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Metabolic consequences of anabolic steroids, insulin, and growth hormone abuse in recreational bodybuilders : implications for the world anti-doping agency passport
Filippo Giorgio Di Girolamo, Chiara Biasinutto, Alessandro Mangogna, Nicola Fiotti, Pierandrea Vinci, Rado Pišot, Filippo Mearelli, Boštjan Šimunič, Chiara Roni, Gianni Biolo, 2024, original scientific article

Abstract: Background Hormonal doping in recreational sports is a public-health concern. The World Anti-Doping Agency (WADA) promoted the creation of the Athlete Biological Passport, aiming to monitor athlete’s biological variables over time to facilitate indirect detection of doping. Detection tests for anabolic androgenic steroids (AAS) and growth hormone (GH) are available while insulin abuse cannot be revealed. We have determined in recreational bodybuilders the metabolic effects associated with different patterns of hormone abuse. All analyses were conducted using Statistical Package for Social Sciences (SPSS) 21.0 software (SPSS Chicago, IL). Results We have assessed plasma concentrations of selected metabolic markers and fatty acid content in erythrocyte membranes of 92 male bodybuilders and in 45 healthy controls. Hormonal abuse was identified by anonymous questionnaires. 43% (%) of recruited bodybuilders regularly abused hormones, i.e., anabolic androgenic steroids (95%) often associated with GH (30%) and/or insulin (38%). HDL-cholesterol was lower in insulin and/or GH abusers. Alanine (ALT) and aspartic (AST) transaminases were greater in hormone abusing bodybuilders than in non-doping bodybuilders and controls. Insulin doping was selectively associated with increased plasma ALT-to-AST ratio. In erythrocyte membranes, elongase activity (i.e., stearic-to-palmitic ratio) was lower in insulin and/or growth hormone doping, whereas increased Δ-9 desaturase activity (i.e., palmitoleic-to-palmitic ratio) was selectively associated with insulin doping. Conclusions In conclusion, our study demonstrates that insulin and GH abuse are characterized by multiple alterations of specific metabolic markers. Although further studies are needed to test whether longitudinal monitoring of selected metabolic marker such as muscle contraction time, HDL levels, ALT-AST ratio as well as the activities of selected enzymes (e.g. Δ-9 desaturase and elongase), could contribute to the detection of insulin and GH abuse in sport.
Keywords: bodybuilders, doping, drug abuse, matabolism
Published in DiRROS: 03.04.2024; Views: 107; Downloads: 52
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Retinal venular vessel diameters are smaller during ten days of bed rest
Adam Salon, Göktuğ Mert Çiftci, Damir Zubac, Boštjan Šimunič, Rado Pišot, Marco Vicenzo Narici, Per Morten Fredriksen, Benedicta Ngwenchi Nkeh-Chungag, Harald Sourij, Nandu Goswami, 2023, original scientific article

Abstract: Older individuals experience cardiovascular dysfunction during extended bedridden hospital or care home stays. Bed rest is also used as a model to simulate accelerated vascular deconditioning occurring during spacefight. This study investigates changes in retinal microcirculation during a tenday bed rest protocol. Ten healthy young males (22.9± 4.7 years; body mass index: 23.6± 2.5 kg·m–2) participated in a strictly controlled repeated-measures bed rest study lasting ten days. High-resolution images were obtained using a hand-held fundus camera at baseline, daily during the 10 days of bed rest, and 1 day after re-ambulation. Retinal vessel analysis was performed using a semi-automated software system to obtain metrics for retinal arteriolar and venular diameters, central retinal artery equivalent and central retinal vein equivalent, respectively. Data analysis employed a mixed linear model. At the end of the bed rest period, a signifcant decrease in retinal venular diameter was observed, indicated by a signifcantly lower central retinal vein equivalent (from 226.1 µm, CI 8.90, to 211.4 µm, CI 8.28, p= .026), while no signifcant changes in central retinal artery equivalent were noted. Prolonged bed rest confnement resulted in a signifcant (up to 6.5%) reduction in retinal venular diameter. These fndings suggest that the changes in retinal venular diameter during bedrest may be attributed to plasma volume losses and refect overall (cardio)-vascular deconditioning.
Keywords: eyes, retinal venular vessel, venske žile, bed rest, gibalna neaktivnost
Published in DiRROS: 23.11.2023; Views: 712; Downloads: 160
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Participation in youth sports influences sarcopenia parameters in older adults
Kaja Teraž, Miloš Kalc, Boštjan Šimunič, Uroš Marušič, Primož Pori, Saša Pišot, Rado Pišot, 2023, original scientific article

