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Effects of Eight Weeks of Aerobic Exercise Training on Pulmonary Function Indices, Inflammatory Markers, and Vascular Endothelial Growth Factor in Active Young Females
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Bahar Saljoughi Beranji1    , Elnaz Rezayi1 , Roghayyeh Afroundeh2 , Marefat Siahkouhian *3 |
1- M.Sc Student of Exercise Physiology, Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, Iran.
2- Professor, Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, Iran.
3- Professor, Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, Iran. , m_siahkohian@uma.ac.ir |
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Keywords: Exercise [MeSH], Pulmonary Function Tests [MeSH], C-Reactive Protein [MeSH], Vascular Endothelial Growth Factor-A [MeSH]
Article ID: Vol28-06 |
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Type of Study: Original Articles |
Subject:
Exercise Physiology
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Abstract: (232 Views) |
Extended Abstract
Introduction
Aerobic exercise refers to activities characterized by continuous, rhythmic, and relatively prolonged movements, which are primarily sustained by the aerobic energy system. Typically, the intensity of these exercises ranges from 50% to 85% of the heart rate reserve, or 40-70% of maximal oxygen uptake (VO2max). Pulmonary function is a critical factor in determining an individual's level of physical fitness and overall health. Indices such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and total lung capacity (TLC) are recognized as the primary metrics of pulmonary function, which can be enhanced through aerobic exercise training. C-reactive protein (CRP) is a systemic inflammatory marker, and its elevation is consistently associated with an increased risk of cardiovascular diseases. CRP is identified as a novel risk factor for atherosclerosis, the levels of which increase with a sedentary lifestyle. Although physical activity induces significant alterations in immune function markers, the nature and magnitude of these changes depend on various factors. These factors include the type, intensity, and duration of the exercise, the specific immune parameter being investigated, the physical fitness level and athletic background of the individuals, environmental conditions such as ambient temperature, and the timing of blood sampling. Generally, the magnitude of change in any given immune marker is proportional to the dose, intensity, and duration of the physical activity. Creatine phosphokinase (CPK) is recognized as a vital enzyme in the process of supplying energy to muscles; its concentration in the blood elevates during muscle injury or inflammation. Physical activities, particularly high-intensity exercises, induce the release of CPK into the bloodstream due to mild injuries to the muscle fibers. Conversely, in sedentary individuals, aerobic and resistance training culminates in reduced CPK and CRP levels, underscoring the role of regular exercise in attenuating systemic inflammation and muscle damage.
Another important factor in the present study is the evaluation of capillary density through the measurement of vascular endothelial growth factor (VEGF). Although numerous factors are involved in the process of angiogenesis, VEGF appears to be the most critical influencing factor. Research investigating the impact of exercise on VEGF levels demonstrates that physical activity, in both the short and long term, can influence the levels of this factor. Findings demonstrate that endurance training leads to an increase in angiogenesis-related factors across various organs; however, this effect is dependent on the type and intensity of the exercise. The present study aimed to determine the effect of eight weeks of aerobic exercise training on pulmonary function, CRP, CPK, and VEGF in active young females.
Methods
This field trial was conducted on 20 active young females aged 19 to 24 years.
The inclusion criteria comprised physical well-being and a history of moderate-intensity physical activity over the preceding six months, without any participation in professional or specific structured athletic training. The exclusion criteria included the presence of chronic respiratory and cardiovascular diseases and the use of medications affecting these systems, as well as any factors that could potentially influence the final outcomes of the research or disrupt the implementation of the study protocol.
To control for the effects of confounding variables, baseline matching was performed between the two groups prior to the intervention, based on age, body mass index (BMI), and VO2max. Additionally, the general health status of the participants was assessed through an informal oral interview, which included questions regarding medical history, medication use, and underlying health issues. To determine the subjects' VO2max, a maximal exercise test was initially utilized to directly measure the maximal heart rate (HRmax). Subsequently, resting heart rate (HRrest) was recorded under quiet and calm conditions. Using the ratio of these two values, the participants' VO2max was calculated indirectly. Prior to the commencement of the study, written informed consent was obtained from all participants.
Eligible participants were randomly assigned to two groups of 10, including an aerobic training group and a control group.
The intervention group underwent an aerobic training program for eight weeks, whereas the control group had no physical activity.
The training program consisted of three sessions per week, with the training executed on a treadmill. Each session comprised 40 minutes of exercise at an intensity equivalent to 70% of the HRmax. In the training protocol of this study, the participants—who possessed a high level of aerobic fitness prior to the commencement of the research—initiated their training based on an intensity of 70% of their HRmax, and the training intensity was progressively increased. To adjust the training intensity, each participant's HRmax was initially determined via a practical test on the treadmill following a standardized warm-up. In this test, the training intensity was incrementally increased until the individual reached exhaustion, and the HRmax was recorded using a Polar heart rate sensor (Polar H10, Finland). Throughout the training sessions, the heart rate was continuously monitored, and if necessary, the treadmill speed was adjusted to maintain the training intensity within the designated target zone. All training sessions were conducted under the supervision of an expert coach.
