Adolescent patients with T1DM showed a reduced aerobic exercising capacity when compared to healthy peers matched to anthropometric conditions. This potential condition should be taken into consideration by the time of evaluation of the aerobic performance of these patients with glycemic control level.

There are several methods used in sports science to identify asymmetries in athletes, given their purported relevance to injury prevention and performance optimization. We aimed to verify whether asymmetries provided by isokinetic assessments, jump tests, and tensiomyography (TMG) are associated with each other, and whether their respective functional indices are related to jumping ability. TMG parameters, unilateral and bilateral squat-jump (SJ) and countermovement-jump (CMJ) performances, and peak torque in knee-extension and flexion with angular velocities of 60/s and 300/s for twenty-four soccer players were retained for analyses. Asymmetry was detected by examining the percentage difference between dominant and non-dominant legs. The median-split technique was used to identify the best and worst performers in SJ and CMJ tests. Results revealed that the asymmetries detected in the three different methods were not interrelated. Curiously, better performances in SJ and CMJ tests were associated with higher asymmetry levels. Furthermore, only the knee-extension peak torque at both angular velocities was correlated moderately to largely (r=0.48-0.66) with jump performance. Despite their recognized ability to predict the risk of injury, the absence of interrelationships between TMG, isokinetic tests, and unilateral jumps precludes their single use as a unique functional screening diagnostic. Finally, and very importantly, lower-limb asymmetry is not necessarily related to impaired vertical jump performance in soccer players.

OBJECTIVETo compare the aerobic exercise capacity and pulmonary function between athletes with and without type 1 diabetes.RESEARCH DESIGN AND METHODSFifty-one adult age-matched individuals were assessed in random order to the maximum volume of O2 consumption (Vo2peak max) (ml/kg/min), anaerobic threshold (ml/kg/min), peak pulmonary ventilation (Ve), heart rate (beats per min), time to exhaustion (min), forced vital capacity (FEV) (%), forced expiratory volume in the first second (FEV1) (%), total lung capacity (TLC) (%), and lung diffusion capacity for carbon monoxide (DLCO) (%). Individuals were 27 with type 1 diabetes: 15 athletes (ADM) and 12 nonathletes (NADM); and 24 healthy individuals: 12 ADM and 12 NADM. Duration of diabetes was 14.6 ± 6.2 and 15.2 ± 6.7 years in ADM and NADM, respectively.RESULTSVo2peak max was higher in ADM than in NADM (P < 0.001). The anaerobic threshold was lower in subjects with type 1 diabetes than in control subjects (P < 0.001). FEV1 was lower in ADM than in other groups (NADM, athletes control, and nonathletes control, P < 0.001).CONCLUSIONSAerobic capacity in subjects with type 1 diabetes with programmed exercise is similar to the capacity of normal athletes despite lower anaerobic threshold and FEV1.

Context:The biological significance of GH-induced changes in serum TH concentrations is unknown. It has been suggested that serum free T 4 (FT 4 ) should be targeted at the high-normal range during GH replacement.Objective: Our objective was to evaluate the effects of GH replacement on T 4 biological effects. Hypothesis:If GH modulates thyroxine biological effects, serum FT 4 should be targeted accordingly. Design and Setting:We conducted observational (study 1) and interventional (studies 2 and 3)/outpatient studies.Patients: Thirty-two GH-deficient patients (13 off GH; 22 on L-T 4 ) participated in the study. Interventions:In study 2, levothyroxine was administered to increase FT 4 (Ͼ1.0 ng/dl). In study 3, GH was administered or withdrawn. Main Outcome Measures:We measured FT 4 , total T 3 (TT 3 ), myocardial isovolumic contraction time (ICT), and resting energy expenditure (REE). Results:In study 1, off-GH and on-GH groups had similar FT 4 , but off GH showed lower TT 3 (P Ͻ 0.01) and REE (P ϭ 0.02), higher ICT (P Ͻ 0.05) than on-GH and controls. On GH, ICT and REE correlated only with TT 3 (r ϭ Ϫ0.48; r ϭ 0.58; P Ͻ 0.05). Off GH, ICT correlated only with FT 4 (P Ͻ 0.01). In study 2, off GH, levothyroxine intervention increased FT 4 (P ϭ 0.005) and TT 3 (P ϭ 0.012), decreased ICT (P ϭ 0.006), and increased REE (P ϭ 0.013); ICT and FT 4 changes correlated (r ϭ Ϫ0.72; P ϭ 0.06). On GH, levothyroxine increased FT 4 (P ϭ 0.0002), TT 3 (P ϭ 0.014), and REE (P ϭ 0.10) and decreased ICT (P ϭ 0.049); REE and TT 3 changes correlated (r ϭ 0.60; P ϭ 0.05). In study 3, GH decreased FT 4 , increased TT 3 , decreased ICT, and increased REE (P Ͻ 0.05). REE correlated (P Ͻ 0.05) with IGF-I (r ϭ 0.57) and TT 3 (r ϭ 0.64). ICT correlated only with TT 3 (r ϭ Ϫ0.46). C ENTRAL HYPOTHYROIDISM (CH) is a common disorder in patients with hypothalamic-pituitary disease. It results from decreased stimulation of an otherwise normal thyroid gland by a decreased and/or biologically less active TSH (1, 2). At diagnosis, serum TSH levels in CH may be decreased, normal, or slightly elevated and consistently decline to low/undetectable levels during physiological levothyroxine replacement (3). Thus, both diagnosis and adequacy of levothyroxine replacement in CH have to rely on serum T 4 levels, which show intraindividual variations much narrower than the normal reference range (4). In addition, GH deficiency (GHD) is usually present in patients with CH, and GH replacement is known to change serum concentrations of thyroid hormones (TH), decreasing T 4 and increasing T 3 through peripheral mechanisms (5-9). ConclusionsIn practice, a low serum T 4 in patients with hypothalamicpituitary disease is highly specific, but insensitive, to diagnose CH given the high prevalence of CH in that population. Biochemical markers of peripheral TH action like cholesterol, SHBG, angiotensin-converting enzyme, carboxyl-terminal telopeptide of type I collagen, osteocalcin, and bone ␥-carboxyglutamic acid protein have all been proved insufficiently sensitive and/...

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