Abstract: Background The degree of deterioration in sarcopenia parameters may be affected by a person’s level of physical activity (PA) and sedentary behavior (SB). Our study focused on examining the PA and SB of active older adults including those with and without history of sports in youth. Methods Forty-four participants (20 men and 24 women, mean age of total sample 76.1 ± 5.2 years) were included in analysis of PA, SB habits and sarcopenia parameters, determined by skeletal muscle index, hand-grip strength, gait speed, Timed Up and Go tests (TUG). PA and SB were recorded with accelerometers. Our primary aim was to compare participants with (AH) or without a sport history in youth (NAH), in their sarcopenia parameters and PA and SB habits. Results When divided participants in two groups (AH and NAH) and adjusting for age, we have detected the differences for skeletal muscle index (p = 0.007) and hand-grip strength (p = 0.004) in favor of participants who were engaged in sports in youth. We did not find any differences in PA and SB habits between the AH and NAH groups. After adjusting for age, participants with a higher number of daily steps, longer moderate to vigorous physical activity (MVPA) bouts, a higher number of MVPA bouts in a day and higher overall MVPA engagement achieved better results in hand-grip strength and TUG. Participants with lower SB had better TUG and gait speed results. Conclusions Our findings suggest that engaging in sports activities in youth can make a difference with sarcopenia parameters. Although we found no differences in PA and SB habits between participants with AH and NAH, participants with an athlete history performed better results in sarcopenia parameters.
Keywords: muscles, muscle disorder, elderly, exercise, sedentarism
Published in DiRROS: 10.11.2023; Views: 328; Downloads: 520
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Environmental enrichment through virtual reality as multisensory stimulation to mitigate the negative effects of prolonged bed rest
Luka Šlosar, Manca Peskar, Rado Pišot, Uroš Marušič, 2023, review article

Abstract: Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted.
Keywords: physical inactivity, bed rest, nonphysical interventions, virtual reality
Published in DiRROS: 11.09.2023; Views: 364; Downloads: 177
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Functional characteristics and subjective disease perception in patients with COVID-19 two months after hospital discharge
Kaja Teraž, Boštjan Šimunič, Manca Peskar, Uroš Marušič, Saša Pišot, Luka Šlosar, Mladen Gasparini, Rado Pišot, 2023, original scientific article

Abstract: Introduction: Although early inpatient and post-hospital rehabilitation is recognized as necessary, not all COVID-19 patients have access to rehabilitation. There are no published reports in the literature that investigate the outcomes of patients who do not receive rehabilitation after COVID-19. Our aim was to evaluate possible improvements in determinate functional and psychological parameters in COVID19 patients two months after their hospital discharge. Methods: On both time points various motor, cognitive, and clinical measurements such as body composition, tensiomyography, blood pressure, spirometry, grip strength test, Timed Up and Go test, gait speed, 30-second chair-stand test, and Montreal Cognitive Assessment, were performed. Additionally, questionnaires such as the SARC-CalF test, Edmonton frail scale, International Physical Activity questionnaire andThe Mediterranean Lifestyle index were conducted to assess lifestyle characteristics. Results: A total of 39 patients (87.2% male; mean age of 59.1 ± 10.3 years), who were hospitalized due to COVID-19 at the Izola General Hospital (IGH), Slovenia between December 2020 and April 2021, were included. Patients were assessed at two time points (T1 and T2): T1 was taken after receiving a negative COVID-19 test and T2 was taken two months after T1. After two months of self-rehabilitation, we have detected a BMI increase (p < .001), fat free mass increase (p < .001), better Edmonton frail scale (p < .001), SARC-CalF score (p = .014) and MoCA score (p = .014). There were no detected changes in lifestyle habits nor in physical performance tests. Discussion: It is already known that COVID-19 has long-term negative consequences regardless of the stage of the disease. Our findings support the notion that patients cannot fully regain all their functions within a two-month period without receiving structured or supervised rehabilitation. Therefore, it is crucial to offer patients comprehensive and structured rehabilitation that incorporates clinical, cognitive, and motor exercises.
Keywords: pandemics, coronavirus, functional improvement, hospital stay, health perception
Published in DiRROS: 26.07.2023; Views: 370; Downloads: 184
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Pathophysiological mechanisms of reduced physical activity : insights from the human step reduction model and animal analogues
Fabio Sarto, Roberto Bottinelli, Martino V. Franchi, Simone Porcelli, Boštjan Šimunič, Rado Pišot, Marco Vicenzo Narici, 2023, review article

