Regular physical activity and cardiovascular biomarkers in prevention of atherosclerosis in men: a 25-year prospective cohort study

Background: The purpose of the study was to examine the association between leisure-time physical activity (LTPA), cardiovascular biomarkers and atherosclerosis among asymptomatic men with stable LTPA level throughout the 25-year prospective observation. Methods: Out of 101 asymptomatic men prospectively observed for their lifestyle and cardiovascular risk factors, the cohort of 62 individuals (mean age 59.9 years) maintained a stable LTPA level during the 25-year observation. Regular check-ups with the assessment of traditional risk factors, detailed measurements of LTPA level and aerobic capacity were performed since baseline. At the latest follow-up (2011/12) a set of cardiovascular biomarkers was measured using enzyme-linked immunosorbent assay. Subclinical atherosclerosis was assessed by means of coronary artery calcification score and intima-media thickness (IMT). Endothelial function was evaluated by means of the reactive hyperemia index. The studied biomarkers and indices were analyzed in the three cohorts representing stable low-tomoderate (< 2050 kcal/week), high (2050-3840 kcal/week) and very high LTPA (> 3840 kcal/week). Results: At baseline the three cohorts were comparable in terms of age and clinical characteristics. At follow-up, the cohort with stable high LTPA (2050-3840 kcal/week) had significantly lower concentrations of hs-CRP (2.20 +/- 1.0 mg/L), oxidized-LDL (68.35 +/- 67.7 ng/mL), leptin (4.71 +/- 3.07 ng/mL) and irisin (0.47 +/- 0.13 mu mol/L), and the most favorable indices of atherosclerosis and endothelial function as compared with other groups (p < 0.05). Regular marathon runners had increased concentrations of hsCRP (3.12 +/- 1.4 mg/L), oxidized-LDL (249.8 +/- 129 ng/ml), Interleukine-6 (3.74 +/- 2.4 pg/ml). A positive correlation was observed between hsCRP and IMT (r = 0.301; p < 0.01), and irisin and IMT (r = 0.223; p < 0.05). Conclusions: The data suggest that stable high LTPA (2050-3840 kcal/week) is associated with the most favorable profile of key cardiovascular biomarkers and indices of atherosclerosis. Lifetime very high LTPA is associated with increased lowgrade inflammation and may, therefore, exert an atherogenic effect.