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(Circulation. 2008;118:2353-2359.)
© 2008 American Heart Association, Inc.

Exercise Physiology

Vascular Endothelial Function and Leisure-Time Physical Activity in Adolescents

Katja Pahkala, MSc; Olli J. Heinonen, MD, PhD; Hanna Lagström, PhD; Paula Hakala, PhD; Olli Simell, MD, PhD; Jorma S.A. Viikari, MD, PhD; Tapani Rönnemaa, MD, PhD; Miika Hernelahti, MD, PhD; Lauri Sillanmäki, StudSocSc; Olli T. Raitakari, MD, PhD

From the Research Centre of Applied and Preventive Cardiovascular Medicine (K.P., O.S., M.H., L.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physiology (K.P., O.J.H., M.H.); and Departments of Pediatrics (O.J.H., O.S.), Medicine (J.S.A.V., T.R.), and Clinical Physiology (O.T.R.), University of Turku; Turku Institute for Child and Youth Research (H.L., O.S.); and Research Department of the Social Insurance Institution (P.H.), Turku, Finland.

Correspondence to Katja Pahkala, University of Turku, Research Centre of Applied and Preventive Cardiovascular Medicine, Kiinamyllynkatu 10, FI-20520 Turku, Finland. E-mail katja.pahkala{at}utu.fi

Received May 16, 2008; accepted October 3, 2008.

Background— Exercise training improves endothelial function in high-risk adolescents, but the influence of habitual leisure-time physical activity on endothelial function in healthy adolescents is unknown.

Methods and Results— Brachial artery flow-mediated endothelial function and physical activity habits were assessed in 483 adolescents (13 years of age) participating in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project for Children [STRIP]). Endothelial function was examined with ultrasound; physical activity was assessed with self-administered questionnaires. A leisure-time physical activity index was calculated by multiplying mean weekly leisure-time exercise intensity, duration, and frequency [boys, 31.2±23.0 MET h/wk (mean±SD); girls, 24.0±20.9 MET h/wk; P for gender difference=0.0003]. Maximum flow-mediated dilatation (FMD) and total FMD response (the area under the dilatation curve 40 to 180 seconds after hyperemia) were calculated. In boys, maximum FMD and area under the dilatation curve 40 to 180 seconds after hyperemia were directly associated with leisure-time physical activity index in regression analyses adjusted for brachial artery diameter (maximum FMD, P=0.020; area under the dilatation curve 40 to 180 seconds after hyperemia, P=0.0055). These associations remained significant after further adjustments for body mass index, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein, and systolic blood pressure. A difference of 50 MET h/wk corresponding to 10 hours of moderate intensity activity weekly between sedentary and active boys was associated with an 1% unit difference in maximum FMD.

Conclusions— Leisure-time physical activity is directly associated with brachial artery FMD responses in 13-year-old boys, providing evidence that physical activity beneficially influences endothelial function in healthy male adolescents. Lack of association in girls may reflect their overall lower physical activity level.

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CLINICAL PERSPECTIVE

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