The Mediating Role of Physical Inactivity on the Relationship between Inflammation and Artery Thickness in Prepubertal Adolescents

Abstract

Objective To analyze the relationship between inflammatory markers and the lipid profile, blood flow, and artery structure in prepubertal adolescents stratified according to sports practice. Study designThe sample was composed of 120 adolescents (57 boys and 63 girls) with a mean age of 11.7 AE 0.7 years (ranging from 11 to 13 years). Intima-media thickness (IMT) and blood flow were measured with ultrasonography. The lipid profile and high-sensitivity C-reactive protein were measured after the subjects had fasted for 12 hours overnight. Trunk fatness was measured by dual-energy x-ray absorptiometry. Organized sports participation was analyzed as a categorical variable. Biological maturation was determined via the age at peak height velocity.Results In the adjusted model, high-sensitivity C-reactive protein was significantly related to high-density lipopro- H igh-sensitivity C-reactive protein (hsCRP) is an acute-phase protein produced by the liver in response to interleukin-6, which is directly related to vascular inflammation.1,2 During the atherosclerotic process, hsCRP is associated with greater permeability of the intima layer through stimuli of intercellular/vascular cell adhesion molecules. hsCRP also acts in processes related to oxidation of lipoproteins in the vascular wall.2,3 Strategies to counteract inflammation status commonly include both pharmacologic and nonpharmacologic strategies. In the latter, lifestyle changes frequently are used, especially improved diet, giving up smoking, and practicing physical exercise. 4 Q5Indeed, physical exercise at moderate intensity plays an anti-inflammatory role. 4,5 Its prolonged practice has been linked to the control the progression of intima-media thickness (IMT) in hypertensive adults 6 and also in healthy adolescents. 7,8Recently, studies have reported that behavioral variables can modulate the relationship between the progression of artery IMT and its risk factors.9,10 For instance, smoking exacerbates the relationship between age and the metabolic syndrome components and age and carotid IMT (cIMT) in young adults. 10 In contrast, the same harmful effect related to age has been observed relating to physical inactivity.9 However, physical inactivity seems to exacerbate the relationship between cIMT Q6and overweight, blood pressure, and dyslipidemia in adults. 9The objective of the present study was to analyze the relationship between hsCRP and the lipid profile, blood flow, and artery IMT in prepubertal adolescents who were stratified according to their engagement in sports practice. It was hypothesized that inflammation would be positively and strongly related to cardiovascular/metabolic outcomes in inactive youth compared with the active ones, independent of body fatness and biological maturation.

Impact of physical exercise/activity on vascular structure and inflammation in pediatric populations: A literature review

“…In European adolescents, cross-sectional data identify that sedentary behaviors seem to affect adiposity, while physical activity affects metabolic and cardiovascular outcomes (Coutinho et al, 2013). However, regular engagement in physical activities seems to promote cardiovascular health in children and adolescents independent of body fatness (Cayres, de Lira, et al, 2015;Cayres, Vanderlei, et al, 2015;Christofaro et al, 2013;Herouvi et al, 2013).…”

“…The prevalence of both unhealthy behaviors (e.g., unhealthy diet, skipping breakfast, a large quantity of time spent on sedentary behaviors, and low physical activity practice) and harmful cardiovascular outcomes have increased among adolescents (Cayres, de Lira, et al, 2015;Cayres, Júnior, Barbosa, Christofaro, & Fernandes, 2016;Coutinho, Santos, Folmer, & Puntel, 2013;de Rezende, Lopes, Rey-López, Matsudo, & do Carmo Luiz, 2014). Physical inactivity has been pointed out as a harmful behavior, which should be avoided, particularly in pediatric populations, since obesity (Herouvi, Karanasios, Karayianni, & Karavanaki, 2013), high blood pressure (Stabouli, Kotsis, Karagianni, Zakopoulos, & Konstantopoulos, 2012), and metabolic syndrome (Aydin et al, 2013) constitute outcomes commonly related to physical inactivity (Cayres, de Lira, et al, 2015).…”

“…Physical inactivity is able to modify the lipid plasmatic concentration, by increasing the very low-density lipoprotein/triacylglycerol ratio (VLDL/TG), low-density lipoprotein-cholesterol (LDL-c), and triacylglycerol and decreasing highdensity lipoprotein-cholesterol (HDL-c), given that it contributes to the development of risk factors associated with cardiovascular diseases such as the formation and adhesion of atheroma plaque, and consequently, arterial thickening (D'Adamo et al, 2015;Quijada et al, 2008). In addition, more recent literature has also offered support to the effects of insufficient physical activity on intima-media thickening during adolescence (Cayres, de Lira, et al, 2015;Pahkala et al, 2011), which seems to be principally affected by anti-inflammatory pathways (Juonala, Viikari, et al, 2006). Thus, the aim of this review article was to describe the effects of physical exercise/activity on the vascular architecture of children and adolescents, as well as to identify the effects of inflammation and sedentary behaviors on this relationship.…”

Sports participation is inversely associated with C‐reactive protein levels in adolescents: ABCD Growth Study

“…Sports participation is a typical manifestation of physical exercise during the first decades of life, this behavior being influenced by age, sex, family income, and cultural background . Engagement in sports during adolescence usually embraces activities at a moderate‐to‐vigorous intensity and evidence supports the benefits on inflammatory and cardiovascular risk factors …”

Can participation in sports during childhood influence physical activity in adulthood?

“…Research also reveals how this behavior during youth can develop assets that endorse positive trajectories during life 22 . In this perspective, the promotion of sports participation during the early years of life is important not only because it promotes health during childhood and adolescence [3][4][5][6] but also because it stimulates engagement in physical activity in adulthood. 7 From a preventive point of view, it is reasonable to believe that adults who participated in sports or attempted some kind of extracurricular activities (e.g.…”