Obesity in children and adolescents is on the rise and is a major risk factor for chronic disease, thus posing one of the greatest public health challenges for the 21st century. Although adolescent obesity is increasing in all ethnic groups, its prevalence is higher in non–Caucasian populations. A possible explanation for ethnic differences in the development of obesity could be ethnic differences in resting metabolic rate (RMR). A low RMR would pre–dispose an ethnic group to obesity. In South Africa limited research has been published with regards to body composition (BC) and RMR in adolescents and the possible association of RMR with BC. The first aim of this study, therefore, was to determine differences in BC and RMR between 14 year old black and Caucasian South African adolescents from the Tlokwe municipality of the North West Province, South– Africa. The second aim was to investigate whether significant relationships between the body composition characteristics body mass index (BMI), percentage body fat (%BF), fat free mass (FFM) and RMR exist in this group. The baseline data of participants in the Physical Activity and Health Longitudinal Study (PAHLS) was used. Anthropometric measurements included stature, body mass, triceps and subscapular skinfolds, and waist girth to determine BMI, %BF, FFM and waist–to–height ratio (WHTR). RMR was measured by the FitMate Pro Indirect Calorimetry (Cosmed). An independent t–test was used to compare the two groups (black vs. Caucasian, boys and girls respectively) with regards to body composition and RMR. Pearson correlation coefficients (adjusted for gender and ethnicity) were calculated, to study the relationship between RMR and body composition. Significant difference levels were set at p<0.05. The present cross–sectional results revealed significant differences in BC and RMR in black and Caucasian adolescents of the Tlokwe municipality, with Caucasian adolescents of both genders having a higher RMR and FFM compared to their counterpart black adolescents. The results further indicated that Caucasian adolescents were significantly (p<0.05) taller, heavier and had a higher %BF, WHTR, FFM and RMR than the black adolescents of both genders. Boys of both ethnicities had a higher RMR than the girls, with black girls having the lowest RMR. Both underweight and overweight/obesity were present in both ethnic groups and genders emphasizing the double burden of disease prevalent in South Africa. The overweight/obese group of both ethnicities had a higher FFM and RMR than the normal and underweight group. After adjusting for gender and ethnicity a high non–significant negative relationship was observed between RMR and FFM in the overweight group. The reasons for these persistent differences in ethnic groups for RMR in adolescents are not clear. A positive association between anthropometric indicators of BC and RMR influenced by gender and ethnicity was indicated. Whether the observed ethnic differences in RMR predict future weight gain and obesity awaits the results of longitudinal analyses. It is suggested that intervention programmes be implemented focusing on the prevention of obesity in adolescents, but especially black adolescent girls, as they are indicated to be the group more prone to obesity. These results supported the literature findings and identified the need for longitudinal data regarding RMR and BC in adolescents. The PAHL–Study will continue to follow–up these adolescents over a period of time as some of the conclusions made will further be cleared, including whether the observed ethnic differences in RMR predict future weight gain and obesity. / Thesis (M.Sc. (Biokinetics))--North-West University, Potchefstroom Campus, 2012.

