HIRAMATSU Yuji University of Tsukuba, Graduate School of Comprehensive Human Science, Associate professor, 大学院・人間総合科学研究科, 助教授 (30302417)
TANAKA Kiyoji University of Tsukuba, Graduate School of Comprehensive Human Science, Professor, 大学院・人間総合科学研究科, 教授 (50163514)
|Budget Amount *help
¥3,700,000 (Direct Cost : ¥3,700,000)
Fiscal Year 2005 : ¥600,000 (Direct Cost : ¥600,000)
Fiscal Year 2004 : ¥900,000 (Direct Cost : ¥900,000)
Fiscal Year 2003 : ¥2,200,000 (Direct Cost : ¥2,200,000)
Introduction : Adult disease, including atherosclerosis, has its origins in childhood. Endothelial and platelet functions are implicated in progression of atherosclerosis. Although weight control is important for prevention of adult disease, changes in endothelial and platelet function due to growth or to exercise have not been clarified. Moreover, effective diet and/or exercise intervention from childhood has not been established. We investigated platelet activity and coagulofibrinolytic proteins that enhance endothelial function in children, adults and patients with cyanotic congenital heart disease (CCHD). We also assessed the effect of weight reduction on these markers.
Materials and Method : 1.Plasma levels of soluble P-selectin, beta-thromboglobulin (beta-TG), platelet factor 4 (PF4), protein C and protein S in CCHD patients were measured. 2.Diurnal changes (9:00 am vs 4:00 pm) in plasminogen activator inhibitor-1 (PAI-1) activity and tissue-type plasminogen activator (t-PA) antig
en levels in CCHD patients were evaluated. 3.Effects of weight reduction on platelet derived microparticles (PMP) released from activated platelets, PAI-1 activity and t-PA antigen were compared between 12-week calorie restricted diet with or without aerobic exercise in obese adults.
Results : 1.Plasma levels of P-selectin, beta-TG,PF4 were significantly high, and those of free protein S antigen and protein C activity were significantly low in CCHD patients compared with acyanotic patients. P-selectin and beta-TG correlated positively, and protein S and protein C correlated negatively with hematocrit. 2.Morning increase of PAI-1 activity and t-PA antigen levels was observed in CCHD patients. Plasma levels of t-PA antigen at 9 am and 4 pm were higher in CCHD patients than those in acyanotic patients, and correlated positively with the levels of erythrocytosis. 3.PMP,PAI-1 activity and t-PA antigen values were elevated in obese adults in comparison with non-obese adults, and these three parameters correlated with body mass index (BMI). The intervention significantly reduced PMP,PAI-1 and t-PA antigen levels. There was a significant correlation between percentages of change in PMP values and those in BMI, fat tissue mass.
Conclusion : Weight reduction appears to be essential for prevention of adult disease, through improvement of endothelial and platelet functions. There were platelet and coagulofibrinolytic abnormalities in CCHD patients who were exposed to chronic hypoxia. Strenuous exercise would induce transient tissue hypoxia. Establishment of appropriate diet and exercise therapies for age could contribute to prevention of adult disease from childhood. Less