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Original article
Plasma apelin levels in overweight/obese adults following a single bout of exhaustive exercise: A preliminary cross-sectional study
Niveles plasmáticos de apelina en adultos con sobrepeso/obesidad tras una sola sesión de ejercicio exhaustivo: estudio transversal preliminar
Jun Seok Sona,b, Song Ah Chaeb,c, Byung Ik Parkd, Min Dua,
Corresponding author
min.du@wsu.edu

Corresponding authors.
, Wook Songb,e,
Corresponding author
songw3@snu.ac.kr

Corresponding authors.
a Nutrigenomics and Growth Biology Laboratory, Department of Animal Sciences, Washington State University, Pullman, WA 99164, USA
b Health and Exercise Science Laboratory, Institute of Sport Science, Seoul National University, Seoul 08826, South Korea
c Department of Movement Sciences, University of Idaho, Moscow, ID 83844, USA
d School of Public Health, Indiana University, Bloomington, IN 47405, USA
e Institute on Aging, Seoul National University, South Korea
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Obesity commonly precedes metabolic dysfunction and diseases such as type 2 diabetes mellitus &#40;T2DM&#41; and cardiovascular disease &#40;CVD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a> Poor physical activity is a primary reason for increasing obesity&#44; and preservation of skeletal muscle induced by exercise increases metabolic rate and reduces obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> Obese individuals usually have low exercise capacity and physical dysfunction compared to healthy adults&#44; leading to further weight accumulation and unstable metabolic homeostasis&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">3&#44;4</span></a> Physical activity has been considered as a key factor for increasing lean mass&#44; enhancing muscular strength and cardiorespiratory fitness&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Apelin&#44; also known as APLN&#44; was identified as the ligand of a G-protein-coupled receptor&#44; putative receptor protein related to AT1 &#40;APJ&#41;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">6&#44;7</span></a> and introduced as a therapeutic target for improving insulin sensitivity and preventing obesity and diabetes mellitus&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8&#44;9</span></a> For instance&#44; intravenous injection of apelin improved glucose utilization in insulin resistant obese mice&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">10</span></a> Recently&#44; regular exercise has been shown to stimulate apelin secretion&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">11&#44;12</span></a> In a previous study in obese subjects&#44; 8 weeks of endurance training improved maximal oxygen consumption and decreased fat mass&#44; which upregulated muscle apelin mRNA expression and improved insulin sensitivity&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> In type 2 diabetic rats&#44; endurance exercise enhances circulating apelin levels and improves metabolic parameters&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a> A recent meta-analysis reported that acute exercise was associated with post-exercise increase of a myokine&#44; irisin&#44; which was lower in obese compared to healthy subjects&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">14</span></a> Although there are reports of differential cytokine secretion between lean and obese people following acute exercise&#44; the effects of an exhaustive single bout of exercise in inducing apelin expression and its correlation with body composition&#47;physical fitness between gender and between lean and overweight&#47;obese have not been reported&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the present study&#44; we examined the differences of body composition&#44; metabolic condition&#44; and physical capacity in healthy and overweight&#47;obese individuals in response to a single bout of exhaustive exercise intervention&#46; The hypothesis is that apelin secretion following a single bout of exhaustive exercise is dependent on metabolic state&#44; body composition and sex of subjects&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Participants</span><p id="par0020" class="elsevierStylePara elsevierViewall">A total 60 subjects &#91;34 women &#40;21 lean and 13 overweight&#47;obese&#41; and 26 men &#40;8 lean and 18 overweight&#47;obese&#41;&#93;&#44; age 30&#8211;59 years&#44; with body mass index &#40;BMI&#41; of 18&#8211;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> were recruited in this study based on the guidelines for overweight &#40;BMI of 23&#8211;24&#46;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41; and obesity &#40;BMI of over 25<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a> at the Institute of Sport Science&#44; Seoul National University&#44; Seoul&#44; South Korea&#46; All experimental materials and methods were approved by the ethical committee of the Seoul National University Institutional Review Board &#40;SNUIRB No&#46; 1509&#47;001-017&#41; and registered with the Clinical Research Information Service &#40;<a href="https://cris.nih.go.kr/">https&#58;&#47;&#47;cris&#46;nih&#46;go&#46;kr</a>&#59; CRIS No&#46; KCT0001743&#41; in accordance with the WHO International Clinical Trials Registry Platform &#40;ICTRP&#41;&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Sample size determination</span><p id="par0025" class="elsevierStylePara elsevierViewall">For determining the sample size&#44; nineteen adults &#40;ten women and nine men&#41; were recruited for the pilot study&#46; The correlation between BMI and plasma apelin concentration &#40;baseline&#41; was examined in Supplementary Fig&#46; 1 &#40;<a class="elsevierStyleCrossRef" href="#sec0110">Appendix A</a>&#41;&#46; Forty-four individuals were finally determined as a sample size using G&#42;Power software 3&#46;1 &#40;<span class="elsevierStyleItalic">&#945;</span> err prob<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; Power<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;08&#41;&#46; In present study&#44; total 60 participants were recruited considering approximately 30&#37; of give up rates&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Experimental procedures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Eligibility criteria and consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">Participants were recruited through a public letter to university community members and public relations flyers&#44; and volunteers were screened first under telephone interview and then by