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，但由于生长或运动导致的内皮和血小板功能的变化尚未明确。此外，儿童时期有效的饮食和/或运动干预尚未确立。我们研究了儿童、成人和青紫型先天性心脏病（CCHD）患者的血小板活性和凝血纤溶蛋白增强内皮功能。我们还评估了减肥对这些指标的影响。材料与方法：测定CCHD患者血浆可溶性p选择素、β -血小板球蛋白（β - tg）、血小板因子4 （PF4）、蛋白C、蛋白S水平。2.观察CCHD患者纤溶酶原激活物抑制剂-1 （PAI-1）活性和组织型纤溶酶原激活物（t-PA）抗体的昼夜变化（上午9:00 vs下午4:00）。3.比较了减肥对肥胖成人12周限制热量饮食加或不加有氧运动的血小板衍生微粒（PMP）释放、PAI-1活性和t-PA抗原的影响。结果：1；冠心病患者血浆p -选择素、β - tg、PF4水平明显高于无氰血症患者，游离蛋白S抗原和蛋白C活性明显低于无氰血症患者。p -选择素与β - tg呈正相关，蛋白S和蛋白C与红细胞压积呈负相关。2.冠心病患者早晨PAI-1活性和t-PA抗原水平升高。冠心病患者上午9点和下午4点血浆t-PA抗原水平高于无氰血症患者，且与红细胞增多率呈正相关。3.肥胖成人的PMP、PAI-1活性和t-PA抗原值均高于非肥胖成人，且这三个参数与体重指数（BMI）相关。干预显著降低PMP、PAI-1和t-PA抗原水平。PMP值的变化百分比与BMI、脂肪组织质量的变化百分比有显著的相关性。结论：通过改善内皮和血小板功能，减轻体重对预防成人疾病至关重要。慢性缺氧暴露的冠心病患者存在血小板和凝纤蛋白溶解异常。剧烈运动可引起短暂性组织缺氧。建立适合年龄的饮食和运动疗法有助于从儿童时期预防成人疾病。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