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Doctoral Thesis
DOI
10.11606/T.98.2011.tde-15092011-103643
Document
Author
Full name
Giuseppe Sebastiano Dioguardi
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Batlouni, Michel (President)
Bertolami, Marcelo Chiara
Chalela, William Azem
Ghorayeb, Nabil
Santos Filho, Raul Dias dos
Title in Portuguese
Avaliação dos efeitos da corrida de maratona nos marcadores de estresse oxidativo, inflamatórios e miocárdicos
Keywords in Portuguese
Aterosclerose
Corrida
Estresse oxidativo
Exercício
Tolerância ao exercício
Abstract in Portuguese
Fundamentos: Os efeitos benéficos do exercício físico regular, moderado, estão bem estabelecidos. De outra parte, os efeitos do exercício intenso, prolongado e exaustivo são controversos. Alguns efeitos indesejáveis podem ser o estresse oxidativo, a oxidação da LDL nativa e a resposta inflamatória de fase aguda. Objetivo: avaliar essas variáveis em maratonistas. Os efeitos agudos foram avaliados imediatamente e 72 h após a corrida e os efeitos crônicos foram avaliados na comparação com grupo controle. Casuística e métodos: população constituída por vinte e sete maratonistas, homens, 41+- 8 anos de idade, 74% brancos, sadios e 26 controles equiparáveis. Resultados: 1) Em condições basais (maratonistas x controles) no perfil oxidativo evidenciou-se: a) estado antioxidante total do plasma (TAS); 3,76+-0,34 versus 3,45+-0,32, mmol/L, p=0,002; b) peróxidos; 0,41+-0,15 versus 0,65+-0,42, p=0,011; c) LDLox; sem diferença significativa; d) anticorpos anti-Ldlox; não houve diferença significativa. No perfil imunoinflamatório observou-se: a) PCR us; 1,49+-1,11 versus 1,03+-1,39, mg/L, p=0,004; b) IL-15; 42,83+-109,47 versus 34,80+-128,57 pg/ml, p=0,021; c) TNF-alfa 8,07+-13 versus 33,98+-39,63 pg/ml. 2) Maratonistas, condições basais versus imediatamente após a prova: a) LDLox; 88,18+-22,05 versus 148,46+-74,76 U/L, p<0,001; b) Interleucinas: IL-6=30,08+-40,66 versus 113,61+-91,39, pg/ml, p<0,05, IL-8=38,36+-36,57 versus 85,02+-53,91,pg/ml,p 1600%); CPK; 205+-121 versus 403+-134, p<0,05; DHL; 107+-28 versus 302+-44 U/L, p<0,05. e) Marcadores cardíacos: CKMB-Massa; 2,65+-2,43 versus 5,34+-3,01, troponina I; 0,023+-0,032 versus 0,045+-0,044,ng/ml,p<0,05. 3) Maratonistas, condições basais versus 72 h após a prova: a) TAS; 3,76+-0,34 versus 3,39+-0,92 U/L, p=0,05; b) anticorpos anti-LDLox; 439,23+-409,65 versus 225,10+-189,16,U/L, p<0,001; c) peróxidos=0,41+-0,15 versus 0,49+-0,11 U/L, p=0,03. No perfil inflamatório observou-se: a) PCR us 1,49+-1,11 versus 3,15+-2,22, mg/l,p<0,05; b) IL-8;38,36 +- 36,57 versus 45,28+-25,21 pg/ml, p <0,05. Marcadores músculo-esqueléticos a) CPK; 205,93+-121,47 versus 601,30+_567,80 U/L, p<0,001e b)DHL;197,44+-28,99 versus 267,30+-78,21 U/L, p<0,001. Enzimas cardíacas: a) CKMB-Massa;2,65+-2,43 versus 4,88+-5,60 ng/ml, p<0,05. O ecocardiograma mostrou cavidades esquerdas e massa do VE maiores em maratonistas que em controles. Adicionalmente foram submetidos a angiotomografia coronária 22 maratonistas e 20 controles. Em 5 (22,7%) dos maratonistas e em 3 (15%) dos controles, foram encontradas placas ateroscleróticas discretas. Conclusões: após corrida de maratona observa-se agudamente estresse oxidativo, aumento da LDLoxidada, resposta inflamatória de fase aguda e aumento da CKMB-massa. Estas alterações não foram observadas em condições basais.
