Gardner Andrew W, Montgomery Polly S, Zhao Yan D, Ungvari Zoltan, Csiszar Anna, Sonntag William E
1 Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA.
2 Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.
Angiology. 2018 May;69(5):416-423. doi: 10.1177/0003319717726934. Epub 2017 Aug 24.
We determined whether 6-minute walk total distance and pain-free distance were associated with circulating biomarkers of antioxidant capacity and inflammation and with cultured endothelial cell inflammation, oxidative stress, and apoptosis in 251 patients with symptomatic peripheral artery disease (PAD). In multivariate analyses, pain-free distance during the 6-minute walk test was negatively associated with dyslipidemia ( P < .001), chronic kidney disease ( P = .004), and transient transfection, nuclear factor κ-Light-Chain-Enhancer of activated B (NF-κB) cultured endothelial cells ( P = .007) and was positively associated with height ( P = .008). Furthermore, total distance walked during the 6-minute walk test was negatively associated with cultured endothelial cell NF-κB ( P < .001), coronary artery disease ( P = .009), and body mass index ( P = .022) and was positively associated with ankle-brachial index ( P < .001), male sex ( P < .001), and hydroxyl radical antioxidant capacity ( P < .001). The 6-minute walk performance in symptomatic patients with PAD was associated with vascular biomarkers, as walking distances were negatively associated with cultured endothelial cell inflammation and positively associated with circulating antioxidant capacity. The clinical implication is that behavioral interventions designed to alleviate endothelial cell inflammation and increase circulating antioxidant capacity, such as exercise and antioxidant intake, may improve ambulation of patients with PAD during submaximal exercise that is typically performed during daily activities.
我们在251例有症状的外周动脉疾病（PAD）患者中，确定了6分钟步行总距离和无痛距离是否与抗氧化能力及炎症的循环生物标志物，以及与培养的内皮细胞炎症、氧化应激和细胞凋亡相关。在多变量分析中，6分钟步行试验中的无痛距离与血脂异常（P <.001）、慢性肾病（P =.004）、瞬时转染、培养的活化B细胞核因子κB（NF-κB）内皮细胞（P =.007）呈负相关，与身高呈正相关（P =.008）。此外，6分钟步行试验中的总步行距离与培养的内皮细胞NF-κB（P <.001）、冠状动脉疾病（P =.009）和体重指数（P =.022）呈负相关，与踝臂指数（P <.001）、男性（P <.001）和羟自由基抗氧化能力（P <.001）呈正相关。有症状的PAD患者的6分钟步行表现与血管生物标志物相关，因为步行距离与培养的内皮细胞炎症呈负相关，与循环抗氧化能力呈正相关。临床意义在于，旨在减轻内皮细胞炎症和增加循环抗氧化能力的行为干预措施，如运动和摄入抗氧化剂，可能会改善PAD患者在日常活动中通常进行的次最大运动期间的步行能力。