To evaluate changes in pulmonary function and to measure lung volumes and capacities, an SPM7 spirometer (Bayonet, SPM7, Iran) was utilized. Measurements were performed in a standing position under resting conditions. Each test was repeated three times for each participant to ensure the accuracy and reliability of the results. The parameters assessed included FEV1 and FVC. For the assessment of hematological indicators, blood samples were collected from the participants under resting conditions at two time points: Pre-test (before the initiation of the eight-week training) and post-test (after the completion of the eight-week training). The CRP, CPK, and VEGF levels were quantified using advanced laboratory techniques, including the Gptec-Belgium kit, the Karmania Pas Gen Knowledge-Based Company (Rafsanjan, Iran), and the Biorex Fars-Iran kit, respectively. Primary outcomes of this study included pulmonary function (FEV1 and FVC), as well as CRP, CPK, and VEGF markers, all of which were evaluated at the pre-test and post-test stages in both groups. Secondary outcomes comprised demographic data, including age, BMI, VO2max, general health status, and the adherence rate to the training program within the intervention group. These variables were assessed to control for confounding factors and to serve as complementary analyses.
To assess within-group changes, a paired t-test was utilized, and for between-group comparisons, an analysis of covariance (ANCOVA) was employed. The significance level for all tests was set at less than 0.05.
Results
The mean values of FVC in the intervention group increased significantly following the training (P<0.016). This variable increased from a baseline mean value of 2.72±0.39 L in the pre-test to 3.11±0.61 L in the post-test. Similarly, the mean FEV1 value increased significantly from 2.64±0.37 L in the pre-test to 3.10±0.58 L in the post-test (P<0.002).
The CRP inflammatory marker demonstrated a statistically significant decrease in the intervention group (P<0.018). The mean value of this marker decreased from 4.8±1.5 mg/L in the pre-test to 1.6±0.61 mg/L in the post-test. The mean CPK value was 89.1±19 mg/L in the pre-test and decreased to 87.1±24 mg/L in the post-test; however, this reduction was not statistically significant.
VEGF levels increased significantly in the intervention group (P<0.001). The mean value of this factor increased from 8.22±2.5 pg/mL in the pre-test to 9.74±2.3 pg/mL in the post-test.
In the post-test phase, a statistically significant difference was observed in CRP levels between the intervention and control groups (P<0.03). Other between-group comparisons for the investigated variables were not statistically significant. The difference in CPK levels between the training and control groups (F=4.17, η²=390.7) approached statistical significance (P<0.06). However, no significant difference was observed in the between-group comparisons during the post-test phase.
Conclusion
According to the findings of this study, FVC and FEV1 values increased significantly following eight weeks of aerobic exercise training. The mean FVC values demonstrated statistically significant increases post-training, indicating an improvement in lung capacity and the ability to store and deplete air from the lungs. Moreover, the mean FEV1 values increased significantly, reflecting an enhanced expiratory capacity and increased efficiency of the respiratory system.
In the present study, aerobic exercise training resulted in a significant decrease in the CRP level, whereas the reduction in CPK level was not statistically significant. These findings suggest that aerobic activities can modulate inflammatory responses; however, they may not have a direct effect on CPK. CRP is an inflammatory protein that increases in response to systemic inflammation. The significant reduction in CRP observed in the post-test demonstrates the positive effect of aerobic training on mitigating inflammation.
CPK is one of the markers of muscle damage that typically elevates following strenuous physical activities. Although the results revealed a decrease in CPK from 89.1±19 mg/L to 87.1±24 mg/L, this change was not statistically significant. This finding could be attributed to the participants’ baseline activity levels, as individuals who were already active might be more adapted to aerobic training, thereby exhibiting fewer changes in this marker. It is probable that if the duration of the aerobic training were extended beyond eight weeks, the reduction in CPK might reach a statistically significant level.
The findings demonstrate a positive effect of aerobic training on stimulating the production and release of VEGF, which plays a key role in angiogenesis and the enhancement of tissue oxygenation. VEGF is one of the most critical regulatory factors in the growth and development of new capillary networks, secreted in response to conditions such as hypoxia (tissue oxygen deficiency) and increased metabolic demand. Aerobic training, particularly moderate- to high-intensity activities, induces an increase in blood flow, local oxygen depletion, and the activation of hypoxia-inducible factor-1alpha (HIF-1α)-dependent signaling pathways, ultimately causing elevated VEGF expression and the reinforcement of angiogenic processes.
Ethical Statement
This study was approved by the Research Ethics Committees of Islamic Azad University- Ardabil Branch (IR.IAU.ARDABIL.REC.1403.219).
Authors' Contributions
Bahar Saljoughi Beranji: Project execution, Data collection, Data analysis, Interpretation of the results, Drafting of the initial manuscript and Approval of the final manuscript.
Elnaz Rezayi: Project execution and Data collection.
Roghayyeh Afroundeh (Ph.D): Project administration and design, Data analysis, Interpretation of the results and Approval of the final manuscript.
Marefat Siahkouhian (Ph.D): Project administration and design, Data analysis, Interpretation of the results and Approval of the final manuscript.
Conflicts of Interest
No conflicts of interest.
Acknowledgement
This article has been extracted from the master's thesis of Ms. Bahar Saljoughi Beranji in Exercise Physiology at the Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili. The authors would like to thank all the participants who took part in this study.
Key Message: Eight weeks of moderate-intensity aerobic exercise training was effective in improving pulmonary function, reducing CRP, and increasing VEGF in active young females. |
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Saljoughi Beranji B, Rezayi E, Afroundeh R, Siahkouhian M. Effects of Eight Weeks of Aerobic Exercise Training on Pulmonary Function Indices, Inflammatory Markers, and Vascular Endothelial Growth Factor in Active Young Females. J Gorgan Univ Med Sci 2026; 28 (1) :48-57 URL: http://goums.ac.ir/journal/article-1-4596-en.html
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