Abstract: Physical inactivity represents a heavy burden for modern societies and is spreading worldwide, it is a recognised pandemic and is the fourth cause of global mortality. Not surprisingly, there is an increasing interest in longitudinal studies on the impact of reduced physical activity on different physiological systems. This narrative review focuses on the pathophysiological mechanisms of step reduction (SR), an experimental paradigm that involves a sudden decrease in participants’ habitual daily steps to a lower level, mimicking the effects of a sedentary lifestyle. Analogous animal models of reduced physical activity, namely the “wheel-lock” and the “cage reduction” models, which can provide the foundation for human studies, are also discussed. The empirical evidence obtained thus far shows that even brief periods of reduced physical activity can lead to substantial alterations in skeletal muscle health and metabolic function. In particular, decrements in lean/muscle mass, muscle function, muscle protein synthesis, cardiorespiratory fitness, endothelial function and insulin sensitivity, together with an increased fat mass and inflammation, have been observed. Exercise interventions seem particularly effective for counteracting these pathophysiological alterations induced by periods of reduced physical activity. A direct comparison of SR with other human models of unloading, such as bed rest and lower limb suspension/immobilisation, is presented. In addition, we propose a conceptual framework aiming to unravel the mechanisms of muscle atrophy and insulin resistance in the specific context of reduced ambulatory activity. Finally, methodological considerations, knowledge gaps and future directions for both animal and human models are also discussed in the review.
Keywords: physical inactivity, cage reduction, insulin sensitivity, muscle atrophy
Published in DiRROS: 29.06.2023; Views: 396; Downloads: 281
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Effects of COVID-19 on cognition and mood after hospitalization and at 2-month follow-up
Manca Peskar, Boštjan Šimunič, Luka Šlosar, Saša Pišot, Kaja Teraž, Mladen Gasparini, Rado Pišot, Uroš Marušič, 2023, original scientific article

Abstract: A plethora of evidence links SARS-CoV-2 infection with concomitant cognitive dysfunction, which often persists weeks to months after the acute stages of illness and affects executive function, attention, memory, orientation, and movement control. It remains largely unclear which conditions or factors exacerbate the recovery. In a cohort of N=37 Slovenian patients (5 females, aged M = 58, SD = 10.7 years) that were hospitalized because of COVID-19, the cognitive function and mood states were assessed immediately after discharge and 2-months later to investigate the early post-COVID recovery changes. We assessed the global Montreal Cognitive Assessment (MoCA), Simple and Choice Reaction Times, executive functions (Trail-Making Test – TMT-A and TMT-B), short-term memory (Auditory Verbal Learning Test – AVLT), and visuospatial memory. We monitored depressive and anxiety symptoms and applied general self-efficacy and cognitive complaints questionnaires. Our results showed a global cognitive impairment (MoCA, Z = 332.5; p = 0.012), poorer performance on executive functions (TMT-A, Z = 188; p = 0.014; and TMT-B, Z = 185; p = 0.012), verbal memory (AVLT, F = 33.4; p < 0.001), and delayed recall (AVLT7, F = 17.1; p < 0.001), and higher depressive (Z = 145; p = 0.015) and anxiety (Z = 141; p = 0.003) symptoms after hospital discharge compared to 2-month follow-up, indicating that SARS-CoV-2 may transiently impair cognitive function and adversely affect the mood. No improvement in MoCA was observed in 40.5% of the patients at follow-up, indicating possible long-term effects of COVID-19 on global cognitive performance. Medical comorbidities (p = 0.035) significantly predicted the change in MoCA score over time, while fat mass (FM, p = 0.518), Mediterranean diet index (p = .0.944), and Florida Cognitive Activities Score (p = 0.927) did not. These results suggest that the patients’ medical comorbidities at the time of SARS-CoV-2 infection could importantly contribute to the acute impairment of cognitive function and stress the importance of systemic implementation of countermeasures to limit the negative consequences on public health.
Keywords: Coronavirus, recovery, acute respiratory sindrom, cognitive functions, cognitive impairment, MOCA, trail-making test
Published in DiRROS: 01.06.2023; Views: 532; Downloads: 234
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Sarcopenia parameters in active older adults – an eight-year longitudinal study
Kaja Teraž, Uroš Marušič, Miloš Kalc, Boštjan Šimunič, Primož Pori, Bruno Grassi, Stefano Lazzer, Marco Vicenzo Narici, Mojca Gabrijelčič Blenkuš, Pietro Enrico Di Prampero, Carlo Reggiani, Angelina Passaro, Gianni Biolo, Mladen Gasparini, Rado Pišot, 2023, original scientific article

