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Effect of prolonged standardized bed rest on cystatin C and other markers of cardiovascular risk
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
Institut Pluridisciplinaire Hubert Curien-De'partement d'Ecologie, Physiologie, Ethologie Unite' Mixte de Recherche 7178. Centre National de la Recherche Scientifique, Universite' de Strasbourg, Strasbourg, France.
Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden.
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2011 (English)In: BMC Physiology, ISSN 1472-6793, E-ISSN 1472-6793, Vol. 11, article id 17Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sedentary lifestyle is associated with coronary artery disease but even shorter periods of physical inactivity may increase cardiovascular risk. Cystatin C is independently associated with cardiovascular disease and our objective was to investigate the relation between this novel biomarker and standardized bed rest. Research of immobilization physiology in humans is challenging because good biological models are in short supply. From the Women International Space simulation for Exploration study (WISE) we studied markers of atherosclerosis and kidney function, including cystatin C, in a standardized bed rest study on healthy volunteers. Fifteen healthy female volunteers participated in a 20-day ambulatory control period followed by 60 days of bed rest in head-down tilt position (-6°) 24 h a day, finalized by 20 days of recovery. The subjects were randomized into two groups during bed rest: a control group (n = 8) that remained physically inactive and an exercise group (n = 7) that participated in both supine resistance and aerobic exercise training.

RESULTS: Compared to baseline values there was a statistically significant increase in cystatin C in both groups after bed rest (P < 0.001). Glomerular filtration rate (GFR), calculated by both cystatin C and Cockcroft-Gault equation, decreased after bed rest while there were no differences in creatinine or creatine kinase levels. CRP did not change during bed rest in the exercise group, but there was an increase of CRP in the control group during recovery compared to both the baseline and the bed rest periods. The apo-B/apo-Ai ratio increased during bed rest and decreased again in the recovery period. Subjects experienced a small but statistically significant reduction in weight during bed rest and compared to baseline weights remained lower at day 8 of recovery.

CONCLUSION: During and following prolonged standardized bed rest the concentrations of several clinically relevant cardiovascular risk markers change.

Place, publisher, year, edition, pages
BioMed Central, 2011. Vol. 11, article id 17
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-66787DOI: 10.1186/1472-6793-11-17PubMedID: 22152087Scopus ID: 2-s2.0-83055192077OAI: oai:DiVA.org:oru-66787DiVA, id: diva2:1201713
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-08-27Bibliographically approved
In thesis
1. Immobilization as a risk factor for arterial and venous thrombosis
Open this publication in new window or tab >>Immobilization as a risk factor for arterial and venous thrombosis
2018 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: Immobilization and a sedentary lifestyle are correlated with an elevated risk of both arterial and venous thrombosis. The goal of this research was to investigate whether markers associated with cardiovascular disease risk are altered during long term immobilization in a human model and in the brown bear, which survives annual cycles of long-term immobilization.

Methods: In study populations assigned to 20-60 days of strict head-down-tilt bed rest 24h a day, we analysed blood levels of the emerging cardiovascular disease marker cystatin C, soluble markers of in vivo platelet activation P-selectin and PDGF-BB, and platelet aggregation. Blood samples were taken from free-ranging brown bears in summer and again during hibernation for analysis of lipid profile and platelet aggregation. Histological examination was performed on the left anterior descending coronary artery and aortic arches of bears harvested during the hunting season.

Results: During prolonged bed rest in humans, levels of cystatin C and platelet aggregation remained unchanged, but we observed a significant decrease in platelet activation markers. Brown bear plasma lipids were elevated during hibernation compared with the active state and cholesterol levels were generally considerably higher than normal human values. The arterial specimens showed no signs of atherosclerosis. Platelet aggregation was halved during hibernation compared to the active state.

Conclusions: Long-term immobilization has effects on several cardiovascular risk factors in both humans and bears. Increased knowledge and understanding of the protective mechanisms that allows the brown bear to survive repeated periods of immobilization could contribute to new strategies for prevention and treatment of cardiovascular disease in humans.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 69
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 179
Keywords
Venous thrombosis, arterial thrombosis, atherosclerosis, cystatin C, cholesterol, platelet activation, platelet aggregation, immobilization
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-65003 (URN)978-91-7529-243-4 (ISBN)
Public defence
2018-06-07, Örebro universitet, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 09:15 (Swedish)
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Available from: 2018-02-14 Created: 2018-02-14 Last updated: 2018-05-15Bibliographically approved

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Arinell, KarinFröbert, Ole

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