Research into the effects of sport activity on platelet and endothelial function and on development of atherosclerosis in children.

成人疾病，包括动脉粥样硬化，起源于儿童时期。内皮和血小板功能与动脉粥样硬化的进展有关。虽然体重控制对预防成人疾病很重要，但由于生长或运动引起的内皮和血小板功能的变化尚未阐明。此外，还没有建立从儿童期开始的有效饮食和/或运动干预。我们研究了儿童、成人和紫绀型先天性心脏病（CCHD）患者的血小板活性和凝血纤溶蛋白增强内皮功能。材料与方法：1.测定CCHD患者血浆可溶性P-选择素、β-血小板球蛋白（β-TG）、血小板第4因子（PF 4）、蛋白C和蛋白S水平。2.血浆纤溶酶原激活物抑制剂-1（派-1）活性和组织型纤溶酶原激活物（t-PA）抗纤溶酶原激活物（t-PA）活性的昼夜变化（9：00 am vs 4：00 pm） 关于我们 测定CCHD患者血清en水平。3.比较了肥胖成年人在12周限制热量饮食加或不加有氧运动的情况下，体重减轻对活化血小板释放的血小板衍生微粒（PMP）、派-1活性和t-PA抗原的影响。1.血浆P-选择素、β-TG、PF_4水平显著升高，CCHD患者血清游离蛋白S抗原和蛋白C活性明显低于非紫绀型患者。P-选择素、β-TG与红细胞压积呈正相关，蛋白S、蛋白C与红细胞压积呈负相关。2. CCHD患者派-1活性和t-PA抗原水平晨起升高。CCHD患者上午9时和下午4时血浆t-PA抗原水平均高于非紫绀型患者，且与红细胞增多呈正相关。3.肥胖组与非肥胖组比较，PMP、PAI-1活性和t-PA抗原水平均升高，且与体重指数（BMI）相关。干预显著降低PMP、派-1和t-PA抗原水平。PMP值的变化百分比与BMI、脂肪组织mass.Conclusion的变化百分比之间存在显著相关性：通过改善内皮和血小板功能，体重减轻对于预防成人疾病是必不可少的。慢性低氧暴露的CCHD患者存在血小板和凝血纤溶功能异常。剧烈运动会引起短暂的组织缺氧。建立适当的饮食和运动疗法的年龄可能有助于预防成人疾病从童年。少

Introduction : Adult disease, including atherosclerosis, has its origins in childhood. Endothelial and platelet functions are implicated in progression of atherosclerosis. Although weight control is important for prevention of adult disease, changes in endothelial and platelet function due to growth or to exercise have not been clarified. Moreover, effective diet and/or exercise intervention from childhood has not been established. We investigated platelet activity and coagulofibrinolytic proteins that enhance endothelial function in children, adults and patients with cyanotic congenital heart disease (CCHD). We also assessed the effect of weight reduction on these markers.Materials and Method : 1.Plasma levels of soluble P-selectin, beta-thromboglobulin (beta-TG), platelet factor 4 (PF4), protein C and protein S in CCHD patients were measured. 2.Diurnal changes (9:00 am vs 4:00 pm) in plasminogen activator inhibitor-1 (PAI-1) activity and tissue-type plasminogen activator (t-PA) antig … More en levels in CCHD patients were evaluated. 3.Effects of weight reduction on platelet derived microparticles (PMP) released from activated platelets, PAI-1 activity and t-PA antigen were compared between 12-week calorie restricted diet with or without aerobic exercise in obese adults.Results : 1.Plasma levels of P-selectin, beta-TG,PF4 were significantly high, and those of free protein S antigen and protein C activity were significantly low in CCHD patients compared with acyanotic patients. P-selectin and beta-TG correlated positively, and protein S and protein C correlated negatively with hematocrit. 2.Morning increase of PAI-1 activity and t-PA antigen levels was observed in CCHD patients. Plasma levels of t-PA antigen at 9 am and 4 pm were higher in CCHD patients than those in acyanotic patients, and correlated positively with the levels of erythrocytosis. 3.PMP,PAI-1 activity and t-PA antigen values were elevated in obese adults in comparison with non-obese adults, and these three parameters correlated with body mass index (BMI). The intervention significantly reduced PMP,PAI-1 and t-PA antigen levels. There was a significant correlation between percentages of change in PMP values and those in BMI, fat tissue mass.Conclusion : Weight reduction appears to be essential for prevention of adult disease, through improvement of endothelial and platelet functions. There were platelet and coagulofibrinolytic abnormalities in CCHD patients who were exposed to chronic hypoxia. Strenuous exercise would induce transient tissue hypoxia. Establishment of appropriate diet and exercise therapies for age could contribute to prevention of adult disease from childhood. Less