physical examination&#46; All participants who visited in the screening session understood the purpose of this study and signed written informed consent&#46; All processes were performed as a double-blind controlled clinical trial between volunteers and expert operators&#46; During the screening visit&#44; volunteers were excluded by measuring vital signs &#91;systolic blood pressure<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>120<span class="elsevierStyleHsp" style=""></span>mmHg&#44; diastolic blood pressure<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>80<span class="elsevierStyleHsp" style=""></span>mmHg&#44; or body temperature&#93; and laboratory tests &#91;urinary pregnancy test positive or Human Chorionic Gonadotropin &#40;hCG&#41; level<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>25<span class="elsevierStyleHsp" style=""></span>mlU&#47;mL &#40;positive&#41;&#93;&#44; questionnaires to examine disease history &#40;presence of musculoskeletal disease&#41; and physical activity levels &#40;exercise &#8805;4 times per week&#41; using International Physical Activity Questionnaire &#40;IPAQ&#41; short version&#46; Volunteers in the presence of clinic pathological issues such as severe diseases&#44; pregnancy&#44; and drug addiction were also excluded&#46; In addition&#44; volunteers who joined in other clinical trials within 4 weeks&#44; had eaten any supplementation within 4 weeks&#44; or had regularly exercised over mid-intensity within 3 months&#44; and standard contraindication for dual-energy X-ray absorptiometry &#40;DXA&#41; examinations &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; were excluded&#46; Inclusion criteria were consent to join the current study and could perform a single bout of exhaustion exercise&#46; During the 2nd visit&#44; body composition and physical fitness test were conducted&#44; followed by a single bout of exhaustive exercise&#44; all of which were conducted within 2<span class="elsevierStyleHsp" style=""></span>h duration&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">A single bout of exhaustive exercise and blood collection</span><p id="par0035" class="elsevierStylePara elsevierViewall">To assess cardiovascular function&#44; participants were encouraged to continue treadmill exercise until volitional exhaustion to measure exercise capacity&#44; including maximal oxygen consumption &#40;VO<span class="elsevierStyleInf">2</span>max&#41;&#44; exercise time&#44; and total distance according to the Bruce protocol<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">16</span></a> using the treadmill ergometer &#40;T150&#44; Cosmed&#44; Rome&#44; Italy&#41;&#46; In briefly&#44; following overnight fast&#44; participants were performed an acute treadmill exercise at the same moment of the maximal oxygen consumption test until being exhausted&#46; The results of VO<span class="elsevierStyleInf">2</span>max&#44; exercise time &#40;min&#41;&#44; and total distance &#40;m&#41; are the specific characteristics of the exercise&#44; which are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Blood samples were taken from participants before exercise&#44; and at 0&#44; 15&#44; 30<span class="elsevierStyleHsp" style=""></span>min after exercise based on the half-life of apelin<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">17</span></a> determined through preliminary studies &#40;<a class="elsevierStyleCrossRef" href="#sec0110">Supplementary Fig&#46; 2&#44; Appendix A</a>&#41;&#46; During exercise&#44; the degree of difficulty was numerically recorded following rated perceived exertion &#40;RPE&#41; scale&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Body composition and clinical parameters</span><p id="par0040" class="elsevierStylePara elsevierViewall">Body composition was measured by using Dual-energy X-ray absorptiometry &#40;DXA&#41; &#40;Hologic&#44; Inc&#46;&#44; Waltham&#44; Massachusetts&#41;&#44; including total mass&#44; fat mass&#44; lean mass&#44; and percent fat before performing a single bout of exhaustive exercise&#46; Insulin and blood glucose before&#47;after exercise were analyzed&#44; which was used for the analysis of homeostatic model assessment of insulin resistance &#40;HOMA-IR&#41; and insulin secretion &#40;HOMA-&#37;B&#41; according to the following formula&#58; HOMA-IR &#91;Fasting insulin in &#956;U&#47;mL<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>&#40;fasting blood glucose in mg&#47;dL<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#46;055&#41;&#47;22&#46;5&#93;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a>&#59; HOMA-&#37;B &#91;&#40;360<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>fasting insulin in &#956;U&#47;mL&#41;&#47;&#40;fasting blood glucose<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>63&#41;&#93;&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Physical fitness test</span><p id="par0045" class="elsevierStylePara elsevierViewall">To measure the lower body strength&#44; the isokinetic dynamometer equipment &#40;Humac Norm&#44; CSMi&#44; Massachusetts&#41; was used as previously described&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> All participants were asked to perform knee isokinetic contraction at two angular velocities&#58; 60&#176;&#47;s for assessment of muscle strength &#40;five maximal contractions&#41; and 240&#176;&#47;s for assessment of muscle endurance strength &#40;twenty-five maximal contractions&#41; of knee extension and flexion in right and left limbs in a seated position&#46; For measuring upper body strength&#44; the grip strength test was conducted using digital hand grip dynamometer &#40;my-5401&#44; TAKEI&#44; Niigata&#44; Japan&#41; as previously described&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> Participants performed the grip strength test standing with straight arms&#44; and wrists in a neutral position&#44; and then were asked to conduct a maximal isometric contraction twice using both hands&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Biochemical measurements</span><p id="par0050" class="elsevierStylePara elsevierViewall">Apelin was measured using a previously validated enzyme immunoassay &#40;EIA&#41; apelin-12 kit &#40;&#35;EK-057-23&#44; Phoenix Pharmaceuticals&#44; Burlingame&#44; California&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a> Lactate&#44; lactate dehydrogenase &#40;LDH&#41;&#44; and creatine kinase &#40;CK&#41; were measured by Green Cross Laboratory &#40;Green Cross Corp&#46;&#44; Seoul&#44; South Korea&#41; according to Roche diagnostics &#40;Roche Diagnostics