Effects of 12-week Aerobic Exercise on Arterial Stiffness, Inflammation, and Cardiorespiratory Fitness in Women with Systemic LUPUS Erythematosus: Non-Randomized Controlled Trial.

Alberto Soriano-Maldonado,José Vargas-Hitos,José Sabio,Pablo Morillas-De-Laguno,Cristina Montalbán-Méndez,Blanca Gavilán-Carrera,Antonio Rosales-Castillo,Luis Sáez-Urán,José Callejas-Rubio

doi:10.3390/jcm7120477

Abstract

This study assessed the effect of 12-week aerobic exercise on arterial stiffness (primary outcome), inflammation, oxidative stress, and cardiorespiratory fitness (secondary outcomes) in women with systemic lupus erythematosus (SLE). In a non-randomized clinical trial, 58 women with SLE were assigned to either aerobic exercise (n = 26) or usual care (n = 32). The intervention comprised 12 weeks of aerobic exercise (2 sessions × 75 min/week) between 40–75% of the individual’s heart rate reserve. At baseline and at week 12, arterial stiffness was assessed through pulse wave velocity (PWV), inflammatory (i.e., high-sensitivity C-reactive protein [hsCRP], tumor necrosis factor alpha [TFN-α], and inteleukin 6 [IL-6]) and oxidative stress (i.e., myeloperoxidase [MPO]) markers were obtained from blood samples, and cardiorespiratory fitness was assessed (Bruce test). There were no between-group differences in the changes in arterial stiffness (median PWV difference −0.034, 95% CI −0.42 to 0.36 m/s; p = 0.860) or hsCRP, TNF-α, IL-6, and MPO (all p > 0.05) at week 12. In comparison to the control group, the exercise group significantly increased cardiorespiratory fitness (median difference 2.26 minutes, 95% CI 0.98 to 3.55; p = 0.001). These results suggest that 12 weeks of progressive treadmill aerobic exercise increases cardiorespiratory fitness without exacerbating arterial stiffness, inflammation, or oxidative stress in women with SLE.

Highlights

Systemic lupus erythematosus (SLE) is an autoimmune disease of an unknown etiology that predominantly affects young adult women [1], with a prevalence of up to 1 case in 1000 inhabitants in Europe [2,3]
It has been shown that classical cardiovascular diseases (CVD) risk factors fail to fully describe the excess of coefficient of variation (CV) morbi-mortality observed in SLE [4,6], and novel CV risk factors, such as arterial stiffness, systemic inflammation, or oxidative stress, are involved [4,7,8]
The main findings of this study suggest that 12 weeks of progressive treadmill aerobic exercise following the American College of Sports Medicine (ACSM) guidelines, performed between 40% and 75% of the heart rate reserve (HRR), increases cardiorespiratory fitness without exacerbating arterial stiffness, inflammation, or oxidative stress in women with SLE with mild/inactive disease, in comparison to a control group of patients with SLE that received recommendations for a healthy lifestyle

Summary

Introduction

Systemic lupus erythematosus (SLE) is an autoimmune disease of an unknown etiology that predominantly affects young adult women [1], with a prevalence of up to 1 case in 1000 inhabitants in Europe [2,3]. Its prognosis has significantly improved in recent decades leading to new comorbidities, such as atherosclerotic cardiovascular diseases (CVD) [4], which have become a major cause of mortality in this population [5]. Arterial stiffness is a marker of subclinical atherosclerosis that increases with age and is significantly elevated in patients with SLE compared to the general population [8,9]. Arterial stiffness reveals structural changes in the elasticity of the arteries prior to the development of clinical atherosclerosis, and is a powerful predictor of CVD independently of other CV risk factors, both in the general population [10] and in patients with SLE [11].

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Conclusion