Monitored Daily Ambulatory Activity, Inflammation, and Oxidative Stress in Patients With Claudication

et al. 2015

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Background We compared (a) cellular reactive oxygen species (ROS) production, inflammation, and apoptosis of cultured endothelial cells treated with sera, and (b) circulating inflammatory, antioxidant capacity, vascular biomarkers, and calf muscle hemoglobin oxygen saturation (StO2) in men and women with PAD. A secondary aim was to compare exercise performance and daily ambulatory activity between men and women. We hypothesized that women would have more impaired endothelial cellular ROS, inflammation, and apoptosis than men, as well as worse systemic inflammation, antioxidant capacity, vascular biomarkers, calf muscle StO2, exercise performance, and daily ambulatory activity. Methods One hundred forty-eight symptomatic men and women with PAD were characterized on the endothelial effects of circulating factors present in the sera using a cell culture-based bioassay on primary human arterial endothelial cells. Patients were further evaluated on circulating inflammatory and vascular biomarkers, physical examination and medical history, exercise performance, calf muscle StO2 during exercise, and ambulatory activity monitored during one week. Results Cellular ROS production was higher in African-American women than in men (p = 0.021), but there was no gender difference in Caucasians (p = 537). Men and women were not significantly different on endothelial cell apoptois (p = 833) and NF-κB activity (p = 0.465). For circulating factors, additional gender differences were found when comparisons were made within each race. In African-Americans, women had higher intercellular cell adhesion molecule-1 (p = 0.022) and leptin (p < 0.001), whereas in Caucasians, women had higher matrix metallopeptidase 9 (p = 0.047), higher vascular cell adhesion molecule-1 (p = 0.047), and lower hepatocyte growth factor (p = 0.046). Overall, women had higher apolipoprotein CIII (p = 0.035), lower pain-free distance (p = 0.048) and total distance (p < 0.001) during the 6-minute walk test, shorter time for calf muscle StO2 to reach the minimum value during exercise (p = 0.027), and slower average cadence (p = 0.004) during daily ambulation. Conclusions African-American women with symptomatic PAD have a heightened oxidative status likely resulting in increased endothelial oxidative stress than men. Furthermore, women exhibit a more pronounced pro-inflammatory profile of circulating biomarkers than men, as well as more limited peripheral microcirculation, exercise performance, and ambulatory activity than men. The clinical significance is that women with symptomatic PAD are in greater need of clinical intervention to improve oxidative stress, inflammation, and microcirculation than men, which may, in turn, favorably impact their lower exercise performance and daily activity.

Section: Discussionmentioning

confidence: 99%

Gender and racial differences in endothelial oxidative stress and inflammation in patients with symptomatic peripheral artery disease

Gardner

Parker

et al. 2015

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“…7, 10, 11 We have reported that circulating inflammatory biomarkers are associated with community-based daily walking in symptomatic patients with PAD, but it is not known whether physical activity modifies circulating antioxidant capacity. 12 It is established that physical activity reduces oxidative stress and increases the ability to respond to oxidative challenges in older adults, suggesting that antioxidant capacity may be increased in older adults who are physically active. 13–16 However, the influence of monitored daily walking on antioxidant capacity in symptomatic patients with PAD, who typically have greater cardiovascular burden and inflammation than healthy older adults, has not been addressed.…”

Section: Introductionmentioning

confidence: 99%

“…13–16 However, the influence of monitored daily walking on antioxidant capacity in symptomatic patients with PAD, who typically have greater cardiovascular burden and inflammation than healthy older adults, has not been addressed. 12, 17–19 …”

Section: Introductionmentioning

confidence: 99%

Association between daily walking and antioxidant capacity in patients with symptomatic peripheral artery disease

Gardner

Zhao

et al. 2017

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Objective The primary aim of the study was to assess whether both the amount and pace of daily walking were associated with circulating antioxidant capacity in symptomatic patients with peripheral artery disease (PAD). Methods Community-based walking was measured in 244 men and women who were limited by symptomatic PAD during a one week period in which they wore an ankle-mounted step activity monitor. Patients were further characterized on circulating antioxidant capacity with the OxiSelect hydroxyl radical antioxidant capacity (HORAC) activity assay. Results To assess the amount of walking, patients were grouped into low (≤ 2,440 strides/day), middle (2,441–3,835 strides/day), and high stride (>3,835 strides/day) tertiles. HORAC was higher in the middle (p=.03) and high stride tertiles (p=.01) than in the low tertile, but there was no difference between middle and high tertiles (p=.44). To assess the pace of walking, patients were grouped into slow (<25.0 strides/min), middle (25.0–31.6 strides/min), and fast cadence (>31.6 strides/min) tertiles. HORAC was higher in the high cadence tertile than in the low (p<.01) and middle tertiles (p<.01), but there was no difference between low and middle tertiles (p=.48). Similar findings were obtained on group differences in HORAC after adjusting for age, sex, race, and ankle-brachial index for both the amount and pace of daily walking. Conclusions Walking more than 2,440 strides each day, or walking at a cadence faster than 31.6 strides/min for 30 minutes each day are both associated with greater circulating antioxidant capacity in symptomatic patients with PAD. The clinical significance is that a home-based walking program may be one approach to increase endogenous antioxidant capacity.

“…Physical inactivity is one factor that may negatively impact vascular biomarkers in patients with PAD 5 . More recently, sedentary behavior has emerged as an important cardio-metabolic risk factor in the general population 6-8 , as greater time spent in sedentary activities is associated with type 2 diabetes, fatal and nonfatal cardiovascular disease, and all-cause mortality 6-8 .…”

Section: Introductionmentioning

confidence: 99%

Sedentary behavior is associated with impaired biomarkers in claudicants

Farah

Ritti‐Dias

et al. 2016

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Objective Time spent in sedentary behavior has been associated with worse inflammation and cardio-metabolic biomarkers in various populations. However, the association between time spent in sedentary behavior and biomarkers remains unknown in intermittent claudication patients. The aim of the current study was to analyze the relationship between sedentary behavior and inflammatory and cardio-metabolic biomarkers in patients with symptomatic peripheral artery disease (PAD). Methods The sample included 297 patients with intermittent claudication. Sedentary behavior was assessed using a step activity monitor. Biomarkers of inflammation, oxidative stress, lipid profile, insulin resistance and endogenous fibrinolysis were assessed. Demographic data, body mass index, physical activity status, measures of severity of PAD (ankle brachial index, peak walking time and ischemic window) also were obtained. Results Time spent in sedentary behavior was related with high sensitive C-reactive protein (HsCRP) (b = 0.187 P=.005), glucose (b = 0.238, P<.001), fibrinogen (b = 0.167, P=.017), plasminogen activator inhibitor-1 activity (b = 0.143, P=.036) and high density lipoprotein cholesterol (HDL-C) (b = -0.133, P=.029). After adjustment for sex, age, physical activity status, body mass index and severity of PAD, sedentary behavior remained related with HsCRP (b = 0.170, P=.015), glucose (b = 0.178, P=.004), fibrinogen (b = 0.189, P=.010) and HDL-C (b = -0.128, P=.032). Conclusion Time spent in sedentary activities was associated with worse inflammatory and cardio-metabolic profile in intermittent claudication patients.