Melnikov Andrey A, Vikulov Alexander D, Bagrakova Svetlana V
Pedagogical University, Respublikanskaya 108, 150000 Yaroslavl, Russia.
Clin Hemorheol Microcirc. 2003;29(1):19-24.
It is well established that exercise performance in athletes is related to improved blood fluidity. However, training effects on functional state of endothelium and relations of endothelial cell functions with hemorheology are poorly known. Circulating levels of von Willebrand factor may serve as a good marker of endothelial cell functions, its activation, and damage. Relationships between von Willebrand factor antigen (vWf) and blood rheology in 30 endurance sportsmen were investigated. Athletes were divided according to vWf into tertile groups. Compared to 16 controls, all subgroups of sportsmen had a lower erythrocyte rigidity index Tk (p<0.05-0.01), explained by lower values of mean corpuscular hemoglobin concentration (MCHC) (p<0.05-0.01), and a higher W170. The lower tertile group (<0.35 U/ml) had a lower blood viscosity (p<0.05), explained by a lower Tk, and a lower erythrocyte aggregability index (microscopy of diluted blood samples) (p<0.05). The upper tertile group of athletes demonstrated higher levels of plasma viscosity, explained by higher total globulins (p<0.01), and higher vWf levels (p<0.01) than controls, and a lower W170 compared to athletes from the lower tertile subgroup. In the entire group of athletes, log (vWf) was positively correlated to plasma viscosity (r=0.478, p=0.007), total serum globulins (r=0.430, p=0.018), erythrocyte aggregability index (r=0.427, p=0.019), and negatively to log (W170) (r=-0.449, p=0.013). Multiple stepwise regression analysis revealed that plasma viscosity was the primary correlate of vWf. These data shown that the higher von Willebrand level reflecting strong activation of endothelial cells in a part of athletes was closely correlated with increased plasma viscosity levels. We suggest that these hemorheological and endothelial disturbances in these athletes might be a result of exercise overloads.
众所周知，运动员的运动表现与血液流动性的改善有关。然而，训练对内皮功能状态的影响以及内皮细胞功能与血液流变学的关系却鲜为人知。血管性血友病因子的循环水平可作为内皮细胞功能、其激活和损伤的良好标志物。研究了30名耐力运动员血管性血友病因子抗原（vWf）与血液流变学之间的关系。根据vWf将运动员分为三分位数组。与16名对照组相比，所有运动员亚组的红细胞刚性指数Tk均较低（p<0.05 - 0.01），这是由平均红细胞血红蛋白浓度（MCHC）值较低（p<0.05 - 0.01）所致，且W170较高。三分位数较低组（<0.35 U/ml）的血液粘度较低（p<0.05），这是由较低的Tk和较低的红细胞聚集指数（稀释血样显微镜检查）（p<0.05）所致。运动员三分位数较高组的血浆粘度水平较高，这是由总球蛋白较高（p<0.01）和vWf水平高于对照组（p<0.01）所致，且与三分位数较低亚组的运动员相比W170较低。在整个运动员组中，log（vWf）与血浆粘度（r = 0.478，p = 0.007）、总血清球蛋白（r = 0.430，p = 0.018）、红细胞聚集指数（r = 0.427，p =0.019）呈正相关，与log（W170）呈负相关（r = -0.449，p = 0.013）。多元逐步回归分析显示，血浆粘度是vWf的主要相关因素。这些数据表明，在部分运动员中反映内皮细胞强烈激活的较高血管性血友病因子水平与血浆粘度水平升高密切相关。我们认为这些运动员的这些血液流变学和内皮功能紊乱可能是运动负荷过重的结果。