Abstract: Background Sarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population. Methods The 52 active older adults (22 men and 30 women, mean age: 68.4±5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants’ overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements. Results In the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p<.001), muscle mass index (-5.4%; p<.001), and physical performance measured with gait speed (-28.6%; p<.001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p=.030 and −48.5%; p<.001, respectively). Conclusions Despite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature. Trial registration The clinical trial protocol was registered on, identifier: NCT04899531
Keywords: elderly, physical activities, sedentary behavior, skeletal muscle disorder, sarcopenia
Published in DiRROS: 29.05.2023; Views: 372; Downloads: 186
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Interleukin-18 is a potential biomarker linking dietary fatty acid quality and insulin resistance : results from a cross-sectional study in Northern Italy
Domenico Sergi, Juana Maria Sanz, Stefano Lazzer, Gloria Brombo, Giovanni Zuliani, Gianni Biolo, Boštjan Šimunič, Rado Pišot, Edoardo Dalla Nora, Angelina Passaro, 2023, original scientific article

Abstract: Dietary lipids are pivotal in modulating metabolic inflammation. Among the inflammatory mediators characterizing metabolic inflammation, interleukin 18 (IL-18) has been consistently associated with obesity and insulin resistance. This study aims to evaluate whether the quality of lipid intake impacts upon IL-18 plasma levels and the implications on insulin resistance computed by the homeostatic model assessment for insulin resistance (HOMA-IR). Using a cross-sectional design, this study confirmed that IL-18 correlated positively with insulin resistance and individuals with a HOMA-IR ≥ 2.5 displayed higher circulating IL-18 levels compared with their insulin-sensitive counterparts. In terms of the effect of the quality of dietary lipids on IL-18 circulating levels, the ratio between monounsaturated, omega-3, polyunsaturated and saturated fatty acids as well as the intake of eicosapentaenoic and docosahexaenoic acids correlated negatively with IL-18. Despite this, IL-18 circulating levels, but not dietary fatty acid quality, predicted insulin resistance. Nevertheless, the ratio between omega 3 and saturated fatty acids was a predictor of IL-18 plasma levels. Thus, the downregulation of IL-18 may underpin, at least partially, the beneficial metabolic effects of substituting omega 3 for saturated fatty acids with this cytokine potentially representing a biomarker linking dietary lipids and metabolic outcomes.
Published in DiRROS: 14.04.2023; Views: 492; Downloads: 214
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Report of 4th International SPE Balkan Ski Conference, Pamporovo ski resort, Bulgaria, 13-17 March 2022
Kaja Teraž, Rado Pišot, 2022, other component parts

Keywords: skiing, training, conference, Balkan Ski, reports
Published in DiRROS: 03.03.2023; Views: 462; Downloads: 244
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