RESUMEN
Although iron deficiency is common in women especially during dieting, weight management trials rarely examine the longitudinal impact of genetics on iron. This study examined the associations between the TMPRSS6 rs855791 polymorphism and iron indices at baseline and after a 12-month trial comparing two weight loss diets (higher-protein, higher-haem iron (HPHI) vs lower-protein, lower-haem iron (LPLI)). A total of 76 young overweight women (18-25y; BMI⩾27.5 kg/m(2)) were included at baseline, with 27 (HPHI: n=15; LPLI: n=12) completing the 12-month trial. At baseline, C allele homozygotes exhibited higher serum iron (P=0.047) and lower hepcidin (P=0.023) compared with T allele carriers. After 12 months, no genotypic differences were observed for ferritin and soluble transferrin receptor, although C homozygotes on HPHI showed higher serum iron and transferrin saturation (P<0.05). Results indicate that rs855791 can influence iron metabolism to some extent, but its impact on storage and functional iron status is small relative to dietary protein/iron manipulation.
Asunto(s)
Restricción Calórica , Hierro de la Dieta/administración & dosificación , Sobrepeso/dietoterapia , Sobrepeso/genética , Adolescente , Adulto , Alelos , Anemia Ferropénica/sangre , Anemia Ferropénica/dietoterapia , Índice de Masa Corporal , Estudios Transversales , Dieta Reductora , Proteínas en la Dieta/administración & dosificación , Ferritinas/sangre , Frecuencia de los Genes , Hepcidinas/sangre , Humanos , Hierro de la Dieta/sangre , Estudios Longitudinales , Sobrepeso/sangre , Polimorfismo Genético , Adulto JovenRESUMEN
UNLABELLED: Clinical research on weight management in young women is limited. This randomized controlled trial compared the efficacy of two iso-energetically restricted (5600 kJ) diets [higher protein (HP): 32% protein, 41% carbohydrate, 25% fat or higher carbohydrate (HC): 20, 58, 21%, respectively] in 71 (HP: n = 36; HC: n = 35) young healthy women (18-25 years; body mass index ≥ 27.5 kg/m2) for weight (kg; percent weight loss), body composition, metabolic and iron changes assessed at baseline, 6 and 12 months. DATA: mean (95% CI). In HP completers at 6 months, percent weight loss was higher [HP: 9.3 (5.6-13.1); HC: 5.1 (2.3-7.9)%; p = 0.06]; although, this did not reach statistical significance. Absolute weight [HP: 8.9 (5.3-12.5); HC: 4.6 (2.2-7.0) kg; p = 0.034] and fat loss [HP: 8.0 (4.4-11.5); HC: 3.4 (1.3-5.6) kg; p = 0.022] were significantly greater. No significant between-diet differences were observed at 12 months. Biochemistry remained within normal ranges with HP showing superior preservation of ferritin at 6 months [HP: 53 (40-66); HC: 46 (30-61) µg/l; p = 0.029]. Both diets supported clinically meaningful weight loss with HP tending to be more effective in the medium-term.
Asunto(s)
Dieta Reductora/métodos , Carbohidratos de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Sobrepeso/prevención & control , Adolescente , Adulto , Índice de Masa Corporal , Conducta Alimentaria , Femenino , Ferritinas/sangre , Humanos , Sobrepeso/sangre , Resultado del Tratamiento , Pérdida de PesoRESUMEN
In the elderly, fear of falling (FoF) can lead to activity restriction and affect quality of life (QoL). Our aim was to identify the characteristics of FoF in Parkinson's disease and assess its impact on QoL. We assessed FoF in 130 patients with Parkinson's disease (PD) on scales measuring perceived self-efficacy in performing a range of activities (FES), perceived consequences of falling (CoF), and activity avoidance (SAFFE). A significant difference was found in FoF between PD patients who had previously fallen and those who had not and between frequent and infrequent fallers. Patient-rated disability significantly influenced FoF. Difficulty in rising from a chair, difficulty turning, start hesitation, festination, loss of balance, and shuffling were the specific mobility problems which were associated with greater FoF in PD. Disability was the main predictor of FoF, additionally depression predicted perceived consequences of falling, while anxiety predicted activity avoidance. The FoF measures explained 65% of the variance of QoL in PD, highlighting the clinical importance of FoF. These results have implications for the clinical management of FoF in PD.
