Grabitz Carl, Sprung Katharina M, Amagliani Laura, Memaran Nima, Schmidt Bernhard M W, Tegtbur Uwe, von der Born Jeannine, Kerling Arno, Melk Anette
Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Institute of Sports Medicine, Hannover Medical School, Hannover, Germany.
Front Cardiovasc Med. 2023 Jun 2;10:1081675. doi: 10.3389/fcvm.2023.1081675. eCollection 2023.
Cardiovascular disease remains the most common cause of death worldwide, and early manifestations are increasingly identified in childhood and adolescence. With physical inactivity being the most prevalent modifiable risk factor, the risk for cardiovascular disease is deemed low in people engaging in regular physical exercise. The aim of this study was to investigate early markers and drivers of cardiovascular disease in young athletes pursuing a career in competitive sports.
One hundred and five athletes (65 males, mean age 15.7 ± 3.7 years) were characterized by measurement of body impedance to estimate body fat, blood pressure (BP), carotid femoral pulse wave velocity (PWV) to evaluate arterial elasticity, ergometry to assess peak power output, echocardiography to calculate left ventricular mass, and blood tests.
Systolic BP was elevated in 12.6% and thereby more than twice as high as expected for the normal population. Similarly, structural vascular and cardiac changes represented by elevated PWV and left ventricular mass were found in 9.5% and 10.3%. Higher PWV was independently associated with higher systolic BP (= 0.0186, < 0.0001), which in turn was closely correlated to hemoglobin levels (= 0.1252, = 0.0435). In this population, increased left ventricular mass was associated with lower resting heart rate (= -0.5187, = 0.0052), higher metabolic equivalent hours (= 0.1303, = 0.0002), sport disciplines with high dynamic component (= 17.45, = 0.0009), and also higher systolic BP (= 0.4715, = 0.0354).
Despite regular physical exercise and in the absence of obesity, we found an unexpected high rate of cardiovascular risk factors. The association of PWV, systolic BP, and hemoglobin suggested a possible link between training-induced raised hemoglobin levels and altered vascular properties. Our results point toward the need for thorough medical examinations in this seemingly healthy cohort of children and young adults. Long-term follow-up of individuals who started excessive physical exercise at a young age seems warranted to further explore the potential adverse effects on vascular health.
心血管疾病仍然是全球最常见的死亡原因，且在儿童和青少年中越来越多地发现其早期表现。缺乏身体活动是最普遍的可改变风险因素，从事定期体育锻炼的人患心血管疾病的风险被认为较低。本研究的目的是调查从事竞技体育职业的年轻运动员心血管疾病的早期标志物和驱动因素。
105名运动员（65名男性，平均年龄15.7±3.7岁）通过测量身体阻抗以估计体脂、血压（BP）、颈动脉股动脉脉搏波速度（PWV）以评估动脉弹性、进行运动测试以评估峰值功率输出、超声心动图以计算左心室质量以及血液检测来进行特征描述。
收缩压升高的比例为12.6%，因此比正常人群预期高出两倍多。同样，以PWV升高和左心室质量增加为代表的血管和心脏结构变化分别在9.5%和10.3%的人群中被发现。较高的PWV与较高的收缩压独立相关（=0.0186，<0.0001），而收缩压又与血红蛋白水平密切相关（=0.1252，=0.0435）。在该人群中，左心室质量增加与较低的静息心率（=-0.5187，=0.0052）、较高的代谢当量小时数（=0.1303，=0.0002）、具有高动态成分的运动项目（=17.45，=0.0009）以及较高的收缩压（=0.4715，=0.0354）相关。
尽管有定期体育锻炼且无肥胖情况，但我们发现心血管危险因素的发生率意外地高。PWV、收缩压和血红蛋白之间的关联表明训练引起的血红蛋白水平升高与血管特性改变之间可能存在联系。我们的结果表明需要对这群看似健康的儿童和年轻人进行全面的医学检查。对年轻时开始过度体育锻炼的个体进行长期随访似乎有必要，以进一步探索对血管健康的潜在不利影响。
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