Relation of cardiorespiratory fitness to inflammatory markers, fibrinolytic factors, and lipoprotein(a) in patients with type 2 diabetes mellitus.
Increased inflammation, fibrinolytic factors, and lipoprotein(a) (LP[a]) were associated with increased cardiovascular events in patients with type 2 diabetes, whereas higher levels of cardiorespiratory fitness (CRF) were associated with a lower incidence of cardiovascular mortality. Whether CRF is associated with inflammatory markers, fibrinolytic factors, and LP(a) in patients with type 2 diabetes was investigated. A total of 425 men with type 2 diabetes (mean age 55 +/- 8 years) who participated in a medical screening program were studied. CRF was measured using peak oxygen uptake with expired gas analysis during a symptom-limited exercise test. CRF inversely correlated with C-reactive protein (CRP; r = -0.27, p <0.05), white blood cell count (r = -0.13, p <0.05), fibrinogen (r = -0.28, p <0.05), LP(a) (r = -0.53, p <0.05), tissue plasminogen activator (t-PA) antigen (r = -0.65, p <0.05), and plasminogen activator inhibitor-1 activity (r = -0.17, p <0.05). Men in the highest tertile of CRF had significantly lower CRP, white blood cell count, fibrinogen, LP(a), and t-PA than men in the lowest tertile of CRF (all p <0.05). In separate multivariable linear regression models that adjusted for age, body mass index, smoking, lipid profiles, glucose, and systolic blood pressure, CRP (beta = -0.23, p <0.05), white blood cell count (beta = -0.16, p <0.05), fibrinogen (beta = -0.24, p <0.05), LP(a) (beta = -0.28, p <0.05), and t-PA (beta = -0.69, p <0.05) were each inversely associated with CRF. Each MET increment higher peak oxygen uptake was associated with a lower odds ratio of having abnormal LP(a) (odds ratio 0.43, 95% confidence interval 0.20 to 0.91) in a multivariate logistic regression model. In conclusion, CRF was inversely associated with inflammatory markers, fibrinolytic factors, and LP(a) in men with type 2 diabetes.
Jae
Sae Young
SY
The Health and Integrative Physiology Laboratory, Department of Sports Informatics, University of Seoul, Seoul, South Korea. syjae@uos.ac.kr
Heffernan
Kevin S
KS
Lee
Moon-Kyu
MK
Fernhall
Bo
B
Park
Won Hah
WH
D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D050218:Body Fat Distribution; D002097:C-Reactive Protein / Q000032:analysis; D002320:Cardiovascular Physiological Phenomena; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005080:Exercise Test; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D007958:Leukocyte Count; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012143:Respiratory Physiological Phenomena; D010959:Tissue Plasminogen Activator / Q000097:blood
D015415:Biomarkers; D017270:Lipoprotein(a); D017395:Plasminogen Activator Inhibitor 1; D005340:Fibrinogen; D002097:C-Reactive Protein; D002784:Cholesterol; D010959:Tissue Plasminogen Activator