Verdaet D, Dendale P, De Bacquer D, Delanghe J, Block P, De Backer G
Department of Cardiology, Hospital of the Free University of Brussels (AZ-VUB), Cardiac Rehabilitation, Laarbeeklaan 101, 1090 Brussels, Belgium.
Atherosclerosis. 2004 Oct;176(2):303-10. doi: 10.1016/j.atherosclerosis.2004.05.007.
Some markers of chronic inflammation have been recognized as predictors of cardiovascular risk in apparently healthy subjects and in patients with coronary heart disease (CHD). High sensitivity C-reactive protein (CRP) appears to be the most useful marker in clinical settings. Several studies reported associations between inflammatory markers and other cardiovascular risk factors, such as age, obesity, cholesterol levels, the presence of diabetes mellitus, physical activity, social level and smoking habits. We focussed on the association between C-reactive protein, serum amyloid A (SAA), fibrinogen and leisure time physical activity (LTPA).
This report deals with the results observed in a sub-sample of the BELSTRESS study. 892 male subjects, free from clinical CHD and major ECG abnormalities, working in the same environment, aged 35-59 years, were selected. A questionnaire was used to estimate the level of leisure time physical activity. Associations between CRP, SAA, fibrinogen and leisure time physical activity were evaluated through univariate and multivariate methods. Subjects taking statins or other lipid lowering medication were excluded from the study.
Regular leisure time physical activity is associated with reductions of several cardiovascular risk factors, such as body mass index (BMI), waist hip ratio and the lipid profile. Smokers and low educated subjects had a lower physical activity status. Age adjustment did not alter the means of inflammatory parameters according to the levels of leisure time physical activity. After correction for personal characteristics (BMI, current smoking status, educational level, presence of diabetes and alcohol consumption) no significant relation was found between leisure time physical activity and levels of inflammatory markers. The differences of CRP and fibrinogen according to the level of physical activity, found in bivariate analysis, seem to be explained by linked differences in BMI, or related to current smoking habits. Leisure time physical activity, as reported in this study, is not significantly related to C-reactive protein, serum amyloid A or fibrinogen levels, after correction for other cardiovascular risk factors.
These data indicate that leisure time physical activity, as reported in our study, is not an independent predictor of C-reactive protein, serum amyloid A or fibrinogen levels. Possible interactions of physical activity and other cardiovascular risk factors might explain the (indirect) relation we found in the bivariate analysis.
一些慢性炎症标志物已被视为健康受试者和冠心病（CHD）患者心血管风险的预测指标。高敏C反应蛋白（CRP）似乎是临床环境中最有用的标志物。几项研究报告了炎症标志物与其他心血管危险因素之间的关联，如年龄、肥胖、胆固醇水平、糖尿病的存在、体力活动、社会阶层和吸烟习惯。我们重点关注C反应蛋白、血清淀粉样蛋白A（SAA）、纤维蛋白原与休闲时间体力活动（LTPA）之间的关联。
本报告涉及在BELSTRESS研究的一个子样本中观察到的结果。选取了892名年龄在35 - 59岁、无临床CHD和主要心电图异常、在相同环境工作的男性受试者。使用问卷调查来估计休闲时间体力活动水平。通过单变量和多变量方法评估CRP、SAA、纤维蛋白原与休闲时间体力活动之间的关联。服用他汀类药物或其他降脂药物的受试者被排除在研究之外。
规律的休闲时间体力活动与多种心血管危险因素的降低相关，如体重指数（BMI）、腰臀比和血脂谱。吸烟者和受教育程度低的受试者体力活动水平较低。年龄调整并未改变根据休闲时间体力活动水平划分的炎症参数均值。在校正个人特征（BMI、当前吸烟状况、教育水平、糖尿病的存在和饮酒情况）后，未发现休闲时间体力活动与炎症标志物水平之间存在显著关系。在双变量分析中发现的根据体力活动水平划分的CRP和纤维蛋白原差异，似乎可以由BMI的相关差异或与当前吸烟习惯有关来解释。在本研究中报告的休闲时间体力活动，在校正其他心血管危险因素后，与C反应蛋白、血清淀粉样蛋白A或纤维蛋白原水平无显著相关性。
这些数据表明，如我们研究中所报告的，休闲时间体力活动不是C反应蛋白、血清淀粉样蛋白A或纤维蛋白原水平的独立预测指标。体力活动与其他心血管危险因素之间可能的相互作用或许可以解释我们在双变量分析中发现的（间接）关系。
