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Di Gioia G, Coletti F, Buzzelli L, Maestrini V, Monosilio S, Segreti A, Squeo MR, Lemme E, Nenna A, Pelliccia A. Influence of the Type of Disability and Sporting Discipline on Lipid Profile in a Cohort of Italian Paralympic Athletes. Am J Cardiol 2024; 210:107-112. [PMID: 38682709 DOI: 10.1016/j.amjcard.2023.09.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 05/01/2024]
Abstract
Dyslipidemia is the most frequent cardiovascular (CV) risk factor in able-bodied athletes and is frequently undertreated, resulting in an underestimated risk of atherosclerosis-related diseases. Data on lipid profile in Paralympic athletes are lacking. Our study aimed to identify the prevalence of dyslipidemia and the influence of disability type and sporting discipline in Paralympic athletes. We evaluated 289 athletes who participated in the Paralympic Games from London 2012 to Beijing 2022. All athletes underwent clinical/physical evaluation, blood tests, and body composition analysis. They were divided into different groups based on sports disciplines and disability type (spinal cord injuries [SCIs] and non-SCIs [NSCIs]). Among the Paralympic athletes, 34.6% had a low-density lipoprotein (LDL) level ≥115 mg/100 ml. They were older (38.1 ± 9.2 vs 30.6 ± 9.6, p = 0.001) and had a higher CV risk. Athletes with SCI showed similar total cholesterol and triglycerides, higher LDL (110.9 ± 35.2 vs 102.7 ± 30.6 mg/100 ml, p = 0.03) and lower high-density lipoprotein (HDL) (53.6 ± 13.6 vs 60.5 ± 15.4 mg/100 ml, p = 0.001) than those with NSCI. Endurance athletes had lower LDL, the highest HDL, and the lowest triglycerides and LDL/HDL ratio compared with other sports disciplines. A mean follow-up of 61.5 ± 30.5 months was available in 47% athletes, and 72.7% of the athletes with dyslipidemia continued to present altered LDL values at follow-up. In conclusion, dyslipidemia is the most common CV risk factor in the Paralympics, affecting 35% of athletes, with only mild lipid changes over a medium-term time. The type of disability and sporting discipline has an impact on lipids, improving HDL and reducing LDL, with a better profile observed in NSCI and endurance athletes.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Piazza Lauro de Bosis, Rome, Italy.
| | - Federica Coletti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Lorenzo Buzzelli
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Viviana Maestrini
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy; Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, Rome, Italy
| | - Sara Monosilio
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy
| | - Andrea Segreti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Piazza Lauro de Bosis, Rome, Italy
| | - Maria Rosaria Squeo
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy
| | - Erika Lemme
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy
| | - Antonio Nenna
- Heart Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Antonio Pelliccia
- Institute of Sport Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, Rome, Italy
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De Maria B, Lucini D, Gois MDO, Catai AM, Perego F, Malacarne M, Pagani M, Porta A, Dalla Vecchia LA. Improvement of Sympathovagal Balance by Regular Exercise May Counteract the Ageing Process. A Study by the Analysis of QT Variability. Front Physiol 2022; 13:880250. [PMID: 35514344 PMCID: PMC9065681 DOI: 10.3389/fphys.2022.880250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
QT interval (QT) variability analysis provides pathophysiological and prognostic information utilized in cardiac and non-cardiac diseases, complementary to those obtained from the analysis of heart period (HP) variability. An increased QT variability has been associated to a higher risk for cardiac events and poorest prognosis. Autonomic cardiovascular adaptation to internal and external challenges, such those occurring in athletes exposed to high levels of physical stress and in ageing could also be deepen by analyzing QT variability, searching for early prognostic signatures. The aim of the study was to analyze the QT variability and cardiac control complexity in a group of middle-aged half-marathon runners at baseline (B) and at a 10-year follow-up (FU). We found that the overall QT variability decreased at FU, despite the inescapable increase in age (52.3 ± 8.0 years at FU). This change was accompanied by an increase of the HP variability complexity without changes of the QT variability complexity. Of notice, over the years, the group of athletes maintained their regular physical activity by switching to a moderate intensity rather than strenuous. In conclusion, regular and moderate exercise over the years was beneficial for this group of athletes, as reflected by the decreased overall QT variability that is known to be associated to lower cardiovascular risk. The concomitant enhanced cardiac control complexity also suggests a trend opposite to what usually occurs with ageing, resulting in a more flexible cardiac control, typical of younger people.
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Affiliation(s)
| | - Daniela Lucini
- BIOMETRA Department, University of Milan, Milan, Italy.,Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | | | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Mara Malacarne
- BIOMETRA Department, University of Milan, Milan, Italy.,Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Massimo Pagani
- Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Policlinico San Donato, San Donato Milanese, Milan, Italy
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Sanchis-Gomar F, Lavie CJ, Marín J, Perez-Quilis C, Eijsvogels TMH, O'Keefe JH, Perez MV, Blair SN. Exercise Effects On Cardiovascular Disease: From Basic Aspects To Clinical Evidence. Cardiovasc Res 2021; 118:2253-2266. [PMID: 34478520 DOI: 10.1093/cvr/cvab272] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/31/2021] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobic ET, as well as the potential adverse effects of extreme levels of ET, continue to be investigated, there is no question that most of the world's population have insufficient levels of PA/ET, and many also have lower than ideal levels of CRF. Therefore, assessment and promotion of PA, ET, and efforts to improve levels of CRF should be integrated into all health professionals' practices worldwide. In this state-of-the-art review, we discuss the exercise effects on many areas related to CVD, from basic aspects to clinical practice.
