Exercise, Vascular Function and Cardiovascular Risk in a Sedentary Workforce

内皮功能障碍与心血管风险有关，在男性中，这与骨髓来源的内皮祖细胞（EPCs）缺乏有关。 目的探讨久坐不动且无规律运动的女性血管内皮功能和心血管风险的预测因子。 设计、设置和参与者我们招募了90名女性（年龄范围22-63岁），她们报告没有常规运动（71%超重或肥胖），没有心血管疾病史：43人有1个心血管危险因素。 主要指标前臂缺血5分钟后，通过肱动脉血流介导的舒张功能测定内皮功能。在纤连蛋白包被的威尔斯孔中培养5天后，评价外周血单核细胞的EPC集落形成。在运动峰值（峰值VO 2）时进行跑步机压力测试和气体交换分析，以评估健身水平。 结果肱动脉反应性与峰值VO 2呈正相关（r=0.4483，P<0.0001），并与Fragrance风险评分呈负相关（r=-0.3542，P =0.0007），年龄（r=-0.3420，P =0.0010），体重指数C反应蛋白（r =-0.2220，P =0.0400）与卵泡刺激素、总胆固醇、收缩压的相关性不显著。EPC集落与肱动脉血流介导的扩张（r=0.0025，P=0.9810）或与Fragrance风险评分（r=-0.0144，P=0.8940）无关，即使数据按绝经状态和缺乏可能影响任一测量的治疗分层。多元线性回归分析逐步建模，峰值VO 2（P=0.0003）仍然是肱动脉反应性的最佳独立预测因子。峰值VO 2与危险因素患病率和预测Fragrance危险评分呈负相关（r=-4455，P<0.0001），尤其是肥胖女性（r=-0.5414，P=0.0003）。 结论：内皮功能与久坐女性的心血管风险显著相关; EPCs与两者均无关。相反，健康水平是内皮功能和心血管风险的主要预测因素，即使在超重和肥胖的女性中也是如此。

Context Endothelial dysfunction is associated with cardiovascular risk, which in men has been linked with a paucity of bone marrow-derived endothelial progenitor cells (EPCs). Objective Our purpose was to determine predictors of endothelial function and cardiovascular risk for women with sedentary occupations and no regular exercise. Design, Setting and Participants We recruited 90 women (age range 22-63 years) who reported no routine exercise (71% overweight or obese) with no history of cardiovascular disease: 43 had 1 cardiovascular risk factor. Main Outcome Measures Endothelial function was determined by brachial artery flow-mediated dilation following 5 minutes of forearm ischemia. Peripheral blood mononuclear cells were evaluated for EPC colony formation after five days of culture in fibronectin-coated wells. Treadmill stress testing was performed with gas exchange analysis at peak exercise (peak VO2) to assess level of fitness. Results Brachial artery reactivity correlated positively with peak VO2 (r=0.4483, P<0.0001) and inversely with Framingham risk score (r=-0.3542, P=0.0007), age (r=-0.3420, P=0.0010), body-mass index (r=-0.3065, P=0.0035), C-reactive protein (r=-0.2220, P=0.0400) and marginally with follicle-stimulating hormone, total cholesterol and systolic blood pressure. EPC colonies were not associated with brachial artery flow-mediated dilation (r=0.0025, P=0.9810) or with Framingham risk score (r=-0.0144, P=0.8940), even when data were stratified by menopausal status and absence of therapies that might effect either measurement. By multiple linear regression analysis with stepwise modeling, peak VO2 (P=0.0003) remained as the best independent predictor of brachial artery reactivity. Peak VO2 was inversely associated with risk factor prevalence and predictive of Framingham risk score (r=-4455, P<0.0001), especially for obese women (r=-0.5414, P=0.0003). Conclusions Endothelial function is significantly associated with cardiovascular risk in sedentary women; EPCs are associated with neither. Instead, level of fitness is the dominant predictor of endothelial function and cardiovascular risk, even in overweight and obese women.