Asunto(s)
Accidentes por Caídas , Actividades Cotidianas/psicología , Miedo/psicología , Enfermedad de Parkinson/psicología , Calidad de Vida/psicología , Anciano , Ansiedad/psicología , Personas con Discapacidad , Femenino , Humanos , Masculino , Autoeficacia , Índice de Severidad de la EnfermedadRESUMEN
Patients with Parkinson's disease (PwPD) have a slow, shuffling gait, marked by sporadic freezing of gait (FoG) during which effective stepping ceases temporarily. As these gait problems are not commonly improved by medical and surgical treatments, alternative approaches to manage these problems have been adopted. The aim of this study was to evaluate the effect of real and virtual visual cues on walking in PD. We assessed 26 mid-stage PwPD, on and off medication, on a laboratory-based walking task which simulated real world challenges by incorporating FoG triggers and using appropriate placebo conditions. Cueing interventions were presented via virtual reality glasses (VRG rhythmic, visual flow and static placebo cues), and as transverse lines (TL) on the walkway. Objective measures of gait (task completion time; velocity, cadence, stride length; FoG frequency) and self-rated fear of falling (FoF) were recorded. Cueing intervention affected task completion time only off medication. Whereas placebo VRG cues provided no improvement in walking, visual flow VRG cues marginally reduced the task completion time. TL on the floor elicited more substantial improvements in gait with reduced cadence, increased stride length and reduced FoG frequency. VRG rhythmic cueing impaired overall walking. Notably, a final no-intervention condition yielded quicker task completion, greater walking velocity, increased stride length and less frequent FoG. Although the VRG produced modest improvements only in the visual flow condition, their flexibility is an advantage. These results endorse the use of TL and justify further testing and customisation of VRG cues for individual PwPD.
Asunto(s)
Señales (Psicología) , Retroalimentación Sensorial/fisiología , Trastornos Neurológicos de la Marcha/rehabilitación , Enfermedad de Parkinson/rehabilitación , Interfaz Usuario-Computador , Caminata/fisiología , Anciano , Análisis de Varianza , Anteojos/psicología , Miedo/psicología , Femenino , Trastornos Neurológicos de la Marcha/etiología , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Enfermedad de Parkinson/complicaciones , Periodicidad , Placebos , Desempeño Psicomotor , Factores de Tiempo , Reino UnidoRESUMEN
Freezing of gait (FoG), a transient halt in walking, is a major mobility problem for patients with Parkinson's disease (PD). This study examined the factors that induce FoG, and identified the cues and strategies that help overcome it through a postal survey of 130 PD patients. 72% reported FoG. The factors that commonly induced FoG were turning, fatigue, confined spaces and stressful situations, in addition to emotional factors. FoG was also ameliorated by various attentional and external cueing strategies. The concept of paradoxical kinesis, the potential neural substrates of such external cueing effects, and their importance for rehabilitation in PD are discussed.
Asunto(s)
Trastornos Neurológicos de la Marcha/etiología , Pérdida de Tono Postural , Enfermedad de Parkinson/complicaciones , Estrés Psicológico/complicaciones , Adaptación Psicológica , Anciano , Fatiga/complicaciones , Femenino , Trastornos Neurológicos de la Marcha/psicología , Trastornos Neurológicos de la Marcha/terapia , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/psicología , Conducta EspacialRESUMEN
The gene encoding cytochrome P-450 4A6 (CYP4A6) is transcriptionally activated by peroxisome proliferators. This response is dependent on a strong enhancer element (Z) and weaker elements (X and -27). The peroxisome proliferator response is mediated by the binding of heterodimers containing the peroxisome proliferator-activated receptor alpha (PPAR alpha) and the retinoid X receptor alpha (RXR alpha) to these elements. These peroxisome proliferator response elements (PPREs) contain imperfect direct repeats of the nuclear receptor consensus recognition sequence with a spacing of one nucleotide (DR1) (AGGTCA N AGGTCA). This DR1 motif is seen in the binding sites for other nuclear receptor complexes, such as ARP-1, HNF-4, and RXR alpha homodimers. Mutational analysis of the Z element reveals that the DR1 motif is required for the transcriptional activation of the CYP4A6 gene by peroxisome proliferators; however, deletion of sequences immediately upstream of this motif also abolishes this response. Oligonucleotides corresponding to truncated and mutated Z elements were assayed by gel retardation for binding to RXR alpha, PPAR alpha, and ARP-1. Deletions or mutations within six nucleotides 5' of the DR1 motif dramatically diminish PPAR alpha.RXR alpha binding without reducing the binding of either RXR alpha or ARP-1 homodimers, whereas mutation or deletion of the core DR1 sequences abolishes the binding of PPAR alpha.RXR alpha heterodimers and of RXR alpha or ARP-1 homodimers. Thus, the DR1 motif in the Z element is not sufficient to constitute a PPRE. Moreover, the binding of PPAR alpha.RXR alpha to the Z element requires sequences immediately 5' of the DR1. These sequences are conserved in natural PPREs and promote binding of PPAR alpha.RXR alpha heterodimers in preference to potential competitors such as ARP-1 and RXR alpha.