In this study, we examined a reliability of age-predicted heart rate (HR) for the 50%VO₂max which is widely used during a training program for health promotion as compared to HR at the double product break point (DPBP). Two hundred fifty six non-hypertensive subjects (NHT), and 49 hypertensive ones under medication (HT) were studied. HT subjects were divided into two subgroups based on antihypertensive medications, ones with HR non-suppression agents (HT+HRNS) and the other with HR suppression agents (HT+HRS). DPBP was measured with the use of an incremental exercise test, and HR at DPBP (HR@DPBP) was determined. Age-predicted HR for the 50%VO₂max intensity of exercise was calculated with the following formula; HR=138–age/2. Measurable rate of DPBP and HR@DPBP in NHT, HT+HRNS and HT+HRS were 93.8% and 120±14bpm, 92.7% and 104±12bpm, 78.5% and 94±16bpm, respectively. There were significant differences in HR@DPBP and age-predicted HR in NHT and HT+HRS (p<0.01 in both groups). But %ΔHR ((age-predicted HR–HR@DPBP)/HR@DPBP x 100) within -10%∼+10% in NHT, HT+HRNS and HT+HRS were 68%, 58% and 14%, respectively. This might be due to HR at rest with sitting position that was significantly correlated to %ΔHR in all groups (r=-0.604, p<0.001 in NHT, r=-0.689, p<0.001 in HT+HRNS and r=-0.761, p<0.05 in HT+HRS, respectively). And the range of HR at rest with sitting position corresponding to -10%∼+10% of %ΔHR were 70∼95bpm in NHT, 71∼93bpm in HT+HRNS and 83∼102bpm in HT+HRS. In addition, this study indicated that DPBP could be measured even under antihypertensive medication that might affect DPBP measurement.In conclusion, we demonstrated that HR at DPBP and age-predicted HR were similar among 58-68% of NHT and HT+HRNS. And the range of HR at rest with sitting position to ensure reliability of age-predicted HR was elucidated.

The aim of this study is to elucidate the relationship between the predicted 50%VO₂max/wt (ml/kg/min) and coronary risk factors (CRFs).Seven hundred eighty six men (37.3 +/- 13.5 years old) and 1,268 women (41.5 +/- 13.6 years old) were studied. The predicted 50%VO₂max/wt was calculated by utilizing data from the continuous incremental exercise test with a stationary bicycle ergometer and the age-predicted heart rate at 50%VO₂max (=138-age/2). As CRFs, percent body fat, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and HbA1c were measured.The age-adjusted odds ratio of having abnormal values in CRFs across quartiles of the predicted 50%VO₂max/wt (highest to lowest) were 1.00 (reference), 1.39, 2.64, and 6.78 in men, and 1.00, 1.73, 2.33 and 3.44 in women (for trend, p<0.001), respectively.This study indicated that the lower 50%VO₂max/wt resulted in the higher odds ratio of having abnormal values in CRFs among Japanese. It was also confirmed that the sub-maximal aerobic capacity was associated with CRFs.

Previously, we have reported that age-predicted heart rate at 50%VO₂max (HR@50%VO₂max) is an effective index of adjusting appropriate exercise intensity for health promotion exercise. Thus, the aim of this study is to elucidate the change in HR at double product break point (HR@DPBP) and the validity of HR@50%VO₂max due to improvement of cardiovascular fitness. Ninety two healthy adults (57 +/- 9 years old), who participated in the health exercise training course, were studied. Participants were instructed how to control the intensity of physical activity for DPBP during their daily life. DPBP was determined with the use of incremental exercise test, and METs at DPBP (METs@DPBP), HR@DPBP, ratings of perceived exertion at DPBP (RPE@DPBP) were measured before and after the course. HR@50%VO₂max was calculated with the following formula; 138 - age/2 (bpm). METs@DPBP significantly increased (p<0.001) after 10 weeks of the course, whereas HR@DPBP did not change. Interestingly, however, there was a significantly positive correlation (p<0.001) between amount of change in METs@DPBP and that in HR@DPBP (ΔHR@DPBP). Multiple linear regression analysis indicated this correlation was independent from sex, age and amount of change in HR at rest (p<0.001). Before and after the course, proportion of study subjects’ %ΔHRs ((HR@50%VO₂max - HR@DPBP) / HR@DPBP x 100) within -10% ~ +10% were both 48.9%, and proportion of study subjects’ RPEs@DPBP within 11~13 were 92% and 85%, respectively. In this study, it was identified that significantly positive relation between amount of change in cardiovascular fitness and that of ΔHR@DPBP. This finding was independent from potentially affecting factors. In conclusion, this longitudinal study could suggest that HR@50%VO₂max and RPE were valuable indexes of determining exercise intensity for health promotion exercise.

