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00019616-200901000-00009Miscellaneous-ArticleThe EndocrinologistThe Endocrinologist© 2009 Lippincott Williams & Wilkins, Inc.19January 2009 p 24-30Hormonal and Metabolic Responses to Whole Body Vibration in Healthy AdultsPreliminary StudyFricke, Oliver MD*; Semler, Oliver MD*; Land, Christof MD*; Beccard, Ralf PhD*; Thoma, Philipp MD†; Schoenau, Eckhard MD*From the *Children's Hospital, University of Cologne, Cologne, Germany; and †Department of Internal Medicine II, University of Cologne, Cologne, Germany.Supported by Novo Nordisk.Reprints: Oliver Fricke, MD, Children's Hospital, University of Cologne, Kerpener Street 62, D-50924 Cologne, Germany. E-mail: [email protected] purpose of this study is to investigate the effect of side-alternating whole body vibration (WBV) on hormone secretion and metabolism in healthy adults. Twenty voluntary participants (10 women) were recruited for the experiment to measure hormonal and metabolic responses to WBV (oscillation frequency, 26 Hz; amplitude, 1 mm; acceleration, 2.7 g) in blood samples drawn before, during and after WBV. WBV increased growth hormone serum levels in men and decreased them in women. Adrenocorticotropic hormone and cortisol decreased. Thyroid stimulating hormone, free T3, and free T4 decreased after WBV. Prolactin decreased in men. The secretion of gonadal hormones was not significantly influenced. Lactate levels increased during WBV and glucose levels decreased. Our results suggest that hormonal and metabolic responses to WBV do not simply reflect intensive exercising. The responses were characterized by a pattern of hormonal secretion typical for responses to mechanical vibrations of the whole body.Whole body vibration (WBV) is recently described as a promising therapeutic strategy to improve motor function in immobilized children and adolescents.1–4 Recent reports point out that vibration therapy can increase muscular power and force2,3 in completely or partly immobilized patients, reduce bone reabsorption, and reduce calcium excretion,5 and appears to increase bone density,1 cortical bone area, and paraspinous musculature6 in man, and increase bone formation in mice7 and rats.8 The effects of vibration therapy on bone formation were also reported for low acceleration (low magnitude mechanical) signals that do not stimulate the muscular spinal reflex arc, in contrast to side-alternating WBV.6–8 It is not known if the observed effects on bone and muscle are primarily induced by direct vibrational effects on bone and muscle tissue or by secondary effects mediated by the alteration of hormonal secretion or activation of the muscular spinal reflex arc. The effect of vibration on hormonal secretion was explored in recently published studies focused on men9–14 and rodents.15,16 The studies conducted in humans produced differing results that also deviate from results reported in intensive exercises.17,18 Reports on vibration training were not consistent in the induction of growth hormone (GH) and testosterone release and deviated from the increased cortisol release reported in intensive exercising. Therefore, a mechanism beyond the already known hormonal response to extensive exercising was suggested to explain the observations of hormonal responses to WBV.The present study was conducted to obtain data that could amplify our present understanding of the hormonal responses to side-alternating WBV. Because the recently published results were focused only on men, the present study includes women. In addition, several hormones were analyzed during WBV that had not been analyzed in the previously reported studies (prolactin; LH, luteinizing hormone; FSH, follicle stimulating hormone; ACTH, adrenocorticotropic hormone; TSH, thyroid stimulating hormone; fT3, free triiodothyronine; fT4, free thyroxine; 17β-estradiol; and progesterone).SUBJECTS AND METHODSSubjectsTwenty healthy (10 women) adult (≥8 years and ≤40 years) subjects voluntarily participated in the present study. The mean age was 32.1 ± 5.8 years (men) and 32.0 ± 6.9 years (women). The mean height was 188.3 ± 7.4 cm in men (N = 9; height and weight were not measured in 1 man) and 167.2 ± 8.3 cm in women (N = 7; height and weight were not measured in 3 women). The mean weight was 79.4 ± 7.6 kg in men (N = 9) and 59.0 ± 7.7 kg in women (N = 7). All subjects are physically active and not immobilized. Pregnant women were excluded from the experiment. Each subject was instructed on the protocol. All gave written and informed consent to participate in the experiment. All were examined by a physician before the experiment to exclude relevant diseases or potential drugs that could interfere with