP or W) was given intravenously as a bolus (0.5 ml for 1 min). In the
clearance experiment diuresis (V), plasma osmolality and solute excretion were
measured.
Results: Different kinetics of inhibition of diuresis caused by dDAVP encapsulated in
liposomes and for dDAVP given in water was observed. After administration of
dDAVP in water decrease in diuresis was visible after 0.5 h, however after 1.5h diuresis
slightly started to increase again. dDAVP+LP inhibited diuresis after 1h and after 2h
the decrease was still observed. This was probably caused by slower release of
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Abstracts
Nephrology Dialysis Transplantation
desmopressin from liposomal carriers; in this case dDAVP+LP lasted longer in
cardiovascular system and was characterized by prolonged activity. In the end of
observation diuresis (dDAVP: 33.1±7.5 µl/min; dDAVP+LP: 38.1±8.7 µl/min) and
plasma osmolality (dDAVP: 266±2; dDAVP+LP: 263±2 mosm/l) in both groups was
similar. Also we did not observe any negative changes in cardiovascular system caused
by intravenous administration of amino-prenols, so we obtained additional
confirmation that they are not toxic for living organisms.
Conclusions: Slower release of dDAVP+LP from liposomal carriers into systemic
circulation caused the delay in its antidiuretic response, but the final effectiveness of the
two routes of drug application was comparable. In addition, an inducement of
prolonged activity of applied drugs by our liposomes could be beneficial.
MP077
LOW TRIIODOTHYRONINE SYNDROME IN DIALYSIS: DOES
THE VASCULAR ACCESS PLAYS ANY ROLE?
Francesca Apponi1, Valentina Sinibaldi1, Anna Giuliani1, Matteo Baldinelli2,
Remo Luciani3, Franco Giordano4, Giancarlo Panzieri4, Giorgio Punzo1,
Paolo Mené1 and Nicola Pirozzi1
1
Department of Clinical and Molecular Medicine, UOC Nephrology and Dialysis,
AO Sant'Andrea University of Rome Sapienza Rome Italy, 2Department of Clinical
Science University of Rome, Sapienza Rome Italy, 3UOC Nefrologia AO G. Rummo
Benevento Italy, 4Nephrology Department Casa di Cura Nuova ITOR Rome Italy
Introduction and Aims: Low triiodothyronine (fT3) syndrome has been reported with
a high prevalence in chronic kidney disease (CKD) and have been considered an
independent predictor of mortality in both hemodialysis (HD) and peritoneal dialysis
(PD) patients. Several factors, such as malnutrition, inflammation, acute disease, are
reported to cause this syndrome in ESRD patients. Our aim was to evaluate whether
the incidence of low T3 syndrome in a dialysis patients group was influenced by the
vascular access in use: autogenous arteriovenous fistula (AVF) compared to
arteriovenous graft and central venous catheter (AVG -CVC).
Methods: We studied 43 stable chronic hemodialysis patients (mean age, 60 years; M
30, F 13), divided in group A (AVF, n=21) and group B (AVG-CVC, n=22). The
following parameters were measured in every patient: TSH, fT4, fT3, biochemical data
related to nutritional status (serum albumin) and markers of inflammation (C-reactive
protein, VES, fibrinogen). We excluded from this study any patients with intercurrent
illnesses (infectious diseases, cancer, and hospitalization within the previous 60 days)
and those treated with drugs known to affect the plasma concentration of thyroid
hormones (beta-blockers, amiodarone, levothyroxine).
Results: Group B (AVG-CVC) showed lower mean value of fT3 (1,91 pg/ml ± 0.56)
compared to Group A (2,34 pg/ml ± 0.31) ( p<0.004). No significant difference was
observed between AVG and CVC patients in group B. TSH did not differ between two
groups (Group A: 1,19 uIU/ml ± 0.66, Group B: 1,29 uIU/ml ± 1.11), whereas Group B
showed higher fT4 (0,91 ng/dl ± 0.28) compared to Group A (0,74 ng/dl ± 0.12) ( p<
0.008). C-reactive protein (CRP) and fibrinogen were higher in Group B (CRP 5,84
mg/dl ± 8.6, fibrinogen 391 mg/dl ± 111) then Group A (CRP 0,70 mg/dl ± 0.53,
fibrinogen 302 mg/dl ± 61.4) ( p< 0.004 and p< 0.003 respectively), but no significant
correlation was found with fT3 levels. Nutritional status (serum albumin) did not differ
between groups, nor any correlation with fT3 levels was found.
