Effect Of Exercise Interventionon Vascular Endothelial Function In Postmenopausal Women With ACE D/I Polymorphism

OBJECTIVE: Although the angiotensin-converting enzyme(ACE)plays an important regulatory role in vasomotor function,D/I Polymorphism of the ACE gene has been rarely studied in public health.The lack of estrogen in postmenopausal women reduces the regulation of vasodilatation and increases the risk of cardiovascular disease.There have been some studies on reducing the incidence of cardiovascular disease in postmenopausal women by exercise intervention,but the results were inconsistent.This study was to cross-sectionally analyze the age-dependent changes of vascular endothelial function in women of han nationality with different D/I polymorphism of ACE in Beijing,and evaluate the effectiveness of exercise in improving vascular endothelial function in postmenopausal women by meta analysis,then observe the effects of exercise intervention(aerobic exercise and resistance training)for 12 weeks on vascular endothelial function in postmenopausal women with different D/I polymorphism of ACE.These results may be important in identifying individuals who would benefit from exercises to protect vascular endothelial function.METHODS: Part One: A total of 391 females,age from 22 y to 75 y,were selected for analyzing the relationship between ACE D/I polymorphism and cardiovascular risk factors for endothelial function(Ages 20-44: 120;Ages 45-59: 150;Ages 60-75: 121).Body composition,serum lipids metabolism,endothelial function,endothelium-derived relaxing factor and contracting factor were analyzed.Part Two: A meta-analysis was used to investigate the effect of exercise on improving vascular endothelial function in postmenopausal women.We searched all literature published including FMD as key factor before September 2018.Meta analysis was performed using the Review Manager 5.3.Part Three: 122 postmenopausal women aged 45-75 years were selected in this study and randomly divided into aerobic exercise group(n=71)and resistance training group(n=51).This study observed the effects of different exercise intervention for 12 weeks on vascular endothelial function in postmenopausal women with different D/I Polymorphism of ACE gene.RESULTS: 1.The distribution characteristics of ACE gene D/I Polymorphism and the age-dependent changes of cardiovascular risk factors in han Chinese women in BeijingThe distribution characteristics of D/I polymorphism of ACE gene in han Chinese women in Beijing were as follows: Ages 20-44:63.74% and 36.26%;Ages 45-69:67.33% and 32.67%;Ages 60-75:64.34% and 35.66%.There were no apparent age differences.With the aging,DI/II genotype had a higher TG level,a lower HDL level and a higher chance of hyperglycemia.The percentage of body fat and visceral fat increased more significantly than DD type.FMD,blood pressure,ba PWV and IMT increased earlier and DBP abnormality rate,IMT,IMT thickening rate increased more significantly than DD type.The decrease of NO and NO/ET-1 and the increase of ET-1,Ang?were more significantly than DD type.The interaction between age and ACE gene D/I polymorphism could significantly affect vascular endothelial function.2.A meta-analysis of the effects of exercise on vascular endothelial function in postmenopausal womenAerobic exercise could significantly improve vascular endothelial function in postmenopausal women(SMD=-1.16(95%CI:-1.73,-0.58),Z=3.95,P < 0.001)3.Effects of different exercise interventions on vascular endothelial function in postmenopausal women with different D/I Polymorphism of ACE geneThe effects of 12 weeks of aerobic exercise and resistance training on blood lipids,blood glucose and body composition in postmenopausal women were genetically different.The decreases of TC,blood lipid abnormality rate,blood glucose and visceral fat in DI/II type were more significantly after aerobic exercise intervention compared with DD type.Aerobic exercise could significantly reduce the incidence rate of Low density lipoproteinemia,hyperglycemia,overweight/obesity,high body fat rate,abnormal waist-hip ratio and visceral fat in DI/II,while the decreases of HDL,LDL,blood glucose,waist-hip ratio and visceral fat in DD type were more significantly after resistance training intervention compared with DI/II type.After aerobic exercise intervention,the increases of FMD,NO,NO/ET-1and the decreases of SBP,DBP,ba PWV in DI/II were more obvious than DD type.The increases of FMD,NO/ET-1 and the decreases of SBP,DBP,ba PWV,ET-1,Ang? were more apparent than DI/II type after resistance training intervention.CONCLUSION:1.There is no age difference in the distribution frequency of ACE gene D/I Polymorphism in Beijing han women;2.The occurrence time of vascular endothelial dysfunction and arteriosclerosis in DI/II type are earlier than DD type,and the decrease of vascular function is more obvious than DD type.3.The interaction between age and ACE gene D/I polymorphism plays a key role in endothelial dysfunction4.The intervention of exercise positively influences their endothelial functions,independent of ACE D/I polymorphism;and DI/II carriers show a better response to aerobic exercise,while DD carriers to resistance exercise.