the experimental procedure. The experiment was approved by the ethics committee of the University of Cologne and was consistent with the Declaration of Helsinki (2000).Treatment ProcedureWhole body vibration (WBV) was performed on a commercially available vibration platform (Galileo 2000, Novotec Medizintechnik GmbH, Pforzheim, Germany). Vibration on the entire body is applied by side-alternating rotation around the central axis of the platform on which the subject is standing. The amplitude increases with distance from the rotational center, and the frequency can be freely adjusted to 1 to 30 Hz. The platform produces sinusoidal oscillations and the acceleration transmitted to the body is calculated as a = A (2π f)2, where A is the amplitude of oscillations and f is the frequency.19 Subjects removed their shoes during the experimental period to ensure that the soles of the footwear would not dampen the vibrations. The vibration conditions were performed with the subject in a half squat position, with body mass distributed over the balls of the feet and heels raised off the vibrating platform. The vertical sinusoidal WBV was applied with the amplitude of 1 mm. The frequency was set to 26 Hz. Therefore, the calculated acceleration on the platform was a = 2.7 g (g = 9.81 m/s2). The complete treatment session consisted of 2 series of 5 times WBV for 60 seconds each with 60 seconds break between WBV episodes. The 2 series were interrupted by a break of 6 minutes while a blood sample was drawn 1 minute after the first set (t = 10). An upright relaxed posture was adopted during rest periods between WBV courses, and the participants were sitting on a chair during the 6 minutes break between the 2 series of WBV.Hormonal and Metabolic Response to WBVParticipants were not allowed to exercise on the day before the experiment. On the morning of the WBV treatment subjects reported to the laboratory at 8 am following an overnight fast. Blood samples were drawn from a superficial forearm vein 1 minute before starting WBV, and 10 (t = 10), 35 (t = 35), and 60 minutes (t = 60) after starting WBV. WBV was finished after 24 minutes Therefore t = 35 and t = 60 represent hormone levels 11 and 36 minutes after the end of WBV. The blood samples were drawn with minimal stasis for the determination of hormones and metabolic parameters. An indwelling catheter was inserted 30 minutes before the WBV experiment and kept patent by flushing with sterile 0.9% NaCl to allow blood collection later during the experiment. Blood samples for GH analysis were centrifuged at 17,000 g for 2 minutes and serum was subsequently stored at −30°C until it was analyzed. Blood samples for all other analyses were immediately transferred to the analytical laboratory (Department of Clinical Chemistry, University of Cologne) to start the analysis in less than 30 minutes after blood samples were drawn. Hormone concentrations were measured using commercially available methods. Blood samples were handled and assays were carried out in accordance with the manufacturer's instructions. Commercially available standards and quality control samples were used for assays. Metabolic parameters (glucose, lactate) were analyzed in plasma samples and all other parameters in serum samples.Analytical MethodsHuman GH was analyzed using the Immulite 1000 Analyzer (DPC, Los Angeles, CA). ACTH was measured using a chemiluminiscence-immunoassay (Immulite 2000, Siemens Medical Solutions Diagnostics, Munich, Germany) in EDTA-plasma. Cortisol, TSH, fT3, fT4, prolactin, FSH, LH, testosterone, 17β-estradiol, progesterone were analyzed in serum samples using electro-chemiluminiscence-immunoassays (Elecsys-Cortisol, Elecsys-TSH, Elecsys-fT4, Elecsys-fT3, Elecsys-prolactin II, Elecsys-FSH, Elecsys-LH, Elecsys-testosterone, Elecsys-estradiol II, Elecsys-progesterone II; all purchased from Roche Diagnostics, Rotkreuz, Switzerland) in the analyzing system Modular E-Modul (Roche Diagnostics). Glucose and lactate were measured in heparin- (glucose) and fluoride-plasma (lactate) samples using Gluco-quant-test and Lactate-test (Roche Diagnostics) in the analyzing system Modular P-Modul (Roche Diagnostics).Statistical AnalysesDescriptive statistical parameters (mean, standard deviation) were calculated for hormones and metabolic parameters to compare the levels of hormones and metabolic parameters at different time points (t = −1, 10, 35, 60) statistically (paired Student t tests, 2-tailed). Differences between genders were analyzed by 2-tailed unpaired Student t tests for equal or differing variances after F tests for the comparison of variances between compared groups. Statistical differences were ascribed to be significant at P < 0.05. All