Volume 15, Issue 4 (Jul-Aug 2021)                   mljgoums 2021, 15(4): 28-32 | Back to browse issues page


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Parvizifar M, Ghanbarzadeh M, Shakerian S, Tavakol H. Effect of Short-Term Continuous Aerobic Exercise with Vitamin D Supplementation on high-sensitivity C-reactive protein, Lactate Dehydrogenase and Creatine Kinase in Asthmatic Women. mljgoums 2021; 15 (4) :28-32
URL: http://mlj.goums.ac.ir/article-1-1298-en.html
1- Department of Exercise Physiology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran , m.parvizi.114@gmail.com
2- Department of Exercise Physiology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran
3- Department of Internal Medicine, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
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INTRODUCTION
Asthma is caused by the release of various mediators and cytokines following pulmonary vasoconstriction and narrowing of the arteries, which lead to enlargement of the right ventricle and impaired cardiac function with increased pulmonary pressure (1). Airway inflammation is usually caused by pathogens or exposure to toxins, pollutants, irritants and allergens. Studies show that obesity is a prelude to asthma and the risk of developing asthma increases with obesity (2, 3). Obesity also causes inflammation in various body parts, including the airways (4). On the other hand, the mechanical effect of obesity on the respiratory system can affect the contractile power of the smooth muscle of the bronchial trunk inducing bronchial hyperreactivity (5). Obesity also negatively affects lung function by reducing the strength of the respiratory muscles, increasing the resistance of the airways and reducing the volume of the lungs (6). On the other hand, research has demonstrated high levels of systemic inflammation in people with asthma and respiratory problems compared to healthy people (2). Several studies have shown the relationship between the levels of inflammatory markers high-sensitivity C-reactive protein (hs-CRP), creatine kinase (CK), lactate dehydrogenase (LDH) and shortness of breath (7). Physical inactivity is also associated with mild chronic inflammation and the development of inflammatory processes in many chronic diseases (8). Therefore, regular exercise can be considered as a basic and important mean of improving the symptoms of asthma as well as the quality of life asthmatic patients (9, 10). Aerobic exercise has beneficial effects on the lungs and blood vessels (11).
Researchers believe that vitamin D supplementation can improve symptoms of asthma (12). Vitamin D can be metabolized by airway cells and exert immunomodulatory effects by controlling expression of cytokines, production of antimicrobial peptides, differentiation of dendritic cells and activation of T cells (13). Most studies have shown the beneficial effects of vitamin D on inflammatory cytokines in chronic diseases (14). In a study by Kang et al. (2018), vitamin D supplementation reduced inflammatory markers in children with asthma (15). Another study found that vitamin D can reduce respiratory infection, prevent asthma attacks and steroid resistance, reduce osteoporosis and control chronic asthma (16). Therefore, the aim of this study was to determine the effect of vitamin D supplementation on some indicators of pulmonary function, hs-CRP, CK and LDH in women with asthma.
 
MATERIALS AND METHODS
This study was a quasi-experimental and applied study on 30 overweight (body mass index=26.97± 1.24 kg / m2) females with mild to moderate asthma. These subjects had mild to moderate bronchial asthma with a baseline capacity of 3.23±0.9 per minute (at the discretion of a physician) for at least two years. In addition, at least three months had passed since the subjects last experienced a relapse. The research was approved by the ethics committee of Shahid Chamran University (code: Ir.medilam.rec.1396.0240377881).
Fasting blood samples were taken in four stages: before and immediately after the exercise and before and after vitamin D supplementation. Serum was separated by centrifugation at 3,500 rpm and was placed at -70 °C until analysis. Serum level of hs-CRP levels was measured using a commercial enzyme-linked immunosorbent assay (ELISA, Biomerica, Germany). Serum levels of CK and LDH were measured using Pars Azmoun kits (Iran) and spectrophotometry.
Inclusion criteria included having mild to moderate asthma for at least two years, no asthma attack in the past three months, lack of vitamin D deficiency, age range of 40-50 years, not having regular activity in the last six months, not taking vitamin D supplements in the last six months and no history of cardiovascular disease, high blood pressure and musculoskeletal disorders. Unwillingness to continue participation in the study, participating in sports activities outside the study protocol, experiencing an asthma attack or recurrence during training, hospitalization, inability to perform deep tail maneuvers and changing the dose of medication outside the doctor's prescription were considered as the exclusion criteria.
Ambient temperature fluctuated between 22 and 24 °C. First, the subjects warmed up for 10 minutes. Subjects received a vitamin D tablet with a daily dose of 1000 IU for six weeks (12). After six weeks of vitamin D supplementation, the Balke treadmill test was performed again. Blood samples were taken from the subjects before and after the Balk test. Table 2 describes the details of the Balke treadmill test. The exercise intensity was set based on the target heart rate. The maximum oxygen consumption (VO2max) of the subjects was indirectly calculated using the following formula: VO2max = 1.38 (time) +5.22. Table 1 shows the details of the Balke test.
Table 1. Details of the Balke treadmill test performed by women with asthma
(km/h) Speed Gradient (%) Time (min) Step
5.5 0 0-1 1
5.5 2 1-2 2
5.5 3 2-3 3
5.5 4 3-4 4
5.5 5 4-5 5
5.5 6 5-6 6
5.5 7 6-7 7
5.5 8 7-8 8
5.5 10 8-9 10
5.5 11 10-11 11
5.5 12 11-12 12
5.5 13 12-13 13
5.5 14 13-14 14
5.5 15 14-15 15
 
