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The Effect of Physical Activity on Cardiometabolic Health and Inflammation in HIV
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Reported by Jules Levin
CROI 2015 Feb 23-26, Seattle, WA
Sahera Dirajlal-Fargo DO1,2, Allison Webel1,3, Bruce Kinley1, Danielle Labbato, Ying Jiang MS1, Abdus Sattar PhD1,
Sara Debanne PhD1, Grace A McComsey MD1,2
1 Case Western Reserve University, Cleveland, OH, 2Rainbow Babies and Children's Hospital, Cleveland, OH, 3Frances Payne Bolton School of Nursing, Cleveland, OH
.......Physical activity is independently associated with insulin resistance, vascular disease and endothelial function......physical activity was independently associated with insulin resistance and with several markers of markers of cardiovascular disease.....over the 96 week study period, exercise was associated with multiple measures of subclinical vascular disease, suggesting that exercise in HIV-infected patients may improve vascular structure as well as function .......At baseline, exercise was associated with several markers of inflammation, however these relationships were not evident during the study period. Prospective studies assessing the effect of exercise on inflammation markers and cardiovascular health are needed in HIV ....... in the next report I send you reported at CROI/2015 exercise improved the brain, cognition, brain volume!....The aim of this study was to examine the effects of physical activity and statin use on markers of cardiometabolic health and inflammation over 96 weeks in HIV+. ....In healthy adults, increased physical activity is associated with reduced inflammation independent of cardiovascular disease risk factors. In HIV-infected adults, little is known about the effect of physical activity on inflammatory markers and cardiometabolic health .....Regular physical activity lowers all-cause mortality by protecting against atherosclerosis and insulin resistance. However, the long term benefits of physical activity, including preventing diseases associated with chronic inflammation ( e.g., type 2 diabetes, atherosclerosis, and rheumatoid arthritis) may be associated an anti-inflammatory effect .....Erlandson found inflammation & immune activation which are associated with frailty to be associated with functional impairment/physical functioning capacity that is limited physical activity......at CROI 2014 - "level of physical function affects quality of life....at baseline the HIV+ participants in this study had quality of life lower than general population, but after an exercise routine provided through this study exercise capacity improved which was correlated with improved physical functioning due to the exercise & which all correlated with improved quality of life"
from Jules: This study was not a prospective study but was nested as merely analysis within the large SATURN Trial which examined the effects of statins, so this study examined associations between study participants & their exercise routines & bio markers of cardiovascular health, inflammation/immune activation. But there have been many studies in healthy ........and in HIV+
Study design: Secondary analysis from a double blind placebo controlled trial (SATURN Trial)
at CROI 2014: this study reported...."Physical Function Impairment on Quality of
Life among Persons Aging with HIV Infection"
http://www.natap.org/2014/CROI/croi_85.htm: ......level of physical function affects quality of life....at baseline the HIV+ participants in this study had quality of life lower than general population, but after an exercise routine provided through this study exercise capacity improved which was correlated with improved physical functioning due to the exercise & which all correlated with improved quality of life....in a previous study discussed just below this author Erlandson found inflammation & immune activation which are associated with frailty to be associated with functional impairment/physical functioning capacity that is limited physical activity, in this study participants underwent exercise tests to evaluate their level of physical functioning......"functional impairment during HIV infection is associated with markers of immune activation and inflammation.......Aging with HIV infection is associated with early decline in physical function and development of frailty......this is the first evidence linking physical function and frailty to immune activation and inflammation among persons with HIV infection....."
"Exercise is Nonpharmacological Intervention To Reduce Inflammation...prevent metabolic diseases" Taming HIV-Related Inflammation with Physical Activity: A Matter of Timing
Physical Activity and Inflammation.....http://www.natap.org/2014/HIV/102914_02.htm......It is well established that in healthy individuals, regular aerobic exercise of moderate intensity and duration is associated with a reduced incidence of metabolic diseases. In addition, exercise reduces the excess storage of fat in adipocytes and their production of inflammatory mediators, thus limiting the inflammation associated with obesity.47 Indeed, regular aerobic exercise reduces inflammation in diseases associated with low-grade inflammation (e.g., obesity, chronic heart failure, atherosclerosis, diabetes).48,49 While the protective antiinflammatory effect of physical exercise is well documented, there is also evidence that physical inactivity may favor the development of low-grade systemic inflammation. This is due to the fact that sedentary behavior leads to the accumulation of visceral fat, which is accompanied by increased release of adipokines and adipose tissue infiltration by proinflammatory immune cells. This negative interplay between immune and metabolic dysfunction is associated with the development of insulin resistance, atherosclerosis, and neurodegeneration.50-52 For these reasons, there is growing interest in studying the effects of physical activity as a nonpharmacological tool to reduce chronic inflammation, even though the mechanisms responsible for this immune modulatory effect remain poorly understood.
program abstract
The Effect of Physical Activity on Cardiometabolic Health and Inflammation in HIV
Sahera Dirajlal-Fargo1, Grace McComsey1, Allison Webel2, Bruce Kinley3, Danielle Labbato3, Ying Jiang4, Sara Debanne4
1 Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States;2 Frances Payne Bolton School of Nursing Case Western Reserve University, Cleveland, Ohio, United States;3 University Hospitals Case Medical Center, Cleveland, Ohio, United States;4 Case Western Reserve University, Cleveland, Ohio, United States
Abstract Body:
Background: In HIV-uninfected populations, physical activity decreases mortality and reduces inflammation. Persistent inflammation is a potential cause for increased co-morbidities in HIV+ adults, yet the evidence examining the effect of physical activity on cardiometabolic health and inflammation in this population is limited. This analysis examines the relationship between physical activity and markers of cardiometabolic health and inflammation.
Methods: We conducted a nested study within the SATURN-HIV trial in which 147 HIV+ adults on stable antiretroviral therapy (ART), with HIV-1 RNA
Results: Median age (Q1, Q3) was 46 (40.4, 52.7) years, 80% were male, 69% were African American and 46% on protease inhibitors. Baseline median physical activity was 49.5 (30.1, 67.9) minutes per week. Physical activity was significantly correlated with several markers of cardiometabolic health and inflammation (all p0.05) (see table). After adjustment for factors known to affect cardiometabolic health and inflammation, physical exercise remained independently associated with markers of vascular disease (carotid bulb intima-media thickness; ß=
Conclusions: Physical activity is independently associated with insulin resistance, vascular disease and endothelial function, and may be a low-risk adjuvant to decreasing co-morbidities in HIV+ adults. Further studies should examine long-term effects of physical activity on markers of cardiometabolic health and inflammation in this population.
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