Abstract
Introduction
Lactate dehydrogenase (LDH) has historically been used as an indicator of negative health outcomes, such as myocardial ischaemia and lung disease; however, recent evidence has suggested that LDH levels within normal limits may be inversely related to coronary heart disease. Therefore, the purpose of the current study was to examine the association between physical activity and normal-range LDH levels, and how LDH levels, in turn, are associated with the predicted risk of cardiovascular disease (CVD).
Methods
Data from the 2003–2006 National Health and Nutrition Examination Survey (NHANES) were used (N = 2087 adults aged 40–79 years; analysed in 2015). Participants were included if they had LDH levels within the normal range (105–333 IU/L). LDH values were obtained from a blood sample. Physical activity was measured using accelerometry and expressed in total minutes per day (TPA), as well as in the total activity count per day (TAC/d). Finally, the predicted 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was calculated using validated Pooled Cohort Equations.
Results
In a polytomous logistic regression, for a 1-standard-deviation (1SD) increase in TPA (SD 102.3 min/day), the participants were at 30 % increased odds (odds ratio [OR] 1.30, 95 % confidence interval [CI] 1.11–1.52, P = 0.002) of being in LDH quartile 4 (versus quartile 1). Those in LDH quartile 4 (versus quartile 1) were at 55 % reduced odds (OR 0.45, 95 % CI 0.20–0.99, P = 0.04) of being in ASCVD quartile 4 (versus quartile 1).
Conclusion
These findings contribute to mounting evidence of the diagnostic value of normal-range LDH levels, implicating normal-range LDH levels as a novel biomarker through which physical activity may be associated with CVD.
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References
Berg JM, Tymocsko JL, Stryer L. In: Biochemistry: regulating strategies. 7th edn. New York: W H Freeman & Co, 2012. 296–297.
Kopel E, Kivity S, Morag-Koren N, Segev S, Sidi Y. Relation of serum lactate dehydrogenase to coronary artery disease. Am J Cardiol. 2012;110(12):1717–22.
Lee TH, Goldman LEE. Serum enzyme assays in the diagnosis of acute myocardial infarction recommendations based on a quantitative analysis. Ann Intern Med. 1986;105(2):221–33.
Hammond GL, Nadal-Ginard B, Talner NS, Markert CL. Myocardial LDH isozyme distribution in the ischemic and hypoxic heart. Circulation. 1976;53(4):637–43.
Drent M, Cobben NA, Henderson RF, Wouters EF, van Dieijen-Visser M. Usefulness of lactate dehydrogenase and its isoenzymes as indicators of lung damage or inflammation. Eur Respir J. 1996;9(8):1736–42.
Coombes JS, McNaughton LR. Effects of branched-chain amino acid supplementation on serum creatine kinase and lactate dehydrogenase after prolonged exercise. J Sports Med Phys Fit. 2000;40(3):240–6.
MedlinePlus. Lactate dehydrogenase test. US National Library of Medicine. 2015. https://www.nlm.nih.gov/medlineplus/ency/article/003471.htm. Accessed 11 Dec 2015.
Rotenberg Z, Seip R, Wolfe LA, Bruns DE. “Flipped” patterns of lactate dehydrogenase isoenzymes in serum of elite college basketball players. Clin Chem. 1988;34(11):2351–4.
Rumley AG, Pettigrew AR, Colgan ME, Taylor R, Grant S, Manzie A, et al. Serum lactate dehydrogenase and creatine kinase during marathon training. Br J Sports Med. 1985;19(3):152–5.
Singh SN, Kanungo MS. Alterations in lactate dehydrogenase of the brain, heart, skeletal muscle, and liver of rats of various ages. J Biol Chem. 1968;243(17):4526–9.
Goff DJ Jr, Lloyd-Jones DM, Bennett G, et al. ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S49–73. doi:10.1161/01.cir.0000437741.48606.98.
van Poppel MNM, Chinapaw MJM, Mokkink LB, Van Mechelen W, Terwee CB. Physical activity questionnaires for adults. Sports Med. 2010;40(7):565–600.
Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey (NHANES 2003–2004): laboratory manual. Bethesda: National Center for Health Statistics. 2015.
Park J-H, Park JH, Ovbiagele B, Kwon H-M, Lim J-S, Kim JY, et al. New pooled cohort risk equations and presence of asymptomatic brain infarction. Stroke. 2014;45(12):3521–6.
Kandula NR, Kanaya AM, Liu K, Lee JY, Herrington D, Hulley SB, et al. Association of 10-year and lifetime predicted cardiovascular disease risk with subclinical atherosclerosis in South Asians: findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. J Am Heart Assoc. 2014;3(5):e001117.
Muntner P, Colantonio LD, Cushman M, Goff DC, Howard G, Howard VJ, et al. Validation of the atherosclerotic cardiovascular disease pooled cohort risk equations. JAMA. 2014;311(14):1406–15.
Loprinzi PD, Smit E, Mahoney S. Physical activity and dietary behavior in US adults and their combined influence on health. Mayo Clin Proc. 2014;89(2):190–8.
Troiano RP, Berrigan D, Dodd KW, Mâsse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181.
Loprinzi PD, Walker JF, Lee H. Association between physical activity and inflammatory markers among US adults with chronic obstructive pulmonary disease. Am J Health Promot. 2014;29(2):81–8.
Loprinzi PD, Lee H, Cardinal BJ, Crespo CJ, Andersen RE, Smit E. The relationship of actigraph accelerometer cut-points for estimating physical activity with selected health outcomes: results from NHANES 2003–06. Res Q Exerc Sport. 2012;83(3):422–30.
Loprinzi PD, Cardinal BJ. Measuring children’s physical activity and sedentary behaviors. J Exerc Sci Fit. 2011;9(1):15–23.
Wolff DL, Fitzhugh EC, Bassett DR, Churilla JR. Total activity counts and bouted minutes of moderate-to-vigorous physical. J Phys Act Health. 2015;12(5):694–700.
Wolff DL, Fitzhugh EC, Bassett DR, Churilla JR. Waist-worn actigraphy: population-referenced percentiles for total activity counts in US adults. J Phys Act Health. 2015;12(4):447–53.
Bassett DR, Troiano RP, McClain JJ, Wolff DL. Accelerometer-based physical activity: total volume per day and standardized measures. Med Sci Sports Exerc. 2014;4:833–8.
Larsson L, Sjödin B, Karlsson J. Histochemical and biochemical changes in human skeletal muscle with age in sedentary males, age 22–65 years. Acta Physiol Scand. 1978;103(1):31–9.
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The authors are not aware of any affiliations, memberships, funding or financial holdings that might be perceived as affecting the objectivity of this manuscript. This study was not supported by any funding.
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Samuel Buckner, Jeremy Loenneke and Paul Loprinzi declare that they have no conflicts of interest and received no funding for preparation of this manuscript.
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Buckner, S.L., Loenneke, J.P. & Loprinzi, P.D. Cross-Sectional Association Between Normal-Range Lactate Dehydrogenase, Physical Activity and Cardiovascular Disease Risk Score. Sports Med 46, 467–472 (2016). https://doi.org/10.1007/s40279-015-0457-x
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DOI: https://doi.org/10.1007/s40279-015-0457-x