GmbH&#44; Mannheim&#44; Germany&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">Data of primary outcomes were analyzed using simple linear regression analysis &#40;<span class="elsevierStyleItalic">Pearson</span> correlation&#41;&#44; including <span class="elsevierStyleItalic">r</span> &#40;slope&#41; and <span class="elsevierStyleItalic">P</span> value to examine the bivariate association between selected variables &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>60&#44; including lean and overweight&#47;obese adults&#41;&#46; For data of exploratory outcomes&#44; independent and&#47;or paired <span class="elsevierStyleItalic">t</span>-tests were used to compare mean outcome values&#44; and regression slopes between selected variables were conducted using <span class="elsevierStyleItalic">Pearson</span> correlation&#46; Imputations were not applied to overcome missing data in the <span class="elsevierStyleItalic">Pearson</span> correlation of primary analysis&#46; Values in the text&#44; figures&#44; and tables are presented as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#44; and statistical significance was determined at <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; using Origin 8&#46;0 and SPSS version 18&#46;0 software &#40;IBM Corp&#46;&#44; Armonk&#44; New York&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The Shapiro&#8211;Wilk test was used for testing normal distribution of data&#46; For the secretion of apelin &#40;baseline&#44; 0&#44; 15&#44; and 30<span class="elsevierStyleHsp" style=""></span>min after exercise&#41;&#44; the groups of lean and overweight&#47;obese adults were not normally distributed&#46; In the case of abnormal distribution&#44; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test was used to test statistical significance&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Results</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Anthropometric and clinical characteristics</span><p id="par0065" class="elsevierStylePara elsevierViewall">A total of 102 adults were screened for trial eligibility &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; including anthropometric parameters and vital signs &#40;Supplementary Table 1&#44; Appendix A&#41;&#44; and 60 participants &#91;51&#46;67&#37; with overweight&#47;obese&#59; 56&#46;67&#37; women&#59; mean age&#44; 39&#46;45 &#40;SD&#44; 8&#46;65&#41; years&#93; were assigned into healthy and overweight&#47;obese groups&#46; Demographics and basic characteristics of participants in each group are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Basic blood and urine tests of participants included in this study were conducted to measure physiological conditions &#40;<a class="elsevierStyleCrossRef" href="#sec0110">Supplementary Table 2&#44; Appendix A</a>&#41;&#46; As expected&#44; overweight&#47;obese women and men had higher body weight&#44; lean mass&#44; fat mass&#44; and percent fat&#44; while lower relative lean mass &#40;the ratio of lean mass to body weight&#41; compared to healthy adults&#46; Bone mineral content and density between overweight&#47;obese and healthy groups only differed in women&#44; but not in men &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>b&#41;&#46; The fasting insulin level and HOMA-IR of overweight&#47;obese adults were higher than healthy adults&#44; consistent with higher fasting glucose of overweight&#47;obese women &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>c&#41;&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Primary outcomes</span><p id="par0070" class="elsevierStylePara elsevierViewall">After a single bout of exhaustive exercise&#44; there was significant correlation between plasma apelin level &#40;0<span class="elsevierStyleHsp" style=""></span>min&#41; and lean mass &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;350&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#46; On the other hand&#44; no significant correlation was found in resting plasma apelin and lean mass &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;137&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;296&#41;&#46; Furthermore&#44; no significant differences between lean mass and HOMA-IR before&#47;after exercise were found &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Circulating apelin level &#40;0<span class="elsevierStyleHsp" style=""></span>min&#41; was also positively associated with HOMA-IR &#40;0<span class="elsevierStyleHsp" style=""></span>min&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;366&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#44; HOMA-&#37;B &#40;0<span class="elsevierStyleHsp" style=""></span>min&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;360&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; and LDH &#40;0<span class="elsevierStyleHsp" style=""></span>min&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;395&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; after exercise immediately&#44; but no correlation was observed before exercise &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Exploratory outcomes</span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Biochemical measurements</span><p id="par0075" class="elsevierStylePara elsevierViewall">The circulating apelin level of overweight&#47;obese men was significantly increased after exercise &#40;30<span class="elsevierStyleHsp" style=""></span>min versus 0<span class="elsevierStyleHsp" style=""></span>min&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;027&#41;&#44; which was absent for lean men&#46; However&#44; no change was observed for women regardless of lean or obese &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A and B&#41;&#46; There was no difference in lactate content between lean and overweight&#47;obese men&#46; In addition&#44; the lactate secretion was more profound in men compared to women after exercise &#91;AUC&#59; lean &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and obese &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#59; <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>C and D&#93;&#46; Consistently&#44; following exercise&#44; there was a significant increase of LDH in overweight&#47;obese men &#40;0<span class="elsevierStyleHsp" style=""></span>min versus 30<span class="elsevierStyleHsp" style=""></span>min&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;035&#41;&#44; so for lean men &#40;0<span class="elsevierStyleHsp" style=""></span>min versus 30<span class="elsevierStyleHsp" style=""></span>min&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;041&#41;&#44; while no