statistical procedures were performed by the use of SPSS for Windows Version 14.0 (SPSS Inc, Chicago, IL).RESULTSHormones and metabolic parameters before the start of WBV are displayed in Table 1. Men and women had significantly different GH levels before WBV (P = 0.006). WBV was characterized by different effects on GH when men and women were compared (Fig. 1). GH increased in men during WBV and was significantly higher after WBV than before the start of WBV in men. Glucose levels decreased significantly after WBV (Table 2). The course of glucose levels was not significantly different between men and women (Fig. 2). But an upward tendency (comparison of glucose levels between t = −1 and t = 35 with P = 0.058 and comparison of glucose levels between t = −1 and t = 60 with P = 0.051 were close to significance) was visible in men in contrast to women. WBV significantly increased lactate levels (Table 2). Men and women were not characterized by different lactate levels before WBV (P = 0.886). Lactate levels significantly increased in women and men during WBV, but the trend to increase was broader in men than in women (comparison of lactate levels between men and women at different point of time: P = 0.05 at t = 10 and P = 0.063 at t = 35; Fig. 3). ACTH and cortisol levels decreased and were still lower 36 minutes after WBV than levels at beginning (Fig. 4). TSH and fT3 levels increased during WBV and were inversely regulated in such a way that 36 minutes after WBV, TSH, and fT3 were significantly lower than levels before WBV (Fig. 5). The level of fT4 was regulated in a parallel direction, but fT4 was not lower than at rest 36 minutes after WBV (Fig. 5). Prolactin levels were significantly decreased in men, but not in women (Fig. 6). In contrast to LH, FSH levels were significantly increased during WBV and inversely regulated in such way that FSH levels were significantly decreased in women after WBV (Fig. 7). Testesterone levels were not significantly decreased in men (Fig. 8) and levels of 17β-estradiol and progesterone (Fig. 8) were not significantly decreased in women due to WBV. The summary of relevant statistical comparisons is displayed in Table 2 and schematically illustrated in Table 3.JOURNAL/endst/04.03/00019616-200901000-00009/table1-9/v/2021-02-17T201901Z/r/image-tiff Hormonal and Metabolic Characteristics of the Study Group Before Starting WBVJOURNAL/endst/04.03/00019616-200901000-00009/figure1-9/v/2021-02-17T201901Z/r/image-tiff Mean and 95% CI of growth hormone. Men and women were different for GH levels before WBV (P = 0.006). GH increased significantly in men during WBV in contrast to women. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**).JOURNAL/endst/04.03/00019616-200901000-00009/table2-9/v/2021-02-17T201901Z/r/image-tiff Significant (P < 0.05) Hormonal and Metabolic Differences Before and After WBVJOURNAL/endst/04.03/00019616-200901000-00009/figure2-9/v/2021-02-17T201901Z/r/image-tiff Mean and 95% CI of glucose. The course of glucose levels was not significantly different between men and women. An upward tendency of glucose levels was visible in men.JOURNAL/endst/04.03/00019616-200901000-00009/figure3-9/v/2021-02-17T201901Z/r/image-tiff Mean and 95% CI of lactate. Men and women were not different for lactate levels before WBV. Lactate levels significantly increased in men and women during WBV. In tendency, the increase of lactate was higher in men than in women.JOURNAL/endst/04.03/00019616-200901000-00009/figure4-9/v/2021-02-17T201901Z/r/image-tiff Mean and 95% CI of ACTH and of cortisol. ACTH and cortisol levels significantly decreased during WBV. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**).JOURNAL/endst/04.03/00019616-200901000-00009/figure5-9/v/2021-02-17T201901Z/r/image-tiff Mean and 95% CI of thyreoid hormones. TSH and fT3 levels significantly increased during WBV and were reversely regulated that TSH and fT3 levels were significantly lower at 36 minutes after WBV than levels before WBV. The level of fT4 was regulated in parallel direction to TSH and fT3. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**).JOURNAL/endst/04.03/00019616-200901000-00009/figure6-9/v/2021-02-17T201901Z/r/image-tiff Mean and 95% CI of prolactin. Prolactin levels significantly decreased in men, but not in women. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**).JOURNAL/endst/04.03/00019616-200901000-00009/figure7-9/v/2021-02-17T201901Z/r/image-tiff Mean and 95% CI of gonadotropins. FSH levels were significantly increased during WBV and reversely regulated. LH levels were significantly decreased in women. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**).JOURNAL/endst/04.03/00019616-200901000-00009/figure8-9/v/2021-02-17T201901Z/r/image-tiff Mean and 95% CI of gonadal hormones. Testosterone, 17β-estradiol, and progesterone were not significantly influenced by WBV in men and women, respectively.JOURNAL/endst/04.03/00019616-200901000-00009/table3-9/v/2021-02-17T201901Z/r/image-tiff Schematic Summary of Results Displayed in Table 2DISCUSSIONOur data partly support results obtained in previously conducted studies on the effects of WBV on hormones and metabolic parameters and allow the characterization of differences between men and women in their responses to WBV. In contrast to Di Loreto et al,11 Kvorning et al,12 and Bosco et al13 reported an acute increase of GH and decrease of cortisol in men which was consistent with our data for men. The previously published report of a trend in an increase of salivary cortisol was measured 2 hours after WBV and was outside the time range of the present study.9 In contrast to Bosco et al13 and in accord with Kvorning et al12 Cardinale et al,10 Di Loreto et al,11 and Erskine et al,9 serum testosterone levels did not acutely change in men receiving WBV. Kvorning et al discussed their different result on testosterone levels in comparison with Bosco et al and pointed out that heavy loads resulting in high forces are needed to stimulate the release of testosterone. Participants were trained with 17 g in the study conducted by Bosco et al13 much higher forces (force = acceleration × mass) applied to the vibrated subject compared with our data (2.7 g; 26 Hz, amplitude = 1 mm) and the studies conducted by Kvorning et al (6 g; 20 Hz, amplitude = 4 mm),12 Cardinale et al (maximal 10.8 g; 30 Hz, amplitude = 3 mm),10 and Erskine et al (3.5 g; 30 Hz, amplitude = 2 mm).9 Therefore, the higher acceleration in the study by Bosco et al13 may explain the increased release of testosterone in comparison with our data and with data reported from Kvorning et al,12 Cardinale et al,10 and Erskine et al.9 This consideration is not supported by results published by Di Loreto et al,11 who did not report an increase of testosterone secretion secondary to WBV with 17 g (30 Hz, amplitude = 4 mm) which was similar to the procedure reported by Bosco et al.13Di Loreto et al11 reported a slight decrease of plasma glucose that was also seen in our data when men and women were not analyzed separately. Interestingly, men were characterized by the tendency to show a stronger increase of lactate levels than women when WBV was applied. Therefore, men have performed their muscle work with more anearobically than women. This result may explain the different response of GH secretion in men and women. Because the muscular system in men was more activated by WBV, GH levels increased in men in contrast to women characterized by decreasing GH levels. Alternatively, there may be a different mechanism between men and women controlling the secretion of GH due to the application of WBV. But the significant difference between men and women for the secretion of prolactin supports the first hypothesis that men experience a stronger muscular activation from WBV explaining the increase of GH in men in contrast to women. The decrease of prolactin in men is not induced by the secretion of the prolactin, because levels of TSH and peripheral hormones of the thyroid gland were increased by WBV. The causality to explain which hormone induced the release of other hormones in this complex interaction between pituitary and peripheral hormones and metabolites during WBV may not be understandable because of the methodological limitations of the present study design. The time lapse between different points of measurements was too large for a detailed analysis of a strict order of hormonal secretion.As far as we know, the present study provides data on the secretion of gonadotropins during and after WBV for the first time. FSH and LH were characterized by different courses, FSH significantly increased in men and women in contrast to LH, which significantly decreased in women. The alteration of the secretion of hypothalamic hormones did not influence the secretion of peripheral gonadal hormones in men and women within 1 hour of WBV which is consistent with the stable serum LH levels in men.Because the cortiscol level decreased, the hormonal response to vibration is likely not characterized by a general stress reaction or a response typical for high intensity exercises.13,20 Bosco et al13 suggested that the activation of hypothalamic autonomic and neurosecretory centers by collaterals of the central motor command in combination with positive feedback influences from proprio-and metaboreceptors in muscles. Influences from hippocampal serotonergic structures were discussed to explain the decrease