Background: Rheumatoid arthritis (RA) is characterised by excessive production of tumour necrosis factor alpha (TNFα). This leads to rheumatoid cachexia, a condition characterised by increased resting energy expenditure (REE) and loss of fat-free mass (FFM) leading to functional disability, decreased strength and balance. The aims of this research work was to: a) to develop a new REE equation in order to continuously monitor abnormal changes in REE in the RA population, b) to investigate if smoking further enhances hypermetabolism and c) to examine if the new anti-TNFα medication reverses this metabolic abnormality. Methods: 68 patients with RA were assessed for demographic and anthropometrical characteristics, REE (indirect calorimetry), body composition (bioelectrical impedance), and disease activity [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), disease activity score 28 (DAS28) and health assessment questionnaire (HAQ)]. 20 of the total 68 patients, about to start anti-TNFα therapy, underwent the exact same aforementioned procedures but on three separate occasions (Baseline: two weeks prior to anti-TNFα treatment, Time-1 and Time-2: two weeks and three months, respectively, after the drug had been introduced. Results: Study 1: Based on FFM and CRP, a new equation was developed which had a prediction power of R2=0.76. The new equation revealed an almost identical mean with measured REE (1645.2±315.2 and 1645.5±363.1 kcal/day, p>0.05), and a correlation coefficient of r=0.87 (p=0.001). Study 2: Smokers with RA demonstrated significantly higher REE (1513.9±263.3 vs. 1718.1±209.2 kcal/day; p=0.000) and worse HAQ (1.0±0.8 vs. 1.7±0.8; p=0.01) compared to age and FFM matched RA non-smokers. The REE difference was significantly predicted by the interaction smoking/gender (p=0.04). Study 3: Significant increases were observed in REE (p=0.002), physical activity (p=0.001) and protein intake (p=0.001) between the three times of assessment. Moreover, disease activity significantly reduced [ESR (p=0.002), DAS28 (p=0.000), HAQ (p=0.000) and TNFα (p=0.024)] while FFM and total body fat did not change (both at p>0.05). Physical activity and protein intake were found to be significant within-subject factors for the observed REE elevation after 12-weeks on anti-TNFα treatment (p=0.001 and p=0.024, respectively). Conclusions: Findings from the first study revealed that the newly developed REE equation provides an accurate prediction of REE in RA patients. Moreover, the results from the second study showed that cigarette smoking further increases REE in patients with RA and has a negative impact on patients’ self-reported functional status. Finally, our data from the third study suggest that REE remains elevated not because of the maintenance of the RA-related hypermetabolism but due to the concomitant significant increases in physical activity and protein intake.

The purpose of this work was to further understand nutritional status, especially body weight and composition, during colorectal cancer progression. Population-based studies of colorectal cancer patients were conducted using administrative health data (primary and co-morbid diseases, demographics), and computed tomography (CT) imaging (body composition). In cohort 1, administrative health data was used to study comorbidities and nutritional status in 574 colorectal cancer patients referred for chemotherapy. Multivariate Cox regression revealed several comorbidities, performance status and weight loss 20% predicted survival. In cohort 2, a serial CT image analysis assessed longitudinal body composition changes during the last 12 months preceding death from colorectal cancer (n=34). Body composition changes were typified by exponential increases in liver metastases with concurrent accelerations of muscle and fat loss. These results have the potential to make a difference in how colorectal cancer patients are treated and researched by dietitians, oncologists, and health services researchers. / Nutrition and Metabolism

Human ageing is accompanied by characteristic metabolic and endocrine changes, including altered hormone profiles, insulin resistance and deterioration of skeletal muscle. Obesity and diabetes may themselves drive an accelerated ageing phenotype. Untangling the causal web between ageing, obesity and diabetes is a priority in order to understand their aetiology and improve prevention and management. The role of biological ageing in determining the risk of obesity and associated conditions has often been examined using mean leukocyte telomere length (LTL), a marker of replicative fatigue and senescence. However, considering phenotypes which represent different domains of biological and functional ageing as exposures for obesity and related traits could allow the elucidation of new understudied phenotypes relevant to cardio-metabolic risk in the wider population. This PhD considers the causal role of (1) hand grip strength (HGS), a marker of overall strength and physical functioning, and (2) resting energy expenditure, an indicator of overall energy metabolism and the major component of daily energy expenditure, in cardio-metabolic risk. I also characterise a new and readily-quantifiable marker of age-related genomic instability, mosaic loss of the Y chromosome (mLOY). Observational evidence implicates each of these phenotypes in cardio-metabolic conditions and intermediate phenotypes. However, it is not possible to infer causality from these observational associations due to confounding and reverse-causality. Mendelian randomisation offers a solution to these limitations and can allow the causal nature of these relationships to be investigated. Using population-based data including UK Biobank, this thesis presents the first large-scale genetic discovery effort for each trait and provides new biological insight into their shared and separate aetiology. I used identified variants to investigate the bidirectional causal associations of each trait with cardio-metabolic outcomes, intermediate phenotypes and other related traits such as frailty and mortality. In total I identified 16 loci for hand grip strength, 19 for mLOY, and one signal for REE. I have shown that HGS is likely to be causally linked to fracture risk, and I have identified the important shared genetic architecture between mLOY, glycaemic traits and cancer. I have also demonstrated that at least one known genetic variant contributing to obesity risk acts partially via reduced REE. Overall the findings of my PhD contribute to our wider understanding of the aetiological role of ageing processes in metabolic dysfunction, and have implications for both basic science and translational applications.