difference was observed for women &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>E and F&#41;&#46; Similar trends of changes were observed for CK &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>G and H&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Basic physical fitness measurements and correlations with apelin</span><p id="par0080" class="elsevierStylePara elsevierViewall">No differences in maximal oxygen consumption and distance were observed between lean and overweight&#47;obese subjects&#46; Similarly&#44; no difference in the relative grip strength and the relative isokinetic knee flexion and extension &#40;60&#176; and 240&#176;&#47;s&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; There was no association between resting plasma apelin level and physical fitness such as maximal oxygen consumption&#44; grip strength&#44; and isokinetic knee flexion and extension&#46; On the other hand&#44; after exhaustive treadmill exercise&#44; apelin levels in 0 and 15<span class="elsevierStyleHsp" style=""></span>min were associated with grip strength and isokinetic knee flexion&#47;extension &#40;60&#176; and 240&#176;&#47;s&#41; of both limbs &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; except isokinetic knee 240&#176;&#47;s flexion in left leg&#46; In addition&#44; differences between gender in cardiovascular function and physical strength were further observed &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; After 30<span class="elsevierStyleHsp" style=""></span>min of exercise&#44; on the other hand&#44; no differences were found in apelin secretion and physical fitness measurements except grip strength &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span></span></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">Skeletal muscle is the largest organ that contributes to approximately 40&#37; of the whole-body&#44;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a> which is the major organ secreting myokines<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">21</span></a> and correlates with muscle strength&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a> Exhaustive exercise is known to stimulate expression of myokines&#44; which may improve glucose homeostasis and prevent metabolic dysfunction&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a> The decrease of circulating apelin level in obese subjects compared to lean has been reported&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">24</span></a> suggesting that low apelin level can be used as one of the markers for obesity and metabolic dysfunction&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">4</span></a> Regular exercise is known to increase apelin secretion&#44; but apelin secretion after an acute exhaustive exercise remains poorly defined&#46; In the present study&#44; we analyzed exercise-induced circulating apelin secretion and its correlation with body composition&#44; metabolic status and physical fitness of participants&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The main finding was that a single bout of exhaustive exercise elevated circulating apelin level&#44; which was dependent upon skeletal muscle mass&#44; insulin resistance &#40;HOMA-IR&#41;&#44; and insulin secretion &#40;HOMA-&#37;B&#41; of healthy and overweight&#47;obese adults&#46; In addition&#44; following exercise&#44; the changes of circulating apelin level were gender dependent&#46; A positive correlation between apelin secretion during exercise and upper&#47;lower body strength were found&#44; but not in cardiorespiratory function such as maximal oxygen uptake &#40;VO<span class="elsevierStyleInf">2</span>max&#41;&#44; showing that exercise-induced apelin secretion might be dependent on muscle mass and function&#46; In addition&#44; we found the significant correlation between skeletal muscle mass and strength &#40;<a class="elsevierStyleCrossRef" href="#sec0110">Supplementary Table 3&#44; Appendix A</a>&#41;&#46; The finding of acute exercise is effective in elevating the apelin level suggests that even limited exercise could be beneficial for overweight&#47;obese adults&#46; In the meanwhile&#44; blood collection was performed before physical fitness test in the present study in order to collect a steady state of blood&#44; which may affect to the results by this test&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Obese adults have higher body mass&#44; fat mass&#44; and percent fat&#44; and lower lean mass compared to lean control adults&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">4&#44;25</span></a> which are consistent with our analyses of basic characteristics between overweight&#47;obese and lean women and men&#46; Initially&#44; although we expected that there was a correlation between plasma apelin level and BMI following exercise based on the pilot study&#44; the correlation between apelin and BMI after exercise was not found &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;118&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;370&#41;&#46; Low maximal oxygen uptake was further reported in response to the increase of percent fat mass&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">26</span></a> On the other hand&#44; no correlation of cardiorespiratory function and physical strength was observed in the present study&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Myokines secreted from skeletal muscle during contraction have been considered as mediators with endocrine&#44; paracrine&#44; and autocrine actions&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">21</span></a> Skeletal muscle mass is one of the quantitative factors correlated with myokine secretion&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">21</span></a> In this present study&#44; there was a positive correlation between increased apelin level after exercise and muscle mass&#44; though such association was absent before exercise&#46; These data suggest that apelin secretion might be primarily stimulated by contraction&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">27</span></a> Meanwhile&#44; apelin level in circulation might be influenced by other organs such as heart&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a> adipose tissue&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a> and liver&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">30</span></a> which may also secrete low levels of apelin&#46; The effects of exercise in the plasma apelin level differed between genders&#44; being more effective to overweight&#47;obese men than lean men&#44; but