Bayesian network modeling: A case study of an epidemiologic system analysis of cardiovascular risk.

An extensive, in-depth study of cardiovascular risk factors (CVRF) seems to be of crucial importance in the research of cardiovascular disease (CVD) in order to prevent (or reduce) the chance of developing or dying from CVD. The main focus of data analysis is on the use of models able to discover and understand the relationships between different CVRF. In this paper a report on applying Bayesian network (BN) modeling to discover the relationships among thirteen relevant epidemiological features of heart age domain in order to analyze cardiovascular lost years (CVLY), cardiovascular risk score (CVRS), and metabolic syndrome (MetS) is presented. Furthermore, the induced BN was used to make inference taking into account three reasoning patterns: causal reasoning, evidential reasoning, and intercausal reasoning. Application of BN tools has led to discovery of several direct and indirect relationships between different CVRF. The BN analysis showed several interesting results, among them: CVLY was highly influenced by smoking being the group of men the one with highest risk in CVLY; MetS was highly influence by physical activity (PA) being again the group of men the one with highest risk in MetS, and smoking did not show any influence. BNs produce an intuitive, transparent, graphical representation of the relationships between different CVRF. The ability of BNs to predict new scenarios when hypothetical information is introduced makes BN modeling an Artificial Intelligence (AI) tool of special interest in epidemiological studies. As CVD is multifactorial the use of BNs seems to be an adequate modeling tool.

Influence of training load on upper respiratory tract infection incidence and antigen-stimulated cytokine production.

This study examined the effect of training load on upper respiratory tract infection (URTI) incidence in men and women engaged in endurance-based physical activity during winter and sought to establish if there are training-associated differences in immune function related to patterns of illness. Seventy-five individuals provided resting blood and saliva samples for determination of markers of systemic immunity. Weekly training and illness logs were kept for the following 4 months. Comparisons were made between subjects (n = 25) who reported that they exercised 3-6 h/week (LOW), 7-10 h/week (MED) or ≥ 11 h/week (HIGH). The HIGH and MED groups had more URTI episodes than the LOW group (2.4 ± 2.8 and 2.6 ± 2.2 vs 1.0 ± 1.6, respectively: P < 0.05). The HIGH group had approximately threefold higher interleukin (IL)-2, IL-4 and IL-10 production (all P < 0.05) by antigen-stimulated whole blood culture than the LOW group and the MED group had twofold higher IL-10 production than the LOW group (P < 0.05). Other immune variables were not influenced by training load. It is concluded that high levels of physical activity are associated with increased risk of URTI and this may be related to an elevated anti-inflammatory cytokine response to antigen challenge.

Respiratory infection risk in athletes: association with antigen-stimulated IL-10 production and salivary IgA secretion.

The purpose of this study was to examine factors influencing susceptibility to upper respiratory tract infections (URTI) in 18-35-year-old men and women engaged in endurance-based physical activity during the winter months. Eighty individuals (46 males, 34 females) provided resting blood and saliva samples for determination of markers of systemic immunity. Weekly training and illness logs were kept for the following 4 months. Thirty subjects did not experience an URTI episode and 24 subjects experienced 3 or more weeks of URTI symptoms. These illness-prone subjects had higher training loads and had ∼2.5-fold higher interleukin (IL)-4 and IL-10 production by antigen-stimulated whole blood culture than the illness-free subjects. Illness-prone subjects also had significantly lower saliva S-IgA secretion rate and higher plasma IgM (but not IgA or IgG) concentration than the illness-free subjects. There were no differences in circulating numbers of leukocyte subtypes or lymphocyte subsets between the illness-prone and illness-free subjects. The production of IL-10 was positively correlated and the S-IgA secretion rate was negatively correlated with the number of weeks with infection symptoms. It is concluded that high IL-10 production in response to antigen challenge and low S-IgA secretion are risk factors for development of URTI in physically active individuals.

Effects of exercise intensity on lymphocyte H2O2 production and antioxidant defences in soccer players.

OBJECTIVE: Physical exercise is capable of enhancing or suppressing the immune response depending on the intensity and duration of exercise. This study investigated how exercise intensity influences the lymphocyte antioxidant response and the induction of cellular oxidative damage. DESIGN: Eighteen voluntary male pre-professional soccer players participated in this study. Sportsmen played a 60 min training match, and were divided into three groups depending on the intensity degree during the match: low, medium and high intensities. MEASUREMENTS: Malondialdehyde (MDA), vitamins C and E and haem oxygenase-1 (HO-1) gene expression were measured in lymphocytes. Reactive oxygen species (ROS) production was determined in lymphocytes and neutrophils. RESULTS: Lymphocyte MDA levels and H(2)O(2) production were significantly increased in the group which performed the most intense exercise. Neutrophil counts and ROS production increased progressively with the exercise intensity. Vitamin C significantly decreased after exercise in the highest-intensity group in comparison with initial values, whereas vitamin E levels significantly increased in the medium and high-intensity groups. HO-1 gene expression significantly increased in the medium and high-intensity groups. CONCLUSIONS: Exercise intensity affects the lymphocyte and neutrophil oxidant/antioxidant balance, but only exercise of high intensity induces lymphocyte oxidative damage.