Conclusions: Our results would suggest that type of vascular access could influence the
incidence of lowT3 syndrome in stable hemodialysis patients, independently from
inflammation/nutritional parameters. Autogenous accesses (AVF) seems protective, by
a mechanism that need to be clarified.
MP078
HEMODIALYSIS-INDUCED CHANGES IN THYROID
HORMONE CONCENTRATIONS
Sylvie Dusilova Sulkova1, Jiri Horacek2, Roman Safranek1, Marta Kalousova4,
Eva Malirova3, Blanka Dlabalova3, Michaela Kubisova1 and Pavel Zak2
1
Hemodialysis Center Medical Faculty and University Hospital Hradec Kralove
Czech Republic, 2IV. Department of Internal Medicine Medical Faculty and
University Hospital Hradec Kralove Czech Republic, 3Department of Nuclear
Medicine Medical Faculty and University Hospital Hradec Kralove Czech Republic,
4
Institute for Clinical Biochemistry Charles University Prague Czech Republic
Introduction and Aims: Thyroid function tests are often abnormal in end-stage renal
disease patients on maintenance hemodialysis. However, the effect of single
hemodialysis (HD) procedure on thyroid hormone serum concentrations is not
known.
Methods: Hemodialysis patients (n=110, 71 M, median age 65 years) were studied
during conventional low-flux HD procedure (spKt/V 1.52; 1.32-1.72). Pre- and
post-HD serum concentrations of total and free thyroxine (T4 and fT4), total and free
triiodothyronine (T3 and fT3), reverse triiodothyronine (rT3) and thyrotropin (TSH)
levels were measured using radioisotope assays. Data are given as median; interquartil
range.
Results: All thyroid hormones increased significantly during HD (P<0.001, Wilcoxon
test): T4 by 18.1%, fT4 by 45.5%, T3 by 14.6%, fT3 by 8.7%, and rT3 by 15.7%. The
ratio free/total T3 did not change during HD. On the contrary, the ratio free/total T4
increased significantly from 1.658-4 to 1.973-4 (P<0.0001). Conversely to peripheral
Volume 28 | Supplement 1 | May 2013
thyroid hormones, TSH levels significantly decreased during HD from 1.80 to 1.60
mIU/l. Data are shown in the table.
Conclusions: HD procedure induces profound changes in serum thyroid hormones
concentrations. The concordant increase in all thyroid peripheral hormones
(maximum in fT4) suggests an increased release of the hormones from thyroid gland
into peripheral circulation and is probably responsible for observed decrease in TSH.
We can only hypothesize that removal of an excess of iodide during HD might be
responsible for observed changes (Wolff-Chaikoff effect). Removal of other
non-specific uremic toxins may also be involved, as well as correction of metabolic
acidosis. Finally, the timing of blood sampling (before vs. after HD) is important for
proper interpretation of thyroid function tests in HD patients.
MP078
TSH (mIU/L)
fT3 (pmol/L)
T3 (nmol/l)
fT4 (pmol/L)
T4 (nmol/L)
rT3 (nmol/L)
MP079
Pre-HD
1.80; 1.21-3.47
3.39; 2.91-3.78
0.98; 0.81-1.19
12.07; 10.50-14.12
70.9; 59.6-83.4
0.265; 0.211-0.363
Post-HD
1.60; 0.90-2.73
3.61; 3.12-4.36
1.12; 0.91-1.33
17.87; 15.91-20.62
91.1; 74.0-108.6
0.311; 0.242-0.430
P<
0.001
0.001
0.001
0.001
0.001
0.001
PROLACTIN EFFECT ON WATER-SOLUTE BALANCE IN THE
RAT MODEL OF CHOLESTASIS OF PREGNANCY IS RENAL
AQUAPORIN INDEPENDENT
Natalia Sirotina1, Yuri Fidchenko1 and Olga Smirnova1
1
Laboratory of Endocrinology, Biological Department Lomonosov Moscow State
University Moscow Russian Federation
Introduction and Aims: Prolactin regulates lactation in mammals, but in fishes and
lower vertebrates it controls water-solute balance. Level of this hormone elevates
during pregnancy and additionally elevates under condition of cholestasis of
pregnancy. Our goal was to determine whether prolactin has any effect on water-solute
homeostasis in female rats in the model of cholestasis of pregnancy.