less effective to women with&#47;without obesity&#44; which could be related to the compensatory effect associated with obesity&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a> and high muscle mass and contraction strengthen in men compared to women&#44; which was additionally confirmed in different strength between gender at the present study &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Alternatively&#44; the hormone dysregulation in menopause women might affect the amount of plasma apelin level &#40;3 menopause women in healthy adults and 1 menopause woman in overweight&#47;obese adults&#41;&#46; It has been reported that apelin is negatively correlated with insulin resistance and elevated glucose level&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">31</span></a> On the other hand&#44; in our study&#44; exercise-induced increase in circulating apelin level was positively associated with insulin resistance measured by HOMA-IR&#44; which might be due to hyperglycemia after acute exercises&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a> The circulating lactate level of both gender was elevated due to exercise&#44; suggesting the biological effects of an exhaustive exercise to all participants&#46; Although the lactate level of men was higher than that of women after exercise &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; no difference of intensity in subjective feeling is found based on the rated of perceived exertion &#40;RPE&#41;&#44; suggesting that the higher muscle mass or strengthen in men compared to women might be a contributing factor&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The elevation of apelin after exercise was correlated with the upper and lower body muscle strength that includes muscle power &#40;isokinetic 60&#176;&#47;s&#41; and muscle endurance strength &#40;isokinetic 240&#176;&#47;s&#41;&#44; indicating that exercise-induced apelin is correlated with muscle strength&#46; In addition&#44; the hand grip strength is associated with the lower body strength&#44; suggesting that the hand grip strength represents the whole-body strength&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In summary&#44; the present study shows that apelin secretion following an exhaustive acute exercise is associated with muscle mass&#44; insulin sensitivity&#44; and physical fitness in overweight&#47;obese adults&#46; An acute exercise elevated apelin level and improved metabolic parameters more profoundly in overweight&#47;obese men compared to lean men&#44; while such effects were much weaker for women regardless of obese status&#46; Thus&#44; the beneficial effects of apelin expression followed by a single bout of exhaustive exercise might be dependent on gender and metabolic states of the subjects&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Abbreviations</span><p id="par0120" class="elsevierStylePara elsevierViewall">Apelin&#44; ligand of a G-protein-coupled receptor&#59; APJ&#44; putative receptor protein related to AT1&#59; IPAQ&#44; International Physical Activity Questionnaire&#59; DXA&#44; dual-energy X-ray absorptiometry&#59; VO<span class="elsevierStyleInf">2</span>max&#44; maximal oxygen consumption&#59; RPE&#44; rated perceived exertion&#59; HOMA-IR&#44; homeostatic model assessment of insulin resistance&#59; HOMA-&#37;B&#44; homeostatic model assessment of insulin secretion&#59; LDH&#44; lactate dehydrogenase&#59; CK&#44; creatine kinase&#59; BMI&#44; body mass index&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Conflict of interests</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interests&#46;</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Author contributions</span><p id="par0135" class="elsevierStylePara elsevierViewall">W&#46;S&#46; planned and designed the study with contribution from J&#46;S&#46;S&#46; The authors participated in the collection &#40;J&#46;S&#46;S&#46; and S&#46;A&#46;C&#46;&#41; and interpretation &#40;J&#46;S&#46;S&#46;&#44; S&#46;A&#46;C&#46;&#44; M&#46;D&#46;&#44; and W&#46;S&#46;&#41; of the data&#46; J&#46;S&#46;S&#46; was involved in the writing&#44; and M&#46;D&#46; and W&#46;S&#46; reviewed and edited the manuscript&#46; B&#46;I&#46;P&#46; further reviewed the manuscript&#46; All authors contributed final approval and agreed to be accountable for all aspects of the work&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Physical activity is beneficial for preventing metabolic diseases&#46; Here&#44; the circulatory level of apelin&#44; one of the myokines&#44; was assessed in patients with obesity to examine the effects of body composition&#44; metabolic parameters&#44; and physical fitness on apelin secretion following an exercise program&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A total 60 subjects &#91;34 women &#40;21 lean and 13 overweight&#47;obese&#41; and 26 men &#40;8 lean and 18 overweight&#47;obese&#41;&#93;&#44; age 30&#8211;59 years&#44; with body mass index &#40;BMI&#41; of 18&#8211;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> were recruited based on the guidelines for Korean obesity therapy in a clinical trial&#46; Body composition&#44; biochemical parameters&#44; and physical fitness test were conducted&#46; A single bout of exhaustive exercise was performed following Bruce protocol&#46; Relationships among exercise-induced apelin&#44; metabolic factors&#44; and physical capacity were then analyzed&#46; Independent&#47;paired <span class="elsevierStyleItalic">t</span>-test between groups&#47;time points and <span class="elsevierStyleItalic">Pearson</span> correlations were performed&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">There were significant positive correlations in post-exercise apelin and lean mass &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#44; homeostatic model assessment of insulin resistance &#40;HOMA-IR&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#44; HOMA insulin secretion &#40;HOMA-&#37;B&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; lactate dehydrogenase &#40;LDH&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; grip strength &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#44; and isokinetic knee flexion and extension tests in 60&#176; and 240&#176;&#47;s &#40;all variables&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; but these parameters were not correlated with pre-exercise apelin&#46; Exercise was more effective in increasing apelin level in men compared to women&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Acute exercise increased circulating apelin&#44; which was more effective