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Exercise training for intermittent claudication: Does it adversely affect biochemical markers of the exercise-induced inflammatory response?
Open accessAbstract
Objectives To identify a stable biochemical marker of disease severity in patients with intermittent claudication and to use these findings to assess the effect of therapeutic exercise training.Design Case-control study: prospective randomised-controlled trial of exercise training.Materials and methods Plasma fibrinogen, serum amyloid A protein (SAA), C-reactive protein (CRP) and urinary albumin-creatinine ratio (ACR) were measured in 67 claudicants and 15 controls. Twenty-two patients were randomised to supervised exercise training and 17 randomised to observation. Subjects were reviewed at 3, 6 and 12 months.Results The median (interquartile range) baseline fibrinogen was 3.7 g/l (3.3-4.25) in claudicants and 3.5 g/l (2.9-3.95) in controls (p = 0.045); CRP was 4.7 mg/l (2.2-9.0) and 2.1 mg/l (1.0-2.8), respectively (p < 0.0001); SAA was 72 mg/l (35-132) and 30 mg/l (20-89) (p = 0.0009). Claudicants showed an increased urinary ACR following treadmill exercise (Wilcoxon, p < 0.0001) with no change in controls. Exercise training reduced SAA at 6 months, CRP at 3 months and progressively attenuated the post-exercise increase in ACR. No similar changes were found in controls.Conclusions Repetitive low-grade inflammatory events in claudicants lead to elevation of serum acute-phase proteins. Exercise training is associated with symptomatic improvement and reduction inflammatory markers. The concern that exercise has adverse systemic effects therefore seems to be unjustified.
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“Cross-sectional studies demonstrate an association between physical inactivity and low-grade systemic inflammation in healthy subjects [71–75], in elderly people [76, 77], and in patients with intermittent claudication [78].”
From Exercise as a Mean to Control Low‐Grade Systemic Inflammation (2008) · cites this paper as [78]
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Metadata
- Authors
- Tisi, P. V., Hulse, M., Chulakadabba, A., Gosling, P., & Shearman, C. P.
- Affiliations
- Royal South Hants Hospital (GB)
- Selly Oak Hospital (GB)
- Venue
- European Journal of Vascular and Endovascular Surgery
- Publisher
- Elsevier BV
- Published
- 1997-11
- Volume
- 14
- Issue
- 5
- Pages
- 344-350
- ISSN
- 1078-5884 (ISSN-L)
- OpenAlex
- W2165389773
- Cited by
- 199
- References
- 31
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 7 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 3 · 2017: 6 · 2016: 6 · 2015: 14 · 2014: 9 · 2013: 4 · 2012: 16
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- European Journal of Vascular and Endovascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Keywords
- intermittent claudication, exercise training, inflammatory markers, C-reactive protein, serum amyloid A, fibrinogen, urinary albumin-creatinine ratio, acute phase proteins, peripheral arterial disease, treadmill exercise, disease severity markers
- MeSH terms
- Aged, Albuminuria, Serum Amyloid A Protein, C-Reactive Protein, Creatinine, Exercise Therapy, Female, Fibrinogen, Humans, Inflammation, Intermittent Claudication, Male, Prospective Studies, Biomarkers, Case-Control Studies
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