Miele Ciro, Mennitti Cristina, Gentile Alessandro, Veneruso Iolanda, Scarano Carmela, Vastola Aniello, La Monica Ilaria, Uomo Fabiana, Iafusco Fernanda, Capasso Filomena, Pero Raffaela, D'Argenio Valeria, Lombardo Barbara, Tinto Nadia, Di Micco Pierpaolo, Scudiero Olga, Frisso Giulia, Mazzaccara Cristina
Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy.
UOC Laboratory Medicine, Haematology and Laboratory Haemostasis and Special Investigations, AOU Federico II University of Naples, 80131 Naples, Italy.
J Clin Med. 2024 Aug 19;13(16):4881. doi: 10.3390/jcm13164881.
The hemostatic system is characterized by a delicate balance between pro- and anticoagulant forces, and the smallest alteration can cause serious events such as hemorrhages or thrombosis. Although exercise has been shown to play a protective role in athletes, several factors may increase the risk of developing venous thromboembolism (VTE), including hemoconcentration induced by exertion, immobilization following sports injuries, frequent long-distance flights, dehydration, and the use of oral contraceptives in female athletes. Biomarkers such as D-dimer, Factor VIII, thrombin generation, inflammatory cytokines, and leukocyte count are involved in the diagnosis of deep vein thrombosis (DVT), although their interpretation is complex and may indicate the presence of other conditions such as infections, inflammation, and heart disease. Therefore, the identification of biomarkers with high sensitivity and specificity is needed for the screening and early diagnosis of thromboembolism. Recent evidence about the correlation between the intensity of physical activity and VTE is divergent, whereas the repeated gestures in sports such as baseball, hockey, volleyball, swimming, wrestling, or, on the other hand, soccer players, runners, and martial art training represent a risk factor predisposing to the onset of upper and lower DVT. Anticoagulant therapy is the gold standard, reducing the risk of serious complications such as pulmonary embolism. The aim of this review is to provide a general overview about the interplay between physical exercise and the risk of thromboembolism in athletes, focusing on the main causes of thrombosis in professional athletes and underlying the need to identify new markers and therapies that can represent a valid tool for safeguarding the athlete's health.
止血系统的特点是促凝血和抗凝血力量之间保持着微妙的平衡，最小的改变都可能引发严重事件，如出血或血栓形成。尽管运动已被证明对运动员有保护作用，但有几个因素可能会增加发生静脉血栓栓塞（VTE）的风险，包括运动引起的血液浓缩、运动损伤后的固定、频繁的长途飞行、脱水以及女性运动员使用口服避孕药。生物标志物如D-二聚体、凝血因子VIII、凝血酶生成、炎症细胞因子和白细胞计数参与深静脉血栓形成（DVT）的诊断，尽管它们的解读很复杂，可能还表明存在其他病症，如感染、炎症和心脏病。因此，需要鉴定具有高敏感性和特异性的生物标志物用于血栓栓塞的筛查和早期诊断。最近关于体力活动强度与VTE之间相关性的证据存在分歧，而棒球、曲棍球、排球、游泳、摔跤等运动中的重复动作，或者另一方面足球运动员、跑步者和武术训练，则是导致上下肢DVT发病的危险因素。抗凝治疗是金标准，可降低肺栓塞等严重并发症的风险。本综述的目的是提供关于体育锻炼与运动员血栓栓塞风险之间相互作用的总体概述，重点关注职业运动员血栓形成的主要原因，并强调需要识别新的标志物和疗法，这些标志物和疗法可成为保障运动员健康的有效工具。