of cortisol that was also visible in our data.13,21 The finding that WBV induces an increase of serotonin (5-HT) in the brain in combination with decreased plasma cortisol levels was also previously reported by Ariizumi and Okada15 in the rat. Therefore, available data on the effect of WBV on the secretion of cortisol are consistent in human and animal studies in contrast to data on the release of GH that partly provide evidence that mechanical vibration-induced activation of muscle afferents is capable of producing a hormonal response primarily modulating the release of GH in both rats16 and man.14,22 The present results in men support these reports in contrast to our data in women.As far as we know, our data on women are the first data reported on WBV in women. Because the course of GH secretion during WBV was different between men and women, the question can be raised that gender differences in the control of GH secretion by muscle afferents are responsible for this remarkable contrast of GH secretion. Alternatively, differences of the exercise intensity might be responsible for this observation. Because men are characterized by a greater body and muscle mass, the same acceleration induces higher forces (acceleration × mass) inside the male body. But our data are unable to clarify these open questions.CONCLUSIONOur data are consistent with the previously reported finding that WBW induces the release of GH and decreases the secretion cortisol in men. In contrast to men, WBV in women decreased the release of GH. Prolactin levels were decreased by WBV in men. Thyreoideal hormone secretion was suppressed by WBV. The secretion of gonadal hormones was not significantly influenced. Our data do not clarify the mechanisms behind these differences. More sophisticated studies are required to understand the causality of the present effects.REFERENCES1. Semler O, Fricke O, Vezyroglou K, et al. Preliminary results on the mobility after whole body vibration in immobilized children and adolescents. J Musculoskelet Neuronal Interact. 2007;7:77–81.[Context Link][Medline Link]2. 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Exerc Sport Sci Rev. 2001;29:164–169.[Context Link][Full Text][CrossRef][Medline Link]whole body vibration; lactate; growth hormone; cortisol; testosterone00019616-200901000-0000900134502_2006_26_380_cardinale_preliminary_|00019616-200901000-00009#xpointer(id(citation_FROM_JRF_ID_d1957e1044_citationRF_FLOATING))|11065404||ovftdb|SL0013450220062638011065404citation_FROM_JRF_ID_d1957e1044_citationRF_FLOATING[Full 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Men and women were different for GH levels before WBV (P = 0.006). GH increased significantly in men during WBV in contrast to women. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**). Significant (P < 0.05) Hormonal and Metabolic Differences Before and After WBV Mean and 95% CI of glucose. The course of glucose levels was not significantly different between men and women. An upward tendency of glucose levels was visible in men. Mean and 95% CI of lactate. Men and women were not different for lactate levels before WBV. Lactate levels significantly increased in men and women during WBV. In tendency, the increase of lactate was higher in men than in women. Mean and 95% CI of ACTH and of cortisol. ACTH and cortisol levels significantly decreased during WBV. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**). Mean and 95% CI of thyreoid hormones. TSH and fT3 levels significantly increased during WBV and were reversely regulated that TSH and fT3 levels were significantly lower at 36 minutes after WBV than levels before WBV. The level of fT4 was regulated in parallel direction to TSH and fT3. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**). Mean and 95% CI of prolactin. Prolactin levels significantly decreased in men, but not in women. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**). Mean and 95% CI of gonadotropins. FSH levels were significantly increased during WBV and reversely regulated. LH levels were significantly decreased in women. Significant differences between t = −1 and t = 10, 35, or 60 are indicated by an asterisk (*). A significant difference to the precedent point of time is indicated by a doubled asterisk (**). Mean and 95% CI of gonadal hormones. Testosterone, 17β-estradiol, and progesterone were not significantly influenced by WBV in men and women, respectively. Schematic Summary of Results Displayed in Table 2Hormonal and Metabolic Responses to Whole Body Vibration in Healthy AdultsFricke Oliver MD; Semler, Oliver MD; Land, Christof MD; Beccard, Ralf PhD; Thoma, Philipp MD; Schoenau, Eckhard MDPreliminary StudyPreliminary Study119p 24-30