Methods: For the modeling of pregnancy's prolactin level hyperprolactinemia was
induced by donor pituitary transplantation under renal capsule of female rat recipient,
for the modeling of cholestasis of pregnancy the combination of induced
hyperprolactinemia and bile duct ligation was used. Hyperprolactinemia was
confirmed by measure of rat serum prolactin concentration. Surgical procedures were
conducted under diethyl ether anesthesia. In these models diurnal diuresis, glomerular
filtration rate (GFR) and diurnal sodium excretion were estimated. Aquaporin 1–4
mRNA expression in the renal inner medulla was tested by real-time PCR using 3
housekeeping genes and normalized on GAPDH expression.
Results: Persistent hyperprolactinemia combined with obstructive cholestasis led to
sharp 2-fold elevation of diurnal diuresis and compensatory water consumption as
compared with the control. In spite of this aquaporin 1–4 mRNA expression in the
renal inner medulla and glomerular filtration rate were not changed in this model of
cholestasis of pregnancy. In this model sufficient elevation of diurnal sodium excretion
as compared with control groups was revealed. Alone bile duct obstruction or
hyperprolactinemia had no marked influence on these parameters.
Conclusions: The data on diuretic and natriuretic effects of prolactin in the model of
cholestasis of pregnancy together with the lack of prolactin influence on GFR and
aquaporin 1-4 mRNA expression in renal medulla let us to suggest primary prolactin
influence on the sodium transporters in the kidney without substantial modulation of
aquaporin expression and vasopressin action. Supported by RFBR (grant
11-04-00009-a).
MP080
EFFECTS OF A RESISTANCE EXERCISE TRAINING
PROGRAM ON ACYL- GHRELIN AND OBESTATIN LEVELS IN
HEMODIALYSIS PATIENTS
Cristiane Ferreira Moraes2, Sandra Mara Marinho1, Milena Barcza Stockler-Pinto3,
Amanda Faria Barros2 and Denise Mafra1,2
1
Graduate Program in Medical Sciences Federal University Fluminense Niteroi Rio
de Janeiro Brazil, 2Graduate Program in Cardiovasculare Sciences Federal
University Fluminense Niteroi Rio de Janeiro Brazil, 3Institute of Biophysics Carlos
Chagas Filho Federal University of Rio de Janeiro Rio de Janeiro Rio de Janeiro
Brazil
Introduction and Aims: Appetite hormones peptides are altered by exercises in
general population; however, no study has evaluated the effects of exercise on these
hormones in chronic kidney disease (CKD) patients. The purpose of this study was to
assess the effects of an intradialytic resistance exercise training program (RETP) on
plasma levels of gut peptides (acyl-ghrelin and obestatin) in hemodialysis (HD)
patients.
doi:10.1093/ndt/gft127 | i
Abstracts
Nephrology Dialysis Transplantation
Methods: The study enrolled 37 hemodialysis (HD) patients (61.5% men, 45.9±14.1
yrs, 23.5±3.9kg/m2).Acyl- ghrelin and obestatin plasma levels (measured using the
enzyme immunometric assay) were performed in the fasted state at baseline and after 6
months of RETP (supervised, 3 days/wk, total 72 sessions). Anthropometric
measurement and food intake were assessed. Statistical analyses were performed using
SPSS 17.0.
Results: After 6 months RETP, there was increase in men fat free mass (from 51.3±10
to 53.2±10kg, p<0.05) and arm muscle area in all patients. The energy and protein
intakes were similar before and after exercises, however; there were significant
reduction in the anorexigenic hormone levels (obestatin) from 3.0 (2.3-3.4) ng/mL to
1.9 (0.6-3.4ng/mL) and increase in the orexigenic (acyl-ghrelin) from 21.5 (1.3-77.7)
ng/mL to 37.2 (16.7-94.1) ng/mL .