Scuba diving enhances endogenous antioxidant defenses in lymphocytes and neutrophils.

The aim was to study the effects of a scuba diving session on the lymphocyte antioxidant system, NO synthesis, the capability to produce reactive oxygen species and the antioxidant response in neutrophils. For that purpose seven male divers performed an immersion at a depth of 40 m for 25 min. The same parameters were measured after an hyperbaric oxygen (HBO) treatment at resting conditions in a hyperbaric chamber. Lymphocyte H2O2 production rose after diving and after HBO treatment. Glutathione peroxidase (GPx) and catalase activities increased after diving in lymphocytes, while after HBO exposure only increased GPx activity. Lymphocyte HO-1 mRNA expression increased after diving and after HBO exposure, while iNOS levels and nitrite levels significantly increased after diving. The hyperoxia associated to scuba diving leads to a condition of oxidative stress with increased lymphocyte H2O2 production, HO-1 expression, NO synthesis and antioxidant enzyme adaptations in order to avoid oxidative damage.

Vitamin C supplementation influences the antioxidant response and nitric oxide handling of erythrocytes and lymphocytes to diving apnea.

OBJECTIVE: We have investigated the influence of vitamin C diet supplementation on the antioxidant response and nitrite levels in lymphocytes and erythrocytes during diving apnea. SUBJECTS: Seven male professional apnea divers participated in a double blind crossover study. Divers were randomly assigned to either vitamin C supplemented or placebo groups. The subjects did not take any other supplements than the ones provided for this study. INTERVENTION: One group was supplemented with vitamin C capsules (1 g per day) for 7 days while the other group took a placebo composed of lactose. The usual dietary habits of participants were assessed using a self-reported 7-days 24-h recall before the day of the study. Blood samples were taken under basal conditions, immediately after diving apnea for 4 h and after 1 h of recovery. RESULTS: Catalase activity increased in erythrocytes (23%) and superoxide dismutase increased in lymphocytes (35%) during the recovery only in the placebo group. Lymphocyte ascorbate levels increased in the supplemented group after diving (85%) and maintained high at recovery. Plasma nitrite levels increased about twofold in both groups during the recovery. Erythrocyte nitrite levels increased after diving (50%) and about twofold during the recovery in the supplemented group. Nitrite levels and iNOS levels in lymphocytes were higher in the placebo group than in the supplemented during the recovery. Erythrocyte carbonyl derivates were unchanged in all situations. CONCLUSIONS: Vitamin C supplementation influenced the antioxidant response and NO handling in erythrocytes and lymphocytes to the oxidative stress induced by hypoxia-reoxygenation.

Differential response of plasma and immune cell's vitamin E levels to physical activity and antioxidant vitamin supplementation.

OBJECTIVE: To assess the differential response of plasma, lymphocyte and neutrophil vitamin E levels to high-intensity physical activity and to vitamin C and E supplementation. SUBJECTS: In all, 14 male trained amateur runners (32-36 y old) were randomly divided in two groups (supplemented and placebo), and participated in a half marathon race. The subjects did not take any other supplements than the ones provided for this study. INTERVENTION: Vitamin C (152 mg/day) and E (50 mg/day) supplementation was administrated to athletes for a month, using a new almond-based isotonic and energetic beverage (supplemented group). The usual dietary habits of participants were assessed using a self-reported 7-day 24-h recall before the day of the study. To avoid the beverage influence, nonenriched vitamin C and E almond-based isotonic and energetic beverage was given to the placebo group. After 1 month, subjects participated in a half marathon race (21 km run). Vitamin E concentration was determined in plasma, neutrophils and lymphocytes before and immediately after the race, and 3 h after finishing the race. RESULTS: Daily energy intake and caloric profile of supplemented and placebo group were not different except for vitamin C and E supplementation. Vitamin supplementation and exercise had no effect on vitamins E levels in plasma. The exercise significantly (P<0.05) increased the lymphocyte vitamin E concentration both in the placebo (+119%) and supplemented groups (+128%), and neutrophil vitamin E content in the supplemented group (+88%). These levels remained significantly (P<0.05) high after the short recovery. After exercise, vitamin E levels in lymphocytes and neutrophils of supplemented subjects were practically twice the levels before exercise, whereas neutrophil vitamin E content of the placebo group was close to those in plasma. CONCLUSION: After endurance exercise, lymphocytes increased their vitamin E content in the supplemented and placebo subjects whereas this trend in neutrophils was just observed in the supplemented group. The determination of vitamin E content in lymphocytes and neutrophils after exercise is a useful tool to assess the functional status of vitamin E.

Pre-exercise antioxidant enzyme activities determine the antioxidant enzyme erythrocyte response to exercise.

