Exercise training for intermittent claudication: does it adversely affect biochemical markers of the exercise-induced inflammatory response?

Eur J Vasc Endovasc Surg. 1997 Nov;14(5):344-50. doi: 10.1016/s1078-5884(97)80283-3.


Objectives: To identify a stable biochemical marker of disease severity in patients with intermittent claudication and to use these findings to assess the effect of therapeutic exercise training.

Design: Case-control study: prospective randomised-controlled trial of exercise training.

Materials and methods: Plasma fibrinogen, serum amyloid A protein (SAA), C-reactive protein (CRP) and urinary albumin-creatinine ratio (ACR) were measured in 67 claudicants and 15 controls. Twenty-two patients were randomised to supervised exercise training and 17 randomised to observation. Subjects were reviewed at 3, 6 and 12 months.

Results: The median (interquartile range) baseline fibrinogen was 3.7 g/l (3.3-4.25) in claudicants and 3.5 g/l (2.9-3.95) in controls (p = 0.045); CRP was 4.7 mg/l (2.2-9.0) and 2.1 mg/l (1.0-2.8), respectively (p < 0.0001); SAA was 72 mg/l (35-132) and 30 mg/l (20-89) (p = 0.0009). Claudicants showed an increased urinary ACR following treadmill exercise (Wilcoxon, p < 0.0001) with no change in controls. Exercise training reduced SAA at 6 months, CRP at 3 months and progressively attenuated the post-exercise increase in ACR. No similar changes were found in controls.

Conclusions: Repetitive low-grade inflammatory events in claudicants lead to elevation of serum acute-phase proteins. Exercise training is associated with symptomatic improvement and reduction inflammatory markers. The concern that exercise has adverse systemic effects therefore seems to be unjustified.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Albuminuria
  • Biomarkers / analysis
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Creatinine / urine
  • Exercise Therapy*
  • Female
  • Fibrinogen / analysis
  • Humans
  • Inflammation
  • Intermittent Claudication / metabolism*
  • Intermittent Claudication / therapy*
  • Male
  • Prospective Studies
  • Serum Amyloid A Protein / analysis


  • Biomarkers
  • Serum Amyloid A Protein
  • Fibrinogen
  • C-Reactive Protein
  • Creatinine