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Affiliation(s)
- Fabian Sanchis-Gomar
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain.,Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Jorge Marín
- Growth, Exercise, Nutrition and Development Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | - Carme Perez-Quilis
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Science, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - James H O'Keefe
- St. Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Marco V Perez
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Steven N Blair
- Department of Exercise Sciences, University of South Carolina, Columbia, USA
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Afşin A, Bozyılan E, Asoğlu R, Hoşoğlu Y, Dündar A. Effects of regular exercise on inflammatory biomarkers and lipid parameters in soccer players. J Immunoassay Immunochem 2021; 42:467-477. [PMID: 33750257 DOI: 10.1080/15321819.2021.1898421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Since chronic dyslipidemia and inflammation play a major role in the etiopathogenesis of atherosclerotic plaque, we investigated the effects of a 7-week exercise on the serum lipid profile, plasma atherogenic index (PAI), and inflammatory biomarkers interleukin (IL), tumor necrosis factor (TNF)-α, and monocyte chemoattractant protein (MCP)-1 in male soccer players. Methods: The participants in this study were 22 healthy male soccer players aged 19-25 years. IL-1β, IL-6, IL-10, TNF-a, MCP-1, and lipid profile were recorded before and after the program. PAI was calculated as log (TG/HDL-C), where TG is triglyceride and HDL-C is high-density lipoprotein cholesterol. Results: There were significant decreases in post-exercise IL-6, TNF-α, and MCP-1 (for all, p< .05). Compared to the pretest values, there were significant decreases in posttest total cholesterol (TC), TGs, low-density lipoprotein (LDL), non- high-density lipoprotein cholesterol (non-HDL-C), and PAI (for all, p< .05). In contrast, HDL-C values increased after exercise (p< .001). After exercise training TC, TGs, LDL-C, non-HDL-C, and PAI decreased and HDL-C increased, indicating improvement in parameters of dyslipidemia. The decreases in IL-6, TNF-α, and MCP-1 suggest a decrease in systemic inflammation.
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Affiliation(s)
- Abdulmecit Afşin
- Department of Cardiology, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
| | - Eren Bozyılan
- Department of Coaching training, High School of Physical Education and Sports, University of Adiyaman, Adiyaman, Turkey
| | - Ramazan Asoğlu
- Department of Cardiology, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
| | - Yusuf Hoşoğlu
- Department of Cardiology, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
| | - Aykut Dündar
- Department of Coaching training, High School of Physical Education and Sports, University of Adiyaman, Adiyaman, Turkey
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De Maria B, de Oliveira Gois M, Catai AM, Marra C, Lucini D, Porta A, Pagani M, Dalla Vecchia LA. Ten-year follow-up of cardiac function and neural regulation in a group of amateur half-marathon runners. Open Heart 2021; 8:e001561. [PMID: 33563778 PMCID: PMC7875294 DOI: 10.1136/openhrt-2020-001561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE In the last years, a debate exists about type, intensity and frequency of physical exercise that is really indicated to protect healthy subjects from cardiovascular disease. Regular physical training has been associated with an improved cardiovascular risk profile, but it has also been demonstrated that strenuous and uncontrolled physical exercise could be dangerous, in terms of increased cardiovascular morbidity and mortality. In the present study, we evaluated a group of 35 amateur half-marathon runners, who were likewise studied 10 years before (B). The results of B suggested that an increased cardiac sympathetic modulation could potentially represent a negative prognostic factor. The aim of this follow-up was to assess the medium-long-term effects of moderate to vigorous physical training on the cardiovascular neural control, cardiac function and occurrence of cardiovascular diseases. METHODS Each enrolled subject underwent: (1) an interview and physical examination to ascertain the presence of cardiovascular disease; (2) standing test to evaluate the cardiovascular neural control by means of heart rate variability (HRV), arterial blood pressure (AP) variability and baroreflex sensitivity (BRS); (3) transthoracic echocardiography to evaluate cardiac function. RESULTS At 10-year follow-up (FU), in this group of middle-aged athletes the occurrence of cardiovascular diseases was low, not unlike that of the overall population. The results of HRV analysis showed a decreased sympathetic and increased vagal modulation directed to the heart, compared with B. In addition, HRV, AP variability and BRS indices showed a physiological response to active standing. Finally, athletes had normal echocardiographic measures. CONCLUSION We conclude that in our group of athletes a regular moderate-vigorous physical training through the 10 years was quite beneficial as the prevalence of sympathetic cardiac modulation observed at B was not accompanied by increased cardiovascular risk, on the contrary a slight prevalence of vagal indices was observed at FU.
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Affiliation(s)
- Beatrice De Maria
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy
| | | | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Christian Marra
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy
| | - Daniela Lucini
- Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, University of Milan, Milano, Italy
- Exercise Medicine Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Policlinico San Donato, San Donato Milanese, Italy
| | - Massimo Pagani
- Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, University of Milan, Milano, Italy
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