Relation of cardiorespiratory fitness to inflammatory markers, fibrinolytic factors, and lipoprotein(a) in patients with type 2 diabetes mellitus

Am J Cardiol. 2008 Sep 15;102(6):700-3. doi: 10.1016/j.amjcard.2008.05.012. Epub 2008 Jun 26.

Abstract

Increased inflammation, fibrinolytic factors, and lipoprotein(a) (LP[a]) were associated with increased cardiovascular events in patients with type 2 diabetes, whereas higher levels of cardiorespiratory fitness (CRF) were associated with a lower incidence of cardiovascular mortality. Whether CRF is associated with inflammatory markers, fibrinolytic factors, and LP(a) in patients with type 2 diabetes was investigated. A total of 425 men with type 2 diabetes (mean age 55 +/- 8 years) who participated in a medical screening program were studied. CRF was measured using peak oxygen uptake with expired gas analysis during a symptom-limited exercise test. CRF inversely correlated with C-reactive protein (CRP; r = -0.27, p <0.05), white blood cell count (r = -0.13, p <0.05), fibrinogen (r = -0.28, p <0.05), LP(a) (r = -0.53, p <0.05), tissue plasminogen activator (t-PA) antigen (r = -0.65, p <0.05), and plasminogen activator inhibitor-1 activity (r = -0.17, p <0.05). Men in the highest tertile of CRF had significantly lower CRP, white blood cell count, fibrinogen, LP(a), and t-PA than men in the lowest tertile of CRF (all p <0.05). In separate multivariable linear regression models that adjusted for age, body mass index, smoking, lipid profiles, glucose, and systolic blood pressure, CRP (beta = -0.23, p <0.05), white blood cell count (beta = -0.16, p <0.05), fibrinogen (beta = -0.24, p <0.05), LP(a) (beta = -0.28, p <0.05), and t-PA (beta = -0.69, p <0.05) were each inversely associated with CRF. Each MET increment higher peak oxygen uptake was associated with a lower odds ratio of having abnormal LP(a) (odds ratio 0.43, 95% confidence interval 0.20 to 0.91) in a multivariate logistic regression model. In conclusion, CRF was inversely associated with inflammatory markers, fibrinolytic factors, and LP(a) in men with type 2 diabetes.

MeSH terms

  • Age Factors
  • Biomarkers / blood
  • Body Fat Distribution
  • C-Reactive Protein / analysis
  • Cardiovascular Physiological Phenomena*
  • Cholesterol / blood
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Exercise Test
  • Fibrinogen / analysis*
  • Humans
  • Leukocyte Count
  • Lipoprotein(a) / blood*
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology
  • Physical Fitness / physiology*
  • Plasminogen Activator Inhibitor 1 / blood
  • Respiratory Physiological Phenomena*
  • Tissue Plasminogen Activator / blood

Substances

  • Biomarkers
  • Lipoprotein(a)
  • Plasminogen Activator Inhibitor 1
  • Fibrinogen
  • C-Reactive Protein
  • Cholesterol
  • Tissue Plasminogen Activator