Made available in DSpace on 2015-07-22T20:50:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-05-27 / Introdução/Objetivo: Os fatores orexígenos e anorexígenos e a Taxa Metabólica de Repouso (TMR) desenvolvem um importante papel no controle e regulação do balanço energético e estão diretamente relacionados com a obesidade. Com base nesta relação, o objetivo desta pesquisa foi verificar os efeitos do tratamento multidisciplinar de longo prazo nos fatores orexígenos e anorexígenos e na TMR em adolescentes obesos. Metodologia: No presente estudo foram selecionados 20 adolescentes obesos (11 meninas e 9 meninos), com idade entre 14 e 19 anos. Os critérios de inclusão foram o IMC percentil > 95 de acordo com o Centers for Disease Control and Prevention e estágio de maturação sexual pós púbere. Os fatores orexígenos e anorexígenos foram avaliados por radioimunoensaio. A TMR foi mensurada por calorimetria indireta, a composição corporal por Pletismografia e a gordura visceral e subcutânea por Ultra-sonografia. Resultados: Após 12 meses de intervenção, os adolescentes obesos apresentaram diminuição significativa na massa corporal total, no IMC, na gordura corporal (% e em kg,), na massa magra (kg), e na gordura visceral e subcutânea. O grupo não apresentou diminuição significativa da TMR. Os fatores anorexígenos diminuíram significativamente e o MCH aumentou ao término da terapia. Conclusão: Podemos concluir que a terapia multidisciplinar de longo prazo foi efetiva para melhorar a composição corporal, os fatores orexígenos e anorexígenos, contribuindo para o controle da obesidade e do balanço energético. Palavras-Chave: Fatores orexígenos e anorexígenos; taxa metabólica de repouso; adolescente obeso; terapia multidisciplinar. / Background/Aims: anorexigenic and orexigenic factors and resting metabolic rate (RMR) play an important role in the energy balance and they are directly related to obesity. In this way, it was verified the effects of long-term multidisciplinary therapy on orexigenic and anorexigenic factors and resting metabolic rate in obese adolescents. Methods: Twenty obese adolescents (11 girls and 9 boys) aged between 14 and 19 years, BMI > 95th percentile of CDC, were submitted to intensive long-term multidisciplinary therapy during 12 months. Orexigenic and anorexigenic factors concentrations were measured by a radioimmunoassay (RIA) kit. RMR was measured by indirect calorimetry. Body composition was measured by pletismography, and visceral and subcutaneous fat were analyzed by ultrassonography. Results: After one year of multidisciplinary therapy, the obese adolescents presented a significant decrease in body mass (p<0.001), BMI (p<0.001), fat mass (kg and %), lean mass (kg), subcutaneous and visceral fat. The group did not decrease significantly in RMR and RMR/FFM. The anorexigenic factors (leptin and alpha- MSH concentrations) decreased significantly. The orexigenic neuropeptide (MCH) increased by the end of the multidisciplinary therapy. Conclusion: Our investigation demonstrated that long-term multidisciplinary therapy was effective to improve body composition, anorexigenic and orexigenic factors contributing to obesity control. / TEDE / BV UNIFESP: Teses e dissertações

The oxygen consumption and body temperature were measured in adults and pups of a social Mashona mole-rat(Fukomys darlingi)to test poikilothermic traits in this species and effect of presence of adults on pup´s thermoregulation abilities. The adult´s resting metabolic rate was 0.76 {$\pm$} 0.20 mlO2g-1hod-1 in the thermoneutral zone 27-34°C. We did not confirm poikilotermic traits in this species, because body temperature was stable (33.0 {$\pm$} 0.5°C) at low ambient temperatures. The pups started to thermoregulate in age of one month and they are able to maintain stable body temperature very late in age of three months. My results indicate that presence of adults is necessary for thermoregulation of pups.