Conclusions: In conclusion, the resistance exercise during 6 months in HD patients led
MP080
Parameters
Albumin (mg/dL)
Creatinine (mg/dL)
Kt/V
Potassium (mg/dL)
Acyl-ghrelin (pg/mL)
Obestatin (ng/mL)
Acyl-ghrelin/Obestatin ratio
Before
3.7±0.3
12.4±3.5
1.4±0.3
4.9±0.5
21.5 (1.3-77.7)
3.0 (2.3-3.4)
0.07 (0.01-0.06)
After
3.9±0.2*
12.3±3.3
1.3±0.4
4.8±0.6
37.2 (16.7-94.1)*
1.9 (0.6-3.4)*
0.2 (0.08-0.7)
Introduction and Aims: Irisin, a recently discovered hormone secreted by myocytes
induced in exercise, acts as a muscle-derived energy-expenditure signal that binds to
undetermined receptors on the white adipose tissue surface, stimulating its browning
and uncoupling protein 1 (UCP1) expression. The purposes of this study were to assess
the effect of an intradialytic resistance exercise training program (ETP) on circulating
concentrations of irisin in hemodialysis (HD) patients and compare irisin plasma levels
in these patients and healthy individuals.
Methods: This longitudinal study enrolled 26 chronic kidney disease patients (CKD)
(50% men, 44.7±14.1 yrs, 23.5±3.9kg/m2). The healthy individuals group consisted of
11 women and 7 men with mean age of 50.9 ± 6.1 yrs and BMI, 24.2 ± 2.7kg/m2.
Anthropometric and biochemistry parameters (irisin by Enzyme-Linked
Immunosorbent Assay) were measured at the baseline and after 6 months of strength
ETP (in both lower limbs) that was performed during the first 3 hours of hemodialysis,
three times a week for 72 sessions.
Results: There was no difference regarding gender, age and body mass index (BMI)
between HD patients and healthy individuals. Baseline plasma levels of irisin in HD
patients were significantly lower than in healthy individuals (71.0±41.6 vs 101.3 ±
12.5ng/mL, p<0.05). There was no significant difference in irisin plasma levels between
women and men (77.5 ± 44.4 vs 64.6 ± 39.4 ng/mL). Although the muscle mass has
increased in consequence of exercise (evaluated by arm muscle area from 27.9 (24.1) to
33.1(19.0)cm2), irisin plasma levels did not differ significantly before and after ETP
(71.0 ± 41.6 vs 73.3 ± 36.0 ng/mL).
Conclusions: HD patients seem to have lower irisin levels when compared to healthy
individuals. Moreover, a resistance exercise training program was unable to augment
irisin levels despite increasing muscle mass.
MP083
to significant changes in appetite hormones and it seems a so good intervention to
modulate appetite in HD patients.
MP081
SERUM DEHYDROEPIANDROSTERONE SULFATE IS
ASSOCIATED WITH SKELETAL MUSCLE MASS, ARTERIAL
STIFFNESS, AND DEPRESSIVE MOOD IN JAPANESE MALE
HEMODIALYSIS PATIENTS
Makoto Inoue2, Takako Saito1, Koushi Ueno2, Akio Yoshimura2,
Hisashi Yamamoto1, Osamu Saito1 and Eiji Kusano1
1
Nephrology JIchi Medical University Shimotsuke, Tochigi Japan, 2Dialysis Unit
Kawashima Medical Clinic Chikusei, Ibaraki Japan
Introduction and Aims: The dialysis population is aging. There is a clear age-related
declined in dehydroepiandrosterone sulfate (DHEAs) and this has suggested that a
relative deficiency in this steroid may be causally related to the development of a series
of diseases associated with aging including cardiovascular diseases, osteoporosis, and
depressive mood. The aim of this study was to examine the effect of serum DHEAs on
body composition and aging-associated diseases in hemodialysis patients.
Methods: Cross sectional observational study comprising 61 hemodialysis patients (39
men, mean age 65.2±1.2 years). Serum DHEAs levels were measured by
radioimmunoassay. The Inbody S20 Body Composition Analyzer was used for
bioelectrical impedance analysis. Brachial-ankle pulse wave velocity (baPWV) and
quantitative ultrasound of the calcaneus were measured. Depressive symptoms were
ascertained with the Patient Health Questionnaire (PHQ-9).
Results: The mean DHEAs levels of the male versus the female were 1059 versus 739
ng/mL. DHEAs correlated negatively with age ( p<0.001) and baPWV ( p<0.005), and
positively with skeletal muscle mass ( p<0.01) in men, but not in women. In patients
with higher scores on the PHQ-9, the levels of DHEAs were significantly lower (640
ng/mL) than the levels in other patients (1197 ng/mL). There were no significant
associations between DHEAs and the values of calcaneal speed of sound, which is
correlated with bone density.