Collected data were expressed as mean ± standard deviation. Data analysis was performed in SPSS software (version 23) and Microsoft Excel (2016). Normality of the data was investigated using the Shapiro-Wilk test. Repeated measures ANOVA was used to analyze the data. All statistical studies were carried out at significance level of 0.05.
 
RESULTS
Table 2 presents the characteristics of the study subjects.
 
Table 2.  Physical and anthropometric characteristics of the subjects
Mean ± standard deviation Variable  
48.88 ± 2.57 Age (year)
165.50 ± 16.43 Height (cm)
75.75 ± 4.26 Weight (kg)
25.00 ± 4.19 Body fat percentage
26.97 ± 1.24 Body mass index (kg/m2)
25.98 ± 2.01 VO2max (ml/kg/min)
 
Based on the results, serum levels of hs-CRP, LDH and CK did not change significantly after vitamin D supplementation and the exercise training compared to pretest (Table 3).  
 
Table 3. Comparison of serum levels of hs-CRP, CK and LDH in different study stages
P-value Sampling stages            Test steps  
Indicators
After performing the Balke test and taking vitamin D supplement Before performing the Balke test and after taking vitamin D supplement After  performing the Balk test and before taking vitamin D supplement Baseline
0.08 1.20±0.12 1.00±0.02 0.86±0.12 0.87±0.03 hs-CRP
0.11 70.6±4.25 68.12±4.01 76.90±3.3 73.93±4.10 CK
0.79 218.10±9.98 204.30±14.69 219.64±23.11 206.25±12.04 LDH
 
 
DISCUSSION
Our results show that serum levels of hs-CRP, CK and LDH did not change significantly after the intervention (17). Inconsistent with our findings, Vahdatpour et al. (2016) reported that an acute extraverted exercise session increased muscle damage and inflammatory indices (hs-crp, CK and LDH) in overweight girls (18). Muscle cell damage and membrane disruption leads to an increase in the serum concentration of CK and LDH (19). Gaeini et al. claimed that the inflammatory markers do not increase after exercise and sedation (20). Black et al. also reported that running on a treadmill at 60-85% of VO2max results in an increase in the inflammatory indices (21). Inconsistent with our findings, Choi et al. (2013) reported that high-intensity exercise significantly increased CK and LDH levels (22). In the present study, the levels of inflammatory indicators did not change significantly after aerobic activity and vitamin D supplementation. A study by Dadrass et al. (2019) showed that vitamin D supplementation following resistance exercise decreased CRP in men with type 2 diabetes (23). Another study found that taking vitamin D and calcium supplements along with vibration exercise reduced CK and hs-CRP levels in male mice (24). Another study reported that eight weeks of vitamin D supplementation and exercise could reduce inflammatory and muscle damage indices in mice (25). In a study by Saremi and Parastesh, 12 weeks of aerobic exercise improved lung function in obese men, which was associated with a reduction in inflammatory markers (26). These discrepancies may be related to the differences in the type of exercise, length of the training period, measurement method and the conditions that affect the inflammatory markers (27).
 
CONCLUSION
The findings indicate that the levels of inflammatory and muscle damage indices are not affected by short-term aerobic activity and six weeks of vitamin D supplementation.
 
ACKNOWLEDGMENTS
This article is based on a dissertation approved by the Shahid Chamran University of Ahvaz. We would like to express our sincere gratitude to all those who have contributed to this study.
 
CONFLICT OF INTEREST
The authors declare that there is no conflict of interest regarding publication of this article.
Research Article: Original Paper | Subject: Biochemistry
Received: 2020/06/1 | Accepted: 2020/09/9 | Published: 2021/06/30 | ePublished: 2021/06/30

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