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Shin S, Son S. Associations between ACE Genotypes, +8.5 Gz Tolerance, and Body Composition in F-15 Pilot Candidates. Mil Med 2021; 187:1248-1254. [PMID: 34676420 DOI: 10.1093/milmed/usab430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/14/2021] [Accepted: 10/08/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Pilots' +8.5Gz tolerance is related with their selection, safety and special mission suitability. The preliminary study about F-15 pilot candidates were rare, especially related with genetic effect like ACE (angiotensin converting enzyme) gene. BACKGROUND This study aimed to investigate the associations between the +8.5 Gz test qualification and angiotensin converting enzyme (ACE) genotypes in Korean F-15 pilot candidates for pilot special mission suitability and cadet body composition education. MATERIALS AND METHODS We performed +8.5Gz test (15 seconds), target gene (ACE) identified and body composition measurements from twenty Korean F-15 pilot candidates (ages 23.0-28.6 years). The +8.5Gz test results (pass and not-passed), body composition parameters and their relationship with the ACE genotype were evaluated. RESULTS Four (20%), six (30%), and 10 (50%) pilots had the DD, DI, and II genotypes based on the ACE gene identification results, respectively. Ten (50%) pilots passed by maintaining consciousness during the +Gz test. Of them, three (75%, 3/4), four (66.7%, 4/6), and three (30%, 3/10) had the DD, DI, and II genotypes (P < .05, DD > II), respectively. Compared with other genotypes, the DD genotype was associated with overall higher values of body composition indices, and this association was more prominent among pilots who passed the +8.5 Gz test. DISCUSSION In some ethnic groups, the DD genotype has been found to have an effect on elite players' high-intensity performance, including muscle power and strength. The DD genotype exhibited the highest performance in terms of passing rate, longest mean breathing interval(s), and higher values of body composition parameters in pilots who passed the +8.5 Gz test. CONCLUSIONS In this study, the group with the DD genotype exhibited a higher pass rate and heavier body composition parameters than the group with the II genotype. These results require further investigation to determine their significance and applicability in other ethnic groups.
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Affiliation(s)
- Seunghwan Shin
- Department of Aero Fitness, Republic of Korea Air Force Academy, Cheongju, Chungbuk 28187, Republic of Korea
| | - Seokhee Son
- Department of System Engineering, Republic of Korea Air Force Academy, Cheongju, Chungbuk 28187, Republic of Korea
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Abstract
Purpose of Review We reviewed most current medical literature in order to describe the epidemiology, clinical manifestation, outcome, and management of hypertension in athletes. Recent Findings An estimated quarter of the world’s population is suffering from hypertension and this prevalence is also reflected in athletes and in individuals involved in leisure time sport activities. Several studies found an inverse relationship between physical activity and blood pressure. Therefore, physical exercise is recommended to prevent, manage, and treat hypertension. On the other hand, the prevalence of hypertension may vary by sport and in some cases may even be higher in athletes competing in certain disciplines than in the general population. Hypertension is the most common medical condition in athletes and may raise concerns about its management and the individual’s eligibility for competitive sports. A thorough clinical evaluation should be performed to correctly diagnose or rule out hypertension in athletes, describe the individual’s risk profile, rule out secondary causes, and detect possible hypertension-mediated organ damage caused by hypertension at an early stage. Based on most recent clinical research and international consensus documents, we propose a diagnostic algorithm as well the non-pharmacological and pharmacological management of hypertension in athletes. Summary Although elevated blood pressure levels are less common in the active population, athletes are not protected from hypertension. A thorough diagnostic approach may help to identify individual at risk for adverse cardiovascular events and to address the optimal treatment as well as sport recommendations.