The purpose of this study was to elucidate the relation between double product break point (DPBP) and pulse wave velocity (PWV).Two hundred three healthy Japanese females were studied (mean age; 53.5 +/- 11.7 years old). The DPBP was measured by continuous incremental exercise test with a bicycle ergometer (ML-3600, Fukuda Electronic Co. Ltd). The work rate at DPBP was converted into metabolic equivalents (METs@DPBP). The brachial-ankle PWV (baPWV) was also measured. In addition, height, weight and mean blood pressure (mBP) were measured and physical activity condition in daily life (PA) was evaluated by questionnaire.The mean METs@DPBP was 5.0 +/- 0.7 METs. The mean baPWV was 1,373 +/- 254 cm/ sec. The relation between METs@DPBP and baPWV was investigated with the use of multiple linear regression models with adjustment for affecting factors of baPWV.In this study, it was identified that there was a significantly inverse relation between METs@DPBP and baPWV (p <0.01). This finding was independent from age, height, weight, mBP and PA. Thus, there was an inverse relation between sub-maximal aerobic capacity and arterial stiffness.

Since the effect of the submaximal aerobic exercise on bone had been controversial, the aim of this study was to elucidate the effect of the bench step (BS), that seemed to deliver higher mechanical load on bone than any other aerobic exercises, on the total bone mineral content (BMC) and the bone metabolism of menopausal women. Sixteen menopausal women (65 ± 9 years old) as the exercise group (ExG) and 28 pre-menopausal women (43 ± 3 years old) as the control group (CG) were studied. ExG carried out BS training with the exercise intensity at lactate threshold (LT) for 21 weeks. In ExG, BMC was measured by dual energy X-ray absorptiometry (DXA) at one year before the intervention (A year before), pre-intervention (Pre) and post-intervention (Post). Serum osteocalcin (OC) as the marker of bone formation and serum type I collagen cross-linked N-telopeptide (NTx) as the marker of bone absorption at Pre, 11th week of the intervention and Post. In CG, BMC was measured annually without the intervention. In ExG, OC was not changed, but NTx was significantly decreased by intervention (p<0.05). The decreased amount of annual change in BMC between a year before and Pre (T1) was significantly higher compared to that between Pre and Post (T2) (p<0.01) and CG (p<0.001). There was no significant difference between T2 and CG. In conclusion, BS with LT could prevent decreasing BMC in menopausal women, and maintain the same level of BMC in pre-menopausal women by suppressing the bone absorption.

OBJECTIVETo investigate the clinical and neurodevelopmental profiles of patients with biotinidase deficiency and to determine the efficacy of current therapy with respect to outcome.

METHODSSix patients aged from 3 months to 14 years with biotinidase deficiency were confirmed by urinary organic acid analysis with gas chromatography/mass spectrometry (GC/MS) and biotinidase assay on dried blood spots. Biotin was supplemented individually (10-40 mg/d). Their clinical features, laboratory findings, and treatment regimen were reviewed.

RESULTSAll the 6 patients presented with some extent of neurological abnormalities and dermatological lesions. Cases 1 - 3 had poor feeding, vomiting, seizures, mental retardation, and lethargy onset from their early infancy, with varied degree of anemia, ketosis, acidosis, and hypoglycemia. Case 2 exhibited eczema and dermatitis from his age of 7 months. Case 4 displayed motor deficit and ataxia after 6 months of age, and generalized pustular psoriasis when he was 8 months old. Cases 5 and 6 gradually showed muscle weakness and paraplegia at the age of 7 years and 5 years, respectively. Inflammatory demyelination changes of cervical cord were evident on magnetic resonance imaging in these two patients. Case 6 had progressive optic atrophy, eczema and alopecia. Remarkable elevations of urinary lactate, pyruvate, 3-OH-propionate, methylcitrate, propionylglycine, 3-OH-isovalerate, 3-methylcrontonylglycine were confirmed in cases 1, 2, 3 and 5. Slight increase of urinary lactate, pyruvate, and 3-methylcrontonylglycine was observed in cases 4 and 6. Biotinidase activities assayed on dried blood spots from all the patients were below 0.1 pmol/(min.3 mm) Biotin supplementation for all the patients, except for case 3 who was not treated, resulted in pronounced and rapid clinical and biochemical improvement. Cases 4 and 6 had residual neurological damage comprising ataxia and motor handicap of legs, due to prolonged disease course.

CONCLUSIONSBiotinidase deficiency intensively impairs nervous system and skin in the affected patients. Urinary organic acid analysis and blood biotinidase assay are crucial to the diagnosis. Early diagnosis and biotin supplementation can contribute significantly to the improvement of prognosis.

Adolescent ; Biotin ; administration & dosage ; therapeutic use ; Biotinidase Deficiency ; diagnosis ; drug therapy ; urine ; Child ; Child, Preschool ; Gas Chromatography-Mass Spectrometry ; Humans ; Infant ; Male ; Treatment Outcome