DeSouza C A, Jones P P, Seals D R
Center for Physical Activity, Disease Prevention, and Aging, Department of Kinesiology, University of Colorado, Boulder 80309, USA.
Arterioscler Thromb Vasc Biol. 1998 Mar;18(3):362-8. doi: 10.1161/01.atv.18.3.362.
Adverse changes in coagulation and fibrinolytic factors are thought to contribute to the increased risk of cardiovascular disease and atherothrombosis with age. We tested the hypothesis that such age-related changes in specific coagulation and fibrinolytic factors are absent in physically active women. Resting levels of plasma fibrinogen, tissue-type plasminogen activator (t-PA) antigen and activity, plasminogen activator inhibitor-1 (PAI-1) antigen and activity, and fibrin D-dimer were measured in 24 healthy premenopausal women: 11 sedentary (aged 28+/-1 years; Pre-S) and 13 physically active (aged 30+/-1 years; Pre-PA) and in 27 healthy postmenopausal women: 14 sedentary (aged 61+/-1 years; Post-S) and 13 physically active (aged 58+/-1 years; Post-PA). Post-S had higher (P<.05) fibrinogen, t-PA antigen, PAI-1 antigen, PAI-1 activity, and fibrin D-dimer levels and lower t-PA activity than Pre-S. Post-PA demonstrated lower (P<.01) plasma fibrinogen, t-PA antigen, PAI-1 antigen, and PAI-1 activity and higher (P<.01) t-PA activity levels than Post-S. In addition, plasma fibrin D-dimer levels tended (P=.06) to be lower in Post-PA than in Post-S. Although plasma levels of fibrinogen and fibrin D-dimer in Post-PA were lower than in Post-S, they were higher (P<.05) than in Pre-PA. Importantly, however, the fibrinolytic profile of Post-PA did not differ from that of Pre-PA. The results of the present study demonstrate that the adverse age-associated differences in plasma fibrinogen concentrations and the endogenous fibrinolytic system in sedentary healthy women are either attenuated or absent in highly physically active women. The smaller or absent age-related differences in coagulation and fibrinolytic factors in women who habitually exercise may represent an important mechanism contributing to their lower age-related increase in both cardiovascular disease and atherothrombotic events. Future studies need to determine whether women who are moderately active would demonstrate the same favorable hemostatic profile.
凝血和纤溶因子的不良变化被认为是导致心血管疾病和动脉粥样硬化血栓形成风险随年龄增加的原因。我们检验了这样一个假设：在体育锻炼的女性中不存在特定凝血和纤溶因子的这种与年龄相关的变化。对24名健康的绝经前女性进行了血浆纤维蛋白原、组织型纤溶酶原激活物（t-PA）抗原和活性、纤溶酶原激活物抑制剂-1（PAI-1）抗原和活性以及纤维蛋白D-二聚体的静息水平测量：11名久坐不动者（年龄28±1岁；绝经前久坐组）和13名体育锻炼者（年龄30±1岁；绝经前锻炼组），以及27名健康的绝经后女性：14名久坐不动者（年龄61±1岁；绝经后久坐组）和13名体育锻炼者（年龄58±1岁；绝经后锻炼组）。绝经后久坐组的纤维蛋白原、t-PA抗原、PAI-1抗原、PAI-1活性和纤维蛋白D-二聚体水平高于（P<0.05）绝经前久坐组，而t-PA活性低于绝经前久坐组。绝经后锻炼组的血浆纤维蛋白原、t-PA抗原、PAI-1抗原和PAI-1活性低于（P<0.01）绝经后久坐组，t-PA活性水平高于（P<0.01）绝经后久坐组。此外，绝经后锻炼组的血浆纤维蛋白D-二聚体水平趋于（P=0.06）低于绝经后久坐组。虽然绝经后锻炼组的血浆纤维蛋白原和纤维蛋白D-二聚体水平低于绝经后久坐组，但高于（P<0.05）绝经前锻炼组。然而，重要的是，绝经后锻炼组的纤溶特征与绝经前锻炼组并无差异。本研究结果表明，在久坐的健康女性中，与年龄相关的血浆纤维蛋白原浓度和内源性纤溶系统的不良差异在高度体育锻炼的女性中要么减弱要么不存在。习惯性锻炼的女性在凝血和纤溶因子方面较小或不存在与年龄相关的差异，可能是她们与年龄相关的心血管疾病和动脉粥样硬化血栓形成事件增加幅度较低的一个重要机制。未来的研究需要确定中度活动的女性是否会表现出相同有利的止血特征。
