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急性透析期间高强度体育锻炼对血液透析患者氧化应激和炎症反应的影响。

Effect of acute intradialytic strength physical exercise on oxidative stress and inflammatory responses in hemodialysis patients.

作者信息

Esgalhado Marta, Stockler-Pinto Milena Barcza, de França Cardozo Ludmila Ferreira Medeiros, Costa Cinthia, Barboza Jorge Eduardo, Mafra Denise

机构信息

University of Medicine of Lisbon, Post-Graduation in Clinical Nutrition, Lisbon, Portugal ; Fluminense Federal University, Post-Graduation in Cardiovascular Sciences, Niterói-RJ, Brazil.

Fluminense Federal University, Post-Graduation in Cardiovascular Sciences, Niterói-RJ, Brazil.

出版信息

Kidney Res Clin Pract. 2015 Mar;34(1):35-40. doi: 10.1016/j.krcp.2015.02.004. Epub 2015 Feb 19.

Abstract

BACKGROUND

Oxidative stress and inflammation are common findings in chronic kidney disease (CKD) patients, and they are directly related to the increased risk of developing cardiovascular disease, which is the major cause of death in these patients, particularly for those undergoing hemodialysis (HD). Strength physical exercise is a new therapeutic approach to reduce these complications in CKD patients. Following this, the purpose of this study was to assess the effect of acute intradialytic strength physical exercise on oxidative stress and inflammatory responses in HD patients.

METHODS

Sixteen HD patients were studied (11 women; 44.4±14.6 years; body mass index 23.3±4.9 kg/m(2); 61.6±43.1 months of dialysis) and served as their own controls. Acute (single session) intradialytic physical exercise were performed at 60% of the one-repetition maximum test for three sets of 10 repetitions for four exercise categories in both lower limbs during 30 minutes. Blood samples were collected on two different days at exactly the same time (30 minutes and 60 minutes after initiating the dialysis-with and without exercise). Antioxidant enzymes activity [superoxide dismutase (SOD), catalase, and glutathione peroxidase], lipid peroxidation marker levels (malondialdehyde), and inflammatory marker levels (high-sensitivity C-reactive protein) were determined.

RESULTS

SOD plasma levels were significantly reduced after acute physical exercise from 244.8±40.7 U/mL to 222.4±28.9 U/mL (P=0.03) and, by contrast, increased on the day without exercise (218.2±26.5 U/mL to 239.4±38.6 U/mL, P=0.02). There was no alteration in plasma catalase, glutathione peroxidase, malondialdehyde, or high-sensitivity C-reactive protein levels in on either day (with or without exercise). Additionally, there was no association between these markers and clinical, anthropometric, or biochemical parameters.

CONCLUSION

These data suggest that acute intradialytic strength physical exercise was unable to reduce oxidative stress and inflammation, and in addition, it seems to reduce plasma SOD levels, which could exacerbate the oxidative stress in HD patients.

摘要

背景

氧化应激和炎症是慢性肾脏病(CKD)患者的常见表现,且与心血管疾病发生风险增加直接相关,心血管疾病是这些患者的主要死因,尤其是对于接受血液透析(HD)的患者。力量型体育锻炼是减少CKD患者这些并发症的一种新的治疗方法。据此,本研究旨在评估急性透析期间力量型体育锻炼对HD患者氧化应激和炎症反应的影响。

方法

对16例HD患者进行研究(11名女性;年龄44.4±14.6岁;体重指数23.3±4.9kg/m²;透析61.6±43.1个月),并以患者自身作为对照。在透析期间进行急性(单次)体育锻炼,针对下肢的四类运动,以一次最大重复量测试的60%进行三组,每组10次重复,共持续30分钟。在两个不同日期的同一时间(透析开始后30分钟和60分钟,分别为锻炼后和未锻炼)采集血样。测定抗氧化酶活性[超氧化物歧化酶(SOD)、过氧化氢酶和谷胱甘肽过氧化物酶]、脂质过氧化标志物水平(丙二醛)和炎症标志物水平(高敏C反应蛋白)。

结果

急性体育锻炼后,血浆SOD水平显著降低,从244.8±40.7U/mL降至222.4±28.9U/mL(P=0.03),相比之下,在未锻炼日血浆SOD水平升高(从218.2±26.5U/mL升至239.4±38.6U/mL,P=0.02)。无论哪一天(锻炼或未锻炼),血浆过氧化氢酶、谷胱甘肽过氧化物酶、丙二醛或高敏C反应蛋白水平均无变化。此外,这些标志物与临床、人体测量或生化参数之间无关联。

结论

这些数据表明,急性透析期间力量型体育锻炼无法减轻氧化应激和炎症,此外,似乎还会降低血浆SOD水平,这可能会加重HD患者的氧化应激。

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