The effect of 8 weeks of aerobic training and vitamins E & C supplementation on the plasma levels of MMP-1 and MMP-3 and TIMP-4 in patients with Coronary artery disease

Subject Areas : Journal of Physical Activity and Hormones

Elham Karami ¹ , Ramin Shabani ² , Farhad Rahmani-Nia ³ , Alireza Elmieh ⁴ , Mahdi Rezagholizadeh ⁵

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Received: 2025-07-18 Accepted : 2025-10-01 Published : 2025-10-02

Keywords: Cardiac artery diseases, Aerobic training, Rehabilitation, Vitamins E & C supplementation,

Abstract :

Introduction: The family of matrix metalloproteinases (MMPs) and its inhibitors play an important role in cardiovascular diseases and vascular wall regeneration. The effect of sports training along with vitamin supplements on heart diseases due to the change of MMPs is not clear.  Therefore, the aim of the present study is investigating the effect of eight weeks of aerobic training with vitamin E & C supplementation on the plasma levels of MMP-1 and MMP-3 and TIMP-4 in patients with coronary artery disease (CAD).

Material & Methods: 60 patients with CAD (53.84±5.49 years old mean ± SD)  participated in this study., All the subjects were randomly divided into 4 equal groups (n=15): (1) control (C), (2) aerobic training (A), (3) supplement (S) and (4) aerobic training + supplement (AS) according to their aerobic capacity: and Groups 3 and 4 received 1000 mg of D-alpha tocopherol and 1000 mg acid ascorbic tablets daily. . The training program was also carried out for eight weeks (three sessions per week) with an intensity of 40 to 80% of the reserve heart rate for 45 minutes.  48 hours after the last session of training, blood samples were taken to analyze MMPs levels by using ELISA. The data were analyzed using analysis of covariance and paired t-test at a significance level of P<0.05.

Results: The plasma levels of MMP-1 (P=0.001) and MMP-3 (P=0.000) in the AS  were significantly lower than the A group. TIMP-4 concentration in the AS group  were significantly higher than in the A group (P=0.000). In addition, plasma MMP-1 and MMP-3 levels in patients with CAD in the AS group were significantly lower than in the S group (P=0.000) and C group (P=0.000). Also, plasma MMP-1 and MMP-3 levels in patients with CAD in the T group were significantly lower than in the C group (P=0.000). However, plasma MMP-1 (P=0.068), MMP-3 (P=0.069), and TIMP-4 (P=1.000) levels in patients with CAD in the T group were not significantly different from those in the S group. Also, plasma MMP-1 (P=0.055), MMP-3 (P=0.392), and TIMP-4 (P=0.405) levels in patients with CAD in the S group were not significantly different from those in the C group. In addition, plasma TIMP-4 levels in patients with CAD in the AS group were significantly higher than in the supplement (P=0.000) and control (P=0.000) groups. Also, plasma TIMP-4 levels in patients with CAD in the A group were significantly higher than in the C group (P=0.021).

Conclusion: combined aerobic training and taking vitamin E and C supplements can affect the plasma levels of the mentioned indicators to a greater extent and cause them to improve, which displays the higher efficiency of training at the same time as the supplement.

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