The purpose of this study was to evaluate the effects of partial sleep deprivation (PSD) on circulating concentrations of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in relation to the secretory profiles of growth hormone (GH), cortisol, and testosterone during a repeated brief sprint interval exercise. Thirty healthy football players (mean age: 21.1 [range: 18–24] years; body mass index [BMI]: 22.6 [range: 18.47–24.46] Kg/m²) completed two test sessions at 08:00 h, one scheduled after a baseline night (bedtime: from 22:30 to 07:00 h) and the other after a PSD night caused by an early awakening (bedtime: from 22:30 to 03:00 h). During each session, participants performed 4 × 250-m run on a treadmill at a constant intensity of 80% of the personal maximal speed with a 3-min recovery in between. Tests session were performed at 08:00 h. Blood samples were collected before, immediately after the first and the fourth 250-m run, and 60 min after the exercise. The results showed that cortisol concentrations were not affected by the PSD. However, GH and testosterone concentrations were higher (p < .05) 60 min after the exercise during PSD in comparison with baseline. Likewise, plasma concentrations of IL-6 and TNF-α were higher (p < .05) after PSD during the exercise (i.e., the first and the fourth run) and remained elevated during the recovery period (i.e., 60 min after the exercise). In conclusion, these results showed that sleep restriction increases the proinflammatory cytokine, GH, and testosterone concentrations after physical exercise but did not affect the cortisol responses. (Author correspondence: n_souissi@yahoo. fr )

There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012. A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV₁/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV₁/FVC < 0.7). Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of "chronic bronchitis" or "emphysema" (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication. False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.

Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0–10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV₁/FVC<lower limit of normal were tested for association with poverty for each site, and the results were combined by meta-analysis.Mean wealth scores ranged from 4 in Blantyre (Malawi) and Kashmir (India) to 10 in Riyadh (Saudi Arabia), and the prevalence of obstruction, from 16% in Kashmir to 3% in Riyadh and Penang (Malaysia). Following adjustments for age and sex, FEV₁/FVC increased by 0.36% (absolute change) (95%CI: 0.22, 0.49; p<0.001) per unit increase in wealth score. Adjustments for other confounders reduced this effect to 0.23% (0.11, 0.34), but even this value remained highly significant (p<0.001). Results were consistent across sites (I²=1%; p_het=0.44). Mean wealth scores explained 38% of the variation in mean FEV₁/FVC between sites (r²=0.385, p=0.031).Airflow obstruction is consistently associated with poverty at individual and community levels across several countries.

In Tunisia, there is a paucity of population-based data on Chronic Obstructive Pulmonary Disease (COPD) prevalence. To address this problem, we estimated the prevalence of COPD following the Burden of Lung Disease Initiative. We surveyed 807 adults aged 40+ years and have collected information on respiratory history and symptoms, risk factors for COPD and quality of life. Post-bronchodilator spirometry was performed and COPD and its stages were defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Six hundred and sixty one (661) subjects were included in the final analysis. The prevalence of GOLD Stage I and II or higher COPD were 7.8% and 4.2%, respectively (Lower Limit of Normal modified stage I and II or higher COPD prevalence were 5.3% and 3.8%, respectively). COPD was more common in subjects aged 70+ years and in those with a BMI < 20 kg/m². Prevalence of stage I+ COPD was 2.3% in <10 pack years smoked and 16.1% in 20+ pack years smoked. Only 3.5% of participants reported doctor-diagnosed COPD. In this Tunisian population, the prevalence of COPD is higher than reported before and higher than self-reported doctor-diagnosed COPD. In subjects with COPD, age is a much more powerful predictor of lung function than smoking.

Aims: The present study was designed to examine the possible changes in body composition, insulin-like growth factor 1 (IGF-1), insulin-like growth factor-binding protein-3 (IGFBP-3) and inflammatory markers of obese children in response to a 2-month program of exercise training combined with dietary restriction. Methods: Twenty-eight obese children (age 13.2 ± 0.7 years, body mass index 30.9 ± 1.3) were randomly assigned to a diet/training group or a control group and were tested two times: once before and once at the end of the experimental period. They performed a progressive cycle ergometer test at each visit. Substrate oxidation was evaluated by indirect calorimetry. Training was individualized at the point when fat oxidation was maximal (Lipoxmax). Results: Diet/training induced a significant decrease in body weight and body fat (after vs. before, p < 0.01). Plasma concentrations of IGF-1, IGFBP-3 and inflammatory markers were significantly decreased after the completion of the program. The diet/training program resulted in an increase in VO2maxACSM (24.6 ± 2.5 to 33.1 ± 3.1 ml/min/kg, p < 0.001) at the end of the intervention period. Conclu- sion: These data suggest that in the presence of weight loss, exercise training improves inflammatory markers and IGF-1 and IGFBP-3 levels in obese children.

Purpose: To evaluate the effect of Ramadan fasting on parameters of insulin resistance in trained athletes at rest and after aerobic exercise.Methods: Nine male rugby players (age 19 ± 2 yr, height 1.78 ± 0.74 m) were tested 3 times: 1 week before observance of Ramadan (C), at the end of the first week (R1), and during the fourth week (R2). They performed a progressive cycle-ergometer test at each visit. Data collected at rest and at the end of aerobic exercise included simple anthropometry (body mass, body-mass index, body fat, fat-free mass), biochemical parameters (serum glucose, cholesterol, HDL cholesterol, triglycerides, creatinine, and serum proteins), and selected hormone concentrations (plasma insulin, leptin, and adiponectin).Results: Ramadan fasting was associated with a reduction of body mass and body fat (R2 vs. C, p < .01) without significant change in leptin or adiponectin levels.Conclusion: Lipolysis might have occurred because of increased plasma triglycerides and HDL cholesterol concentrations.