in obese compared to healthy men&#44; while no effect in women regardless of obesity status&#46; Thus&#44; apelin secretion after a single exercise is dependent on gender and metabolic status of subjects&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La actividad f&#237;sica es beneficiosa para prevenir las enfermedades metab&#243;licas&#46; Se evaluaron los niveles circulantes de apelina&#44; una mioquina&#44; en pacientes obesos para investigar los efectos de la composici&#243;n corporal&#44; los par&#225;metros metab&#243;licos y el estado f&#237;sico en la secreci&#243;n de apelina despu&#233;s de un programa de ejercicio&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Sesenta sujetos &#91;34 mujeres &#40;21 delgadas y 13 con sobrepeso&#47;obesidad&#41; y 26 varones &#40;8 delgados y 18 con sobrepeso&#47;obesidad&#41;&#93;&#44; de 30-59 a&#241;os&#44; con un &#237;ndice de masa corporal &#40;IMC&#41; de 18-30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> fueron incluidos en un ensayo cl&#237;nico basado en las directrices coreanas para el tratamiento de la obesidad&#46; Se evaluaron la composici&#243;n corporal&#44; los par&#225;metros bioqu&#237;micos y el estado f&#237;sico&#46; Se realiz&#243; una sola sesi&#243;n de ejercicio exhaustivo siguiendo el protocolo de Bruce&#46; A continuaci&#243;n se analizaron las relaciones entre la apelina inducida por el ejercicio&#44; los factores metab&#243;licos y el estado f&#237;sico&#46; Se realizaron pruebas de la <span class="elsevierStyleItalic">t</span> independientes&#47;por parejas entre grupos&#47;puntos temporales y correlaciones de Pearson&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se observaron correlaciones positivas y significativas entre los niveles de apelina despu&#233;s del ejercicio y la masa magra &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#44; modelo homeost&#225;tico de resistencia a la insulina &#40;HOMA-IR&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; la secreci&#243;n de insulina seg&#250;n el HOMA &#40;HOMA-&#37;B&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#44; el nivel de lactato deshidrogenasa &#40;LDH&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; la fuerza de prensi&#243;n &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41; y las pruebas isocin&#233;ticas de flexi&#243;n y extensi&#243;n de la rodilla en 60&#176; y 240&#176;&#47;s &#40;todas las variables&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; pero estos par&#225;metros no se correlacionaron con la apelina previa al ejercicio&#46; El ejercicio fue m&#225;s eficaz para aumentar los niveles de apelina en los varones que en las mujeres&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El ejercicio agudo increment&#243; los niveles de apelina circulante y fue m&#225;s eficaz en los varones obesos que en los sanos&#44; mientras que no se observ&#243; ning&#250;n efecto en las mujeres&#44; independientemente del estado de obesidad&#46; Por tanto&#44; la secreci&#243;n de apelina tras una &#250;nica sesi&#243;n de ejercicio depende del sexo y del estado metab&#243;lico de los sujetos&#46;</p></span>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Biochemical measurements such as plasma apelin&#44; lactate&#44; LDH&#44; and CK before and after an exhaustive acute exercise divided by gender and obesity &#40;A&#44; C&#44; E&#44; G&#58; men&#44; B&#44; D&#44; F&#44; H&#58; women&#41;&#46; All measurements are further presented using the area under the curve &#40;AUC&#41; separately&#46; Data presented as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#46; &#42;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 vs&#46; control and <span class="elsevierStyleSup">&#35;</span><span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 vs&#46; resting point&#46;</p>"
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; O&#47;Obese&#44; overweight&#47;obese&#59; HOMA-IR&#44; homeostatic model assessment of insulin resistance&#59; HOMA-&#37;B&#44; homeostatic model assessment of insulin secretion&#59; LDH&#44; lactate dehydrogenase&#59; CK&#44; creatine kinase&#59; VO<span class="elsevierStyleInf">2</span>max&#44; maximal volume of oxygen uptake&#59; R&#46;P&#46;E&#46; scale&#44; rating of perceived exertion&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">P</span>-values less than 0&#46;05 were statistically different &#40;in bold&#41;&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Women &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>34&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Men &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Gender difference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Lean &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">O&#47;Obese &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Lean &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">O&#47;Obese &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>-value &#40;Lean&#47;O&#47;Obese&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#40;a&#41; Demographics</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Age at consent&#44; y</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#46;43 &#40;9&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46;92 &#40;7&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;631&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46;38 &#40;9&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;67 &#40;4&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;192&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;205&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#40;b&#41; Body composition</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Body mass&#44; kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#46;38 &#40;5&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#46;12 &#40;5&#46;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#46;24 &#40;6&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#46;13 &#40;7&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Lean mass&#44; kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;45 &#40;3&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;80 &#40;4&#46;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;003</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;69 &#40;5&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;91 &#40;6&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;003</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Relative lean&#44; kg&#47;kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;63 &#40;0&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;59 &#40;0&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;010</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;75 &#40;0&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;72 &#40;0&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;030</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Fat mass&#44; kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;94 &#40;3&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;03 &#40;3&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;97 &#40;2&#46;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;50 &#40;2&#46;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;004</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Percent fat&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;83 &#40;4&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46;05 &#40;4&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;011</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;78 &#40;3&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;31 &#40;3&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;015</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">0&#46;265&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Exercise time&#44; min</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8&#46;64 &#40;0&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#46;27 &#40;0&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;260&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">12&#46;75 &#40;0&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&#46;92 &#40;1&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;133&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">R&#46;P&#46;E&#46; scale&#44; score</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">8&#46;48 &#40;1&#46;54&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#46;23 &#40;1&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;036</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">7&#46;88 &#40;1&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8&#46;56 &#40;1&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;255&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;341&#47;<span class="elsevierStyleBold">0&#46;025</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#40;f&#41; Physical strength</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Grip strength&#44; kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">22&#46;34 &#40;5&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23&#46;54 &#40;2&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;431&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">37&#46;24 &#40;4&#46;47&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">43&#46;77 &#40;8&#46;12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;044</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Relative grip strength&#44; kg&#47;kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;44 &#40;0&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;38 &#40;0&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;053&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;61 &#40;0&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;58 &#40;0&#46;10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;499&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Isokinetic strength &#40;R&#41;&#44; Nm</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 60&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">43&#46;95 &#40;9&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">50&#46;69 &#40;11&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;077&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">90&#46;88 &#40;16&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">101&#46;28 &#40;24&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;284&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 60&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">90&#46;86 &#40;20&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">96&#46;31 &#40;17&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;435&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">172&#46; 88 &#40;29&#46;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">198&#46;78 &#40;43&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 240&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;14 &#40;8&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">33&#46;69 &#40;8&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">53&#46;88 &#40;12&#46;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">60&#46;78 &#40;14&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;255&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 240&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#46;24 &#40;11&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">50&#46;62 &#40;11&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">88&#46;13 &#40;15&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">104&#46;28 &#40;21&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;067&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="8" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Relative strength &#40;R&#41;&#44; Nm&#47;kg</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 60&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;36 &#40;0&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;37 &#40;0&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;913&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;95 &#40;0&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;84 &#40;0&#46;40&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;518&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 60&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;80 &#40;0&#46;54&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;62 &#40;0&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;306&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3&#46;69 &#40;0&#46;39&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;60 &#40;0&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;697&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 240&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;89 &#40;0&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;92 &#40;0&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;732&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;15 &#40;0&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;10 &#40;0&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;601&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;009&#47;0&#46;018</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 