Free radical production increases during exercise and oxidative damage occurs in several tissues. We examined the effects of three different exercise tests on the pattern of change of erythrocyte enzyme antioxidant activities. The tests were a short maximal exercise test, a submaximal prolonged exercise test and a cycling stage during competition. The participants were amateur and professional cyclists with different training statuses and different basal erythrocyte antioxidant enzyme activities. The maximal test produced no changes in the erythrocyte antioxidant enzyme activities of amateur sportsmen. The submaximal test, performed at 80% of maximal oxygen uptake, decreased erythrocyte catalase (12%), glutathione peroxidase determined with H2O2 (14%) and glutathione reductase (16%); superoxide dismutase activity increased by about 25%. The cycling stage performed by professional cyclists increased erythrocyte catalase (29%) and glutathione reductase (10%) activities. The in vivo changes in glutathione reductase activity were confirmed by in vitro measurements: hydrogen peroxide decreased and the presence of catalase increased the activity of this enzyme. In conclusion, we suggest that the different erythrocyte antioxidant enzyme responses to diverse exercise tests can be explained by the effects of hydrogen peroxide and the superoxide anion on the antioxidant enzyme activities in erythrocytes.

Suplementación de la dieta del/la deportista con nutrientes antioxidantes / Dietary supplementation with antioxidants for athletes

La actividad física, principalmente la que se desarrolla de forma intensa hasta la extenuación, lleva asociada una situación de estrés oxidativo. El entrenamiento y una correcta alimentación permiten aumentar la capacidad del organismo de hacer frente a la elevada producción de especies reactivas de oxígeno y de radicales libres que tiene lugar durante el ejercicio físico. En este artículo se presentan las características principales de las especies reactivas de oxígeno, su síntesis y su potencial capacidad de generar estrés oxidativo en el deportista. Se describen los principales sistemas de defensa antioxidantes celulares, sus interacciones y como se ven afectados por el ejercicio físico intenso y por la suplementación de la dieta con antioxidantes naturales como la vitamina E, vitamina C y b-caroteno. (AU)

Diet supplementation with vitamin E, vitamin C and beta-carotene cocktail enhances basal neutrophil antioxidant enzymes in athletes.

Exercise increases oxygen consumption and causes a disturbance of intracellular pro-oxidant-antioxidant homeostasis. Few data are available as to the cumulative effects of exercise on the antioxidant defenses of the neutrophil. We studied the effects of 90 days' supplementation with placebo or an antioxidant cocktail of vitamin E (500 mg/day) and beta-carotene (30 mg/day) and the last 15 days also with vitamin C (1 g/day) on sportsmen's basal neutrophil antioxidant defenses. We analyzed the activities of catalase, glutathione peroxidase, glutathione reductase and the activities and levels of superoxide dismutase, glutathione and glutathione disulfide in neutrophils purified from antecubital vein blood of sportsmen before and after diet supplementation. Plasma vitamin E, beta-carotene and vitamin C concentrations in the antioxidant-supplemented group were approximately 1.6, 10, and 1.2 times higher respectively than those of the placebo group. The antioxidant-supplemented group presented a significantly higher glutathione versus glutathione disulfide ratio in neutrophils (about 20%) than the placebo one. Antioxidant supplementation enhances the antioxidant enzyme activity of superoxide dismutase and catalase in neutrophils.

Participation of blood cells in the changes of blood amino acid concentrations during maximal exercise.

We determined the participation of the cellular compartment in the changes of plasma amino acid concentrations during maximal exercise test on a cycle ergometer. Following an overnight fast, male athletes were submitted to a maximal exercise test until fatigue (for 25 min approximately) to determine maximal oxygen uptake. The amino acid concentrations in total blood, plasma, and blood cells were determined before and after the maximal exercise test. Most essential amino acids were decreased significantly in the total blood concentration as a result of the maximal exercise test. However, the concentrations of most nonessential amino acids tended to be significantly increased. Amino acid concentration was increased most in plasma. Concentrations of blood cell alanine and proline were significantly increased by 26% and 15%, respectively, after the maximal exercise test. No significant differences in blood cell concentrations of other amino acids induced by the exercise test were found, although the amount of tryptophan in blood cells was increased after exhaustive exercise.

Regulation of erythrocyte antioxidant enzyme activities in athletes during competition and short-term recovery.

We have determined "in vivo" the influence of strenuous prolonged exercise and short-term recovery on erythrocyte antioxidant enzyme activities. We have also determined the "in vitro" effects of the xanthine/xanthine-oxidase-generating superoxide anion system on catalase activity in haemolysed erythrocytes. Haematological parameters and erythrocyte superoxide dismutase (SOD), glutathione peroxidases and catalase activities were measured in nine healthy duathlon athletes under basal conditions, at the finish of a competition and after 1 h of recovery. We also measured catalase activity in haemolysed erythrocytes--obtained from four overnight-fasted well-trained sportsmen before and after an 80% submaximal exercise test on a cycle-ergometer--prior to and after incubation for 3 min with the superoxide-anion-generating system. Duathlon competition and/or short-term recovery produced a slight haemolysis and increased the activity of catalase and peroxidases but not SOD enzymes. The observed changes in catalase activity were mimicked "in vitro" by the superoxide-anion-generating system.