The oxygen consumption and body temperature were measured in adults and pups of a social Mashona mole-rat(Fukomys darlingi)to test poikilothermic traits in this species and effect of presence of adults on pup´s thermoregulation abilities. The adult´s resting metabolic rate was 0.76 {$\pm$} 0.20 mlO2g-1hod-1 in the thermoneutral zone 27-34°C. We did not confirm poikilotermic traits in this species, because body temperature was stable (33.0 {$\pm$} 0.5°C) at low ambient temperatures. The pups started to thermoregulate in age of one month and they are able to maintain stable body temperature very late in age of three months. My results indicate that presence of adults is necessary for thermoregulation of pups.

Background: Excess white adipose tissue (WAT) in humans is considered as a harmful health index. However, increased brown adipose tissue (BAT) and brown-like adipose tissue activity are associated with increased resting energy expenditure (REE) that may help to control body weight. Exercise may enhance browning formation of WAT and reduce WAT that may lead to health improvements. Aims: a) to examine the effects of physical activity on the link between peroxisome proliferator-activated receptor gamma co-activator 1-alpha (PGC-1α) and fibronectin type III domaincontaining protein 5 (FNDC5) genes in muscle, circulating Irisin and uncoupling protein one (UCP1) of WAT in humans (study 1); b) to examine the relationship between UCP1 mRNA and protein expression as well as PGC-1α, peroxisome proliferatoractivated receptor alpha (PPARα) and PPARγ genes with physical activity levels in WAT of healthy men (study 2); c) to examine the effects of different types of exercise and de-training on the UCP1 mRNA and protein expression (study 3), and d) on leptin mRNA in WAT of healthy men (study 4). Method: Study 1: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta- Analyses. Studies 2-4: The total of 46 healthy men subjected to measurements for physical activity levels, diet, anthropometry, body composition, REE, peak oxygen consumption, 1-repetition maximum and provided subcutaneous fat biopsies to determine mRNA and protein expression of six genes in one cross-sectional study and one randomized controlled trial. Results: Study 1: No link was found between PGC- 1α and FNDC5, circulating Irisin and UCP1 of WAT in response to physical activity. Study 2: The mRNA of, UCP1, PGC-1α, PPARα and PPARγ genes of WAT were not associated with physical activity levels. The UCP1 protein expression however, was negatively associated with physical activity levels. Studies 3-4: Different types of chronic exercise and de-training do not affect UCP1 mRNA and protein expression 3 and leptin mRNA in WAT. However, effect size analyses demonstrated increased UCP1 mRNA and protein expression, PPARγ and leptin in response to chronic exercise. Conclusions: There is no evidence to support the link between PGC-1α and FNDC5 in human muscle or the link between FNDC5 and circulating Irisin and UCP1 in WAT in response to exercise. There are no effects of exercise and de-training on browning formation of WAT and no link between browning formation indices and REE, body weight as well as leptin mRNA in healthy men. Further research is required to elaborate the aforementioned phenomena.

A presença de redes cerebrais funcionais ativadas durante o repouso é bem conhecida e verificada por diferentes técnicas de imagens, como as Imagens por Ressonância Magnética funcionais (IRMf) baseadas no contraste dependente do nível de oxigenação do sangue (BOLD, Blood Oxygenation Level Dependent). Entretanto, apesar de ser atualmente o método não invasivo convencional para tais estudos, o contraste BOLD é sensível a diferentes parâmetros hemodinâmicos (fluxo sanguíneo cerebral, CBF; volume sanguíneo cerebral e extração de oxigênio), cuja relação não é completamente conhecida em diversas patologias. Por outro lado, o método de Marcação dos Spins Arteriais (ASL) é uma técnica de IRM não invasiva que fornece mapas quantitativos de CBF e pode ser usada para avaliar as redes de repouso. Portanto, o objetivo do presente estudo foi investigar a viabilidade de usar sequências de ASL (pulsada e pseudocontínua), disponíveis para o uso na rotina clínica, para o estudo da conectividade funcional do cérebro em estado de repouso. Imagens de ASL e BOLD, de 23 indivíduos jovens e saudáveis, foram adquiridas em um equipamento de 3T. Após o pré-processamento usual das imagens e cálculos dos mapas de perfusão, CBF e pseudo-BOLD (pBOLD), a partir das imagens de ASL, as redes cerebrais de repouso foram obtidas pela Análise de Componentes Independentes (ICA) e pelo método baseado em semente. Utilizando ICA, a análise em grupo conjunta de pBOLD e BOLD identificou cinco redes: rede de modo