The associations between leisure-time physical activity and inflammatory and coagulation markers related to cardiovascular disease: the ATTICA Study
Introduction
In recent years, health care professionals have focus on prevention and therapy of the cardiovascular diseases through the evaluation and modification of several risk factors. Among the factors that may influence the occurrence of cardiovascular disease, the beneficial effect of physical activity on human health has been underlined in several studies, but the exact mechanisms are not well understood [1], [2], [3], [4], [5]. Recent findings support that inflammation plays a role in the pathogenesis of cardiovascular disease [6], [7], [8]. For example, some suggest that levels of C-reactive protein (CRP) in apparently healthy persons or patients with stable angina pectoris constitute an independent risk factor for cardiovascular events [9]. Moreover, since coronary heart disease (CHD) is increasingly seen as an inflammatory process, it is reasonable to hypothesize that physical activity reduces risk of coronary heart disease by reducing or preventing inflammation [10]. However, the strength of the association between several inflammation markers and physical activity is not fully investigated, since several potential confounders may influence it.
The aim of this work is to investigate the association between leisure-time physical activity and inflammation markers related to coronary heart disease [high sensitivity CRP, interleukin (IL)-6, tumor necrosis factor (TNF)-α, fibrinogen, serum amyloid-A (SAA), and white blood cell (WBC) counts], in a population-based sample of healthy adults.
Section snippets
Study's sample and design
The “ATTICA” study is a health and nutrition survey, carried out in the province of Attica (including 78% urban and 22% rural areas), where Athens is a major metropolis. The sampling was random, multistage, and on the city–gender–age distribution of the province of Attica provided by the National Statistical Service (census of 2001). The study's design anticipates enrolling only one participant per household. The number of the participants was determined by power analysis and chosen to evaluate
Results
Table 1 presents the investigated characteristics of the participants according to their physical activity status. From physically active participants, 5% of men and 2% of women reported only resistance training, while 7% of men and 12% of women reported only endurance training. Eight hundred seventy-four (57%) of men and 903 (59%) of women were classified as sedentary. Physically active participants were significantly younger and were less frequent to be active smokers, as compared to
Discussion
Our findings support that inflammatory markers are significantly lower in physically active individuals than those leading a sedentary lifestyle. More specifically, participants in the highest fitness tertile exhibited significantly lower concentrations of CRP, SAA, TNF-α, IL-6, WBC, and fibrinogen than the sedentary group.
The health benefits of a physically activity lifestyle are well recognized. In particular, the risk of coronary heart disease mortality or morbidity is inversely related to
Acknowledgments
The ATTICA Study is funded by research grants from the Hellenic Society of Cardiology.
The authors would like to thank the field investigators of “ATTICA” study: Dr. John Skoumas (principal field investigator), Dr. Natasa Katinioti (physical examination), Dr. Spiros Vellas (physical examination), Dr. Efi Tsetsekou (physical/psychological evaluation), Dr. Dina Masoura (physical examination), and Dr. Lambros Papadimitriou (physical examination); as well as the technical team: Dr. Marina Toutouza
References (24)
- et al.
A questionnaire for the assessment of leisure time physical activities
J. Chronic Dis.
(1978) From research to education: the Greek experience
Nutrition
(2000)- et al.
Mediterranean diet pyramid: a cultural model for healthy eating
Am. J. Clin. Nutr.
(1995) - et al.
Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men
JAMA
(1999) - et al.
Physical activity and coronary heart disease in men: the Harvard Alumni Health Study
Circulation
(2000) Physical Activity and Health: a Report of the Surgeon General
(1996)- et al.
Physical activity and stroke risk: the Framingham Study
Am. J. Epidemiol.
(1994) - et al.
Physical activity and stroke incidence: the Harvard Alumni Health Study
Stroke
(1998) C-reactive protein and risks of future myocardial infarction and thrombotic stroke
Eur. Heart J.
(1998)- et al.
C-reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study
BMJ
(1996)
Relationship of C-reactive protein to risk of cardiovascular disease in the elderly
Arterioscler., Thromb., Vasc. Biol.
C-reactive protein as a cardiovascular risk factor. More than an epiphenomenon?
Circulation
Cited by (133)
Association of Motoric Cognitive Risk Syndrome with Cardiovascular and Noncardiovascular Factors: A Systematic Review and Meta-Analysis
2022, Journal of the American Medical Directors AssociationInflammation and cardiovascular disease: From mechanisms to therapeutics
2020, American Journal of Preventive CardiologyVitamin D and selected cytokine concentrations in postmenopausal women in relation to metabolic disorders and physical activity
2020, Experimental GerontologyCitation Excerpt :Similarly, in the study of Sun et al. (2014), serum 25(OH)D concentrations were not significantly related to IL-6 or IFN-γ levels in healthy Japanese adults, even after adjustment for gender, age, vitamin D intake, alcohol consumption, smoking status, percent body fat, and MVPA. A number of studies have shown that higher physical activity levels are associated with lower circulating levels of proinflammatory cytokines and higher levels of serum 25(OH)D. Panagiotakos et al. (2005) and Scragg and Camargo (2008) demonstrated that a high degree of physical activity is associated with attenuated circulating levels of inflammatory cytokine, and that highly active individuals have significantly higher circulating levels of 25(OH)D than inactive individuals. The confounding effect of PA thus needs to be considered when investigating the association between serum 25(OH)D and inflammatory cytokines (Panagiotakos et al., 2005; Golzari et al., 2010; Scragg and Camargo, 2008).
Effect of onion (Allium cepa L.) peel extract on natural killer cell and cytokines in a randomized, double-blind, placebo-controlled trial
2024, Nutrition Research and Practice