240&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;36 &#40;0&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;37 &#40;0&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;930&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;89 &#40;0&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;89 &#40;0&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;995&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Isokinetic strength &#40;L&#41;&#44; Nm</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 60&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">43&#46;43 &#40;10&#46;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">49&#46;69 &#40;9&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#46;75 &#40;10&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;44 &#40;24&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;298&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 60&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;95 &#40;20&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">94&#46;92 &#40;9&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;261&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">162&#46;50 &#40;22&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">187&#46;89 &#40;39&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 240&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;43 &#40;7&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;23 &#40;8&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;043</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#46;75 &#40;12&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;72 &#40;15&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;350&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleBold">0&#46;001</span>&#47;&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 240&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">43&#46;14 &#40;10&#46;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">49&#46;62 &#40;8&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 60&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Knee 240&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Pearson</span> correlation was examined&#46; <span class="elsevierStyleItalic">Abbreviations</span>&#58; HOMA-IR&#44; homeostatic model assessment of insulin resistance&#59; HOMA-&#37;B&#44; homeostatic model assessment of insulin secretion&#59; LDH&#44; lactate dehydrogenase&#59; CK&#44; creatine kinase&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">P</span>-values less than 0&#46;05 were statistically different &#40;in bold&#41;&#46;</p>"
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                  \t\t\t\t">HOMA-&#37;B&#40;rest&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Lactate&#40;rest&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2075450.png"
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            1 => array:2 [
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                0 => """
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Lactate&#40;0<span class="elsevierStyleHsp" style=""></span>min&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2075453.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Association between apelin and biochemical measurements in circulation&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Pearson</span> correlation was examined&#46; <span class="elsevierStyleItalic">Abbreviations</span>&#58; VO<span class="elsevierStyleInf">2</span>max&#44; maximal volume of oxygen uptake&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">P</span>-values less than 0&#46;05 were statistically different &#40;in bold&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Apelin &#40;rest&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Apelin &#40;0<span class="elsevierStyleHsp" style=""></span>min&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Apelin &#40;15<span class="elsevierStyleHsp" style=""></span>min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Apelin &#40;30<span class="elsevierStyleHsp" style=""></span>min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">VO<span class="elsevierStyleInf">2</span>max&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grip strength&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Isokinetic knee &#40;R&#41; 60&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Isokinetic knee &#40;R&#41; 60&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Isokinetic knee &#40;L&#41; 60&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Isokinetic knee &#40;L&#41; 60&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Isokinetic knee &#40;R&#41; 240&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Isokinetic knee &#40;R&#41; 240&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Isokinetic knee &#40;L&#41; 240&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Isokinetic knee &#40;L&#41; 240&#176;&#47;s extension&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Apelin&#40;rest&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apelin&#40;0<span class="elsevierStyleHsp" style=""></span>min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">r</span><span class="elsevierStyleItalic">P</span>-value&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;758&#60;<span class="elsevierStyleBold">0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Apelin&#40;30<span class="elsevierStyleHsp" style=""></span>min&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Grip strength&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Isokinetic knee &#40;R&#41; 60&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Isokinetic knee &#40;L&#41; 60&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Isokinetic knee &#40;R&#41; 240&#176;&#47;s flexion&nbsp;\t\t\t\t\t\t\n
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        "texto" => "<p id="par0140" class="elsevierStylePara elsevierViewall">The authors would like to thank Health and Exercise Science Laboratory&#46; This work was supported by the National Research Foundation of Korea &#40;NRF&#41; and funded by the <span class="elsevierStyleGrantSponsor" id="gs1">Ministry of Science&#44; ICT and Future Planning</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs1">NRF-2013M3A9B6046417</span>&#44; Korea Mouse Phenotyping Project NRF-2013M3A9D5072550&#41; and KINDS Co&#46; In addition&#44; the work was partially funded by <span class="elsevierStyleGrantSponsor" id="gs2">NIH</span><span class="elsevierStyleGrantNumber" refid="gs2">R01HD067449</span>&#46;</p>"
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