padrão (DMN), visual, auditiva, saliência e motora. Quando analisados separadamente, os dados de pBOLD mostraram apenas as redes DMN e visual, enquanto os dados de BOLD mostraram também as redes auditiva, saliência, motora, atentiva e frontoparietais direita e esquerda. Para ambas as análises, comparações entre as redes de pBOLD e BOLD apresentaram similaridades de moderadas a altas. Entretanto, nenhuma rede foi observada utilizando os dados de perfusão e CBF. Já as análises baseadas em sementes mostraram correlações significativas, para as séries temporais de pBOLD e CBF, entre regiões que constituem algumas redes de repouso conhecidas (DMN, visual, sensorial-motora, atentiva e frontoparietal). Os valores obtidos para a força das conectividades nas redes de pBOLD e CBF se correlacionaram com aqueles obtidos nas redes de BOLD. As diferenças no desempenho de ASL e BOLD devem-se a uma combinação de fatores, como relação sinal ruído e resolução temporal. Além disso, a natureza dos sinais não é a mesma. O sinal BOLD é influenciado por diferentes parâmetros fisiológicos e é proveniente principalmente de grandes veias; enquanto o sinal de ASL é proveniente da rede de capilares, fornecendo especificidade espacial mais alta para a atividade neuronal, além de permitir a quantificação do CBF, que está relacionado mais diretamente ao metabolismo cerebral. Portanto, o presente estudo mostrou ser possível investigar a conectividade funcional do cérebro no estado de repouso com uma sequência comercial, apesar das limitações técnicas da ASL. Além disso, as séries temporais de CBF e BOLD refletem diferentes aspectos do cérebro em repouso, fornecendo informações complementares dos seus processos fisiológicos / The presence of functional brain networks activated during resting state is well known and has been verified by different imaging techniques, such as the functional Magnetic Resonance Imaging (fMRI) based on the Blood Oxygenation Level-Dependent (BOLD) contrast. Although BOLD-fMRI is currently the conventional non invasive method for such studies, BOLD contrast is sensitive to different hemodynamic parameters (Cerebral Blood Flow, CBF; cerebral blood volume and oxygen extraction fraction), whose relationship is not fully understood in several pathologies. In contrast, the Arterial Spin Labeling (ASL) MRI technique is a non invasive tool for CBF quantification and can be used to investigate resting-state networks. Therefore, the goal of the present study was to investigate the feasibility of using ASL sequences (pulsed and pseudocontinuous), available for clinical routine use, for the study of functional connectivity of the brain at rest. ASL and BOLD images of 23 healthy young subjects were acquired in a 3T machine. After the usual image pre-processing and quantification of perfusion, CBF and pseudo-BOLD (pBOLD) maps, from ASL images, resting-state brain networks were obtained by Independent Component Analysis (ICA) and a seed-based method. Five networks were identified in a joint analysis of pBOLD and BOLD: Default Mode Network (DMN), visual, auditory, salience, and motor. When analyzed separately, pBOLD showed only the DMN and visual networks, while BOLD also showed auditory, salience, motor, attentive, right and left frontoparietal networks. For both analyses, comparisons between pBOLD and BOLD networks showed from moderate to high similarities. However, no network was obtained from perfusion and CBF time series. Seed-based analysis showed significant correlations, for pBOLD e CBF time series, between regions that integrate some known networks (DMN, visual, sensorial-motor, attentive and frontoparietal). Functional connectivity strength obtained from pBOLD and CBF networks correlated with the ones from BOLD data. Differences in performance with ASL and BOLD are due to a combination of factors, such as SNR and temporal resolution. Moreover, the nature of the signals is not the same. BOLD signal is influenced by different physiologic parameters and comes mainly from large veins; while ASL signal comes from small capillaries, providing higher spatial specificity regarding neural activity, in addition to allow the quantification of CBF, which is closer related to the cerebral metabolism. In conclusion, the present study showed the feasibility of investigating functional connectivity of the brain at rest using a commercial ASL sequence, even with its technical limitations. Moreover, CBF and BOLD time series reflect different aspects of the resting-state brain and provide complementary information on its physiological processes