Title in English
Assessment of the marathon race effects on oxidative stress, inflammatory and myocardial markers
Keywords in English
Atherosclerosis
Exercise
Exercise tolerance
Oxidative stress
Race
Abstract in English
The beneficial effects of regular, moderate exercise are well estabilished. On the other hand, the effects caused by the heavy and exhaustive exercise for longer periods are controversial. Some of these unpleasant effects. may be oxidative stress, the oxidation of the native LDL and acuse phase inflammatory response. Objective: Assess these variables in marathon runners. The acute effects were assessed immediately and 72 hours after the race, the chronical effects were assessed in basal condition and in comparision with the control group. Methods: A population consisting of 27 marathon runners, male, 41± 8 y old, 74% white, healthy and 26 matchable controls. Results: 1) On basal conditions (marathon runners X control group) regarding oxidative profile, the findings were the following: a) Total Anti-oxidant State of the plasma (TAS); 3.76 ± 0.34 versus 3.45 ± 0.35 mmol/L , p=0.002; b) Peroxides 0.48± 0.15 versus 0.65± 0.42, p=0.011 c) Anti ox LDL antibodies, and oxLDL without a significative difference. In the immunoinflamatory profile the findings are the following observed: a) us CRP; 1.49± 1.11 versus 1.03± 1.36, mg/L, p=0.004; b) IL-15; 42.83± 109.47 versus 4.80± 128.57 pg/ml, p=0.021; c) TNF-alfa 8.07± 13 versus 33.98± 39.63 pg/ml. 2) Marathon runners´ basal conditions versus their condition immediately after the race. a) OxLDL; 88.18± 22.05 versus 148.46± 74.76 U/L, p<0.001; b) Interleukynes: IL-6=30.08± 40.66 versus 113.61± 91.39, pg/ml p<0.05, IL-8=38.63± 36.57 versus 85.02± 53.91,pg/ml, p<0.05, IL-10=21.08± 36.12 versus 141.82± 124.98,pg/ml, p<0.05, IL-15=42.83± 109.47 versus 169.60± 244.84 pg/ml, p<0.05, e TNF-alfa=8.07± 13 versus 32.65± 42.24, ph/ml, p<0.05; c) leucocytes; 5.581± 1.122 versus 13.807± 5.393, mil/ml, p<0.05; d) skeletal muscle markers: myoglobine; 41± 31 versus 659± 344,ng/ml, p<0.05 (>1600%); CPK; 205± 121 versus 403± 134, p<0.05; DHL; 107± 28 versus 302± 44 U/L, p<0.05. e) Myocardial markers: CKMB-mass; 2.65± 2.43 versus troponina I; 0.023± 0.032 versus 0.045± 0.044, ng/ml, p<0.05. 3) Marathon runners´ basal conditions versus their condition 72 hours after the race: a) TAS; 3.76± 0.34 versus 3.39± 0.92 U/L, p=0.05; b) Anti-oxLDL antibodies; 439.23± 409.65 versus 225.10± 489.16, U/L, p<0.001; c) Peroxides= 0.41± 0.15 versus 0.49± 0,11 U/L, p=0.03. Regarding the oxidative profile, the following was found: a) us CRP 1.49± 1.11 versus 3.15± 2.22, mg/l, p<0.05; b) IL-8; 38.36± 36.57 versus 45.28± 25.21pg/ml, p<0.05. Skeletal muscle markers: a) CPK; 205.93± 121.47 versus 601.30± 567.80 U/L, p<0.001 e b) DHL; 197.4± 28.99 versus 267.3± 78.21 U/L, p<0.001. Cardiac enzymes: a) CMKB-mass; 2.65± 2.43 versus 4.88± 5.6 ng/ml, p<0.05. The echocardiogram showed bigger left cavities and increased VE mass in marathon runners than the ones in the control group. In addition, 22 marathon runners and 20 individuals in the control group were submitted to coronary angiotomography. Discreet atherosclerotic plaques were found in five marathon runners and in three individuals of the control group. Conclusion: Accute oxidative stress, inflammatory response acute phase, increased oxLDL as well as a higher level of the CKMB mass were observed after the marathon race.
 
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Publishing Date
2011-09-28
 
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