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Affiliation(s)
- Victor Schweiger
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Christine Attenhofer-Jost
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.,Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
| | - Stefano Caselli
- Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
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Abadir PM, Jain A, Powell LJ, Xue QL, Tian J, Hamilton RG, Bennett DA, Finucane T, Walston JD, Fedarko NS. Discovery and Validation of Agonistic Angiotensin Receptor Autoantibodies as Biomarkers of Adverse Outcomes. Circulation 2016; 135:449-459. [PMID: 27903588 DOI: 10.1161/circulationaha.116.022385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 11/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Agonistic angiotensin II type 1 receptor autoantibodies (AT1RaAbs) have not been associated with functional measures or risk for adverse health outcomes. AT1RaAbs could be used to stratify patient risk and to identify patients who can benefit from angiotensin receptor blocker treatment. METHODS Demographic and physiological covariates were measured in a discovery set of community-dwelling adults from Baltimore (N=255) and AT1RaAb associations with physical function tests and outcomes assessed. A group from Chicago (N=60) was used for validation of associations and to explore the impact of angiotensin receptor blocker treatment. RESULTS The Baltimore group had 28 subjects with falls, 32 frail subjects, and 5 deaths. Higher AT1RaAbs correlated significantly with interleukin-6 (Spearman r=0.33, P<0.0001), systolic blood pressure (Spearman r=0.28, P<0.0001), body mass index (Spearman r=0.28, P<0.0001), weaker grip strength (Spearman r=-0.34, P<0.01), and slower walking speed (Spearman r=-0.30, P<0.05). Individuals with high AT1RaAbs were 3.9 (95% confidence interval, 1.38-11.0) times more likely to be at high risk after adjusting for age (P<0.05). Every 1 µg/mL increase in AT1RaAbs increased the odds of falling 30% after adjusting for age, sex, body mass index, and blood pressure. The Chicago group had 46 subjects with falls and 60 deaths. Serum AT1RaAb levels were significantly correlated with grip strength (Spearman r=-0.57, P<0.005), walking speed (Spearman r=-0.47, P<0.005), and falls (Spearman r=0.30, P<0.05). Every 1 µg/mL increase in AT1RaAbs, decreased time to death by 9% after adjusting for age, sex, body mass index, and blood pressure. Chronic treatment with angiotensin receptor blockers was associated with better control of systolic blood pressure and attenuation of decline in both grip strength and time to death. CONCLUSIONS In older individuals, higher AT1RaAb levels were associated with inflammation, hypertension, and adverse outcomes. Angiotensin receptor blocker treatment may blunt the harm associated with high levels of AT1RaAb.
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Affiliation(s)
- Peter M Abadir
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Alka Jain
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Laura J Powell
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Qian-Li Xue
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Jing Tian
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Robert G Hamilton
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - David A Bennett
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Thomas Finucane
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Jeremy D Walston
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Neal S Fedarko
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.).
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Puthucheary Z, Skipworth JRA, Rawal J, Loosemore M, Van Someren K, Montgomery HE. The ACE gene and human performance: 12 years on. Sports Med 2011; 41:433-48. [PMID: 21615186 DOI: 10.2165/11588720-000000000-00000] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Some 12 years ago, a polymorphism of the angiotensin I-converting enzyme (ACE) gene became the first genetic element shown to impact substantially on human physical performance. The renin-angiotensin system (RAS) exists not just as an endocrine regulator, but also within local tissue and cells, where it serves a variety of functions. Functional genetic polymorphic variants have been identified for most components of RAS, of which the best known and studied is a polymorphism of the ACE gene. The ACE insertion/deletion (I/D) polymorphism has been associated with improvements in performance and exercise duration in a variety of populations. The I allele has been consistently demonstrated to be associated with endurance-orientated events, notably, in triathlons. Meanwhile, the D allele is associated with strength- and power-orientated performance, and has been found in significant excess among elite swimmers. Exceptions to these associations do exist, and are discussed. In theory, associations with ACE genotype may be due to functional variants in nearby loci, and/or related genetic polymorphism such as the angiotensin receptor, growth hormone and bradykinin genes. Studies of growth hormone gene variants have not shown significant associations with performance in studies involving both triathletes and military recruits. The angiotensin type-1 receptor has two functional polymorphisms that have not been shown to be associated with performance, although studies of hypoxic ascent have yielded conflicting results. ACE genotype influences bradykinin levels, and a common gene variant in the bradykinin 2 receptor exists. The high kinin activity haplotye has been associated with increased endurance performance at an Olympic level, and similar results of metabolic efficiency have been demonstrated in triathletes. Whilst the ACE genotype is associated with overall performance ability, at a single organ level, the ACE genotype and related polymorphism have significant associations. In cardiac muscle, ACE genotype has associations with left ventricular mass changes in response to stimulus, in both the health and diseased states. The D allele is associated with an exaggerated response to training, and the I allele with the lowest cardiac growth response. In light of the I-allele association with endurance performance, it seems likely that other regulatory mechanisms exist. Similarly in skeletal muscle, the D allele is associated with greater strength gains in response to training, in both healthy individuals and chronic disease states. As in overall performance, those genetic polymorphisms related to the ACE genotype, such as the bradykinin 2 gene, also influence skeletal muscle strength. Finally, the ACE genotype may influence metabolic efficiency, and elite mountaineers have demonstrated an excess of I alleles and I/I genotype frequency in comparison to controls. Interestingly, this was not seen in amateur climbers. Corroboratory evidence exists among high-altitude settlements in both South America and India, where the I allele exists in greater frequency in those who migrated from the lowlands. Unfortunately, if the ACE genotype does influence metabolic efficiency, associations with peak maximal oxygen consumption have yet to be rigorously demonstrated. The ACE genotype is an important but single factor in the determinant of sporting phenotype. Much of the mechanisms underlying this remain unexplored despite 12 years of research.
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Affiliation(s)
- Zudin Puthucheary
- University College London Institute for Human Health and Performance, London, UK.
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