Esta tese apresenta um novo método para analisar dados de ressonância magnética funcional (FMRI) durante o estado de repouso denominado Análise de Componentes Esparsos Locais (LSCA). A LSCA é uma especialização da Análise de Componentes Esparsos (SCA) que leva em consideração a informação espacial dos dados para reconstruir a informação temporal de fontes bem localizadas, ou seja, fontes que representam a atividade de regiões corticais conectadas. Este estudo contém dados de simulação e dados reais. Os dados simulados foram preparados para avaliar a LSCA em diferentes cenários. Em um primeiro cenário, a LSCA é comparada com a Análise de Componentes Principais (PCA) em relação a capacidade de detectar fontes locais sob ruído branco e gaussiano. Em seguida, a LSCA é comparada com o algoritmo de Maximização da Expectativa (EM) no quesito detecção de fontes dinâmicas locais. Os dados reais foram coletados para fins comparativos e ilustrativos. Imagens de FMRI de onze voluntários sadios foram adquiridas utilizando um equipamento de ressonância magnética de 3T durante um protocolo de estado de repouso. As imagens foram pré-processadas e analisadas por dois métodos: a LSCA e a Análise de Componentes Independentes (ICA). Os componentes identificados pela LSCA foram comparados com componentes comumente reportados na literatura utilizando a ICA. Além da comparação direta com a ICA, a LSCA foi aplicada com o propósito único de caracterizar a dinâmica das redes de estado de repouso. Resultados simulados mostram que a LSCA é apropriada para identificar fontes esparsas locais. Em dados de FMRI no estado de repouso, a LSCA é capaz de identificar as mesmas fontes que são identificadas pela ICA, permitindo uma análise mais detalhada das relações entre regiões dentro de e entre componentes e sugerindo que muitos componentes identificados pela ICA em FMRI durante o estado de repouso representam um conjunto de componentes esparsos locais. Utilizando a LSCA, grande parte das fontes identificadas pela ICA podem ser decompostas em um conjunto de fontes esparsas locais que não são necessariamente independentes entre si. Além disso, as fontes identificadas pela LSCA aproximam muito melhor o sinal temporal observado nas regiões representadas por seus componentes do que as fontes identificadas pela ICA. Finalmente, uma análise mais elaborada utilizando a LSCA permite estimar também relações dinâmicas entre os componentes previamente identificados. Assim, a LSCA permite identificar relações clássicas bem como relações causais entre componentes do estado de repouso. As principais implicações desse resultado são que diferentes premissas permitem decomposições aproximadamente equivalentes, entretanto, critérios menos restritivos tais como esparsidade e localização permitem construir modelos mais compactos e biologicamente mais plausíveis. / This thesis presents Local Sparse Component Analysis (LSCA), a new method for analyzing resting state functional magnetic resonance imaging (fMRI) datasets. LSCA, a extension of Sparse Component Analysis (SCA), takes into account data spatial information to reconstruct temporal sources representing connected regions of significant activity. This study contains simulation data and real data. The simulated data were prepared to evaluate the LSCA in different scenarios. In the first scenario, the LSCA is compared with Principal Component Analysis (PCA) for detecting local sources under Gaussian white noise. Then, LSCA is compared with the expectation maximization algorithm (EM) for detecting the dynamics of local sources. Real data were collected for comparative and illustrative purposes. FMRI images from eleven healthy volunteers were acquired using a 3T MRI scanner during a resting state protocol. Images were preprocessed and analyzed using LSCA and Independent Components Analysis (ICA). LSCA components were compared with commonly reported ICA components. In addition, LSCA was applied for characterizing the dynamics of resting state networks. Simulated results have shown that LSCA is suitable for identifying local sparse sources.For real resting state FMRI data, LSCA is able to identify the same sources that are identified using ICA, allowing detailed functional connectivity analysis of the identified regions within and between components. This suggests that ICA resting state networks can be further decomposed into local sparse components that are not necessarily independent from each other. Moreover, LSCA sources better represent local FMRI signal oscillations than ISCA sources. Finally, brain connectivity analysis shows that LSCA can identify both instantaneous and causal relationships between resting state components. The main implication of this study is that independence and sparsity are equivalent assumptions in resting state FMRI. However, less restrictive criteria such as sparsity and source localization allow building much more compact and biologically plausible brain connectivity models.