Conclusions: In male dialysis patients, the lower levels of DHEAs were associated with
aging process, such as decreased skeletal muscle mass, increased arterial stiffness, and
depressive mood. Large prospective trials and intervention studies are needed to better
assess these benefits of DHEAs in male dialysis patients.
MP082
EXERCISE TRAINING DOES NOT AFFECT THE PLASMA
IRISIN CONCENTRATION IN HEMODIALYSIS PATIENTS
Cristiane Ferreira Moraes1, Viviane Oliveira Leal3, Sandra Mara Marinho2, Sergio
Girão Barroso3, Gabrielle S. Rocha3, Gilson Teles Boaventura2 and Denise Mafra1,2
1
Graduate Program in Cardiovasculare Sciences Federal University Fluminense
Niteroi Rio de Janeiro Brazil, 2Graduate Program in Medical Sciences Federal
University Fluminense Niteroi Rio de Janeiro Brazil, 3Clinical Nutrition Federal
University Fluminense Niteroi Rio de Janeiro Brazil
i | Abstracts
ENDOGENOUS ANABOLIC HORMONES AND HIGH LOAD
STRENGTH TRAINING IN MALE PATIENTS UNDERGOING
DIALYSIS
Stig Molsted1, Jesper L. Andersen2, Inge Eidemak3, Adrian Harrison4 and
Niels Jørgensen5
1
Department of Cardiology, Nephrology & Endocrinology Hillerød University
Hospital Hillerød Denmark, 2Institute of Sports Medicine Copenhagen Bispebjerg
University Hospital Copenhagen Denmark, 3Department of Nephrology P
Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark,
4
Department of Basic Animal and Veterinary Sciences Faculty of Health and
Medical Sciences, Copenhagen University Copenhagen Denmark, 5University
Department of Growth and Reproduction Copenhagen University Hospital,
Rigshospitalet Copenhagen Denmark
Introduction and Aims: Sufficient anabolic hormone levels and functions are
important to avoid muscle atrophy and to induce muscle hypertrophy in relation with
resistance training. In male patients undergoing dialysis testosterone levels are in
general lower than in healthy persons. IGF-1 expressions may also be impaired. The
aim of this study was to investigate circulating testosterone and IGF-1 in a controlled
design before and after 16 weeks of high load strength training in male patients
undergoing dialysis and to investigate if hormone plasma levels were associated with
muscle morphology.
Methods: Thirteen male patients aged 56 ± 4 (mean ± SEM) years were tested before
and after a 16 weeks control period and before and after 16 weeks of high load
resistance training thrice weekly. The training comprised leg press, knee extension, and
knee flexion. Samples of plasma were obtained after an over-night fast to analyse
testosterone, IGF-1, and LH. Hormone values from the male general population was
delivered by the University Department of Growth and Reproduction, Rigshospitalet,
Copenhagen University Hospital, Denmark. Muscle fibre size and percentage number
were analysed in muscle biopsies from the vastus lateralis muscle.
Results: Total testosteron (24.6 ± 3.4 nmol/l), free testosterone (520 ± 73 pmol/l),
IGF-1 (262.8 ± 38.5 ng/ml), and IGF-BP3 (5452 ± 485 ng/ml) remained stable during
the control and training period and was within normal ranges. All participants had LH
values above normal age matched mean values. Age adjusted testosterone was not
associated with muscle fibre size at pre test. Age adjusted log IGF-1 was significantly
associated with type 1 fibre size (3944 (1170-6717) coefficient (95% CI), p = 0.008) and
type 2 fibre size (2348 (586-4110), p = 0.012) at pres test. During the training period
total testosterone variation was positively associated with type 2 muscle fibre size
variation (r = 0.664, p = 0.026), and negatively associated with type 2 muscle fibre area
variation (r = 0.664, p = 0.012).
Conclusions: Circulating testosterone and IGF-1 was not changed by 16 weeks
resistance training. Mean testosterone values were normal due to markedly increased
LH values, which suggest testes dysfunction. Muscle size depend on IGF-1 levels.
Variations within total testosterone may be associated with type 2 muscle fibre size and
architecture variations in relation with resistance training in male patients undergoing
dialysis.
Volume 28 | Supplement 1 | May 2013