The effect of physical activity on growth factor concentrations in platelet-rich fibrin: a cross-sectional study

Authors

  • Elif Yucel lKirikkale University. Faculty of Dentistry. Department of Periodontology.
  • Meltem Karsiyaka Hendek Kirikkale University, Faculty of Dentistry, Department of Periodontology,
  • Hakan Yapici Kirikkale University. Faculty of Sport Sciences. Department of Recreation.
  • Mehmet Gulu lKirikkale University. Faculty of Sport Sciences. Department of Sport Management.
  • Osman Caglayan Kirikkale University, Faculty of Medicine, Department of Medical Biochemistry
  • Ebru Olgun Kirikkale University, Faculty of Dentistry. Department of Periodontology.

DOI:

https://doi.org/10.1590/

Keywords:

International physical activity questionnaire, Growth factors, Physical activity, PRF, Platelets

Abstract

Objective  This study investigated the impact of physical activity levels on growth factor concentrations within leukocyte- and platelet-rich fibrin (L-PRF). Methodology  In total, 120 participants were categorized into sedentary (n=60) and physically active (n=60) groups via the International Physical Activity Questionnaire. Venous blood was collected to analyze platelet count, mean platelet volume, white blood cell count, red blood cell count, plateletcrit, platelet distribution width, and platelet-large cell ratio, and to prepare the L-PRF. Concentrations of vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), and platelet-derived growth factor (PDGF) were determined using ELISA. Results  Metabolic equivalent of task (MET) values were significantly higher in the active group (p<0.001). Conversely, VEGF, TGF-β, and PDGF levels were significantly higher in the sedentary group (p<0.001). Hemoglobin and hematocrit values were also significantly higher in active individuals (p=0.025 and p=0.040, respectively). A significant moderate negative correlation was found between MET values and concentrations of VEGF, TGF-β, and PDGF (r=−0.33, r=−0.33, and r=−0.31, respectively; p<0.01). Multivariable linear regression analyses, adjusted for sex, periodontal parameters, and hematological variables, confirmed that Total MET constituted an independent negative predictor of all growth factors (all p<0.001), whereas periodontal indices showed no significant independent associations. Sex-stratified analyses and interaction models showed that the association between physical activity and growth factor levels was significantly sex dependent (MET × sex interaction: all p<0.05), with stronger effects in women. Conclusions  Physical activity seems to be associated with variations in growth factor levels in L-PRF, suggesting that individual physiological status may influence the biological composition of autologous platelet concentrates.

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References

1- World Health Organization. Global recommendations on physical activity for health [Internet]. Geneva: World Health Organization; 2010 [cited 2026 May 19]. Available from: https://www.who.int/publications/i/item/9789241599979

» https://www.who.int/publications/i/item/9789241599979

2- McTiernan A, Friedenreich CM, Katzmarzyk PT, Powell KE, Macko RF, Buchner DM, et al. Physical activity in cancer prevention and survival: a systematic review. Med Sci Sports Exerc. 2019;51(6):1252-61. doi: 10.1249/MSS.0000000000001937

» https://doi.org/10.1249/MSS.0000000000001937

3- Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673-734. doi: 10.1016/S0140-6736(17)31363-6

» https://doi.org/10.1016/S0140-6736(17)31363-6

4- Schuch FB, Vancampfort D, Richards J, Rosenbaum S, Ward PB, Stubbs B. Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. J Psychiatr Res. 2016;77:42-51. doi: 10.1016/j.jpsychires.2016.02.023

» https://doi.org/10.1016/j.jpsychires.2016.02.023

5- Das P, Horton R. Rethinking our approach to physical activity. Lancet. 2012;380(9838):189-90. doi: 10.1016/S0140-6736(12)61024-1

» https://doi.org/10.1016/S0140-6736(12)61024-1

6- Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, et al. Sedentary Behavior Research Network (SBRN): Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act. 2017;14:75. doi: 10.1186/s12966-017-0525-8

» https://doi.org/10.1186/s12966-017-0525-8

7- Keadle SK, Conroy DE, Buman MP, Dunstan DW, Matthews CE. Targeting reductions in sitting time to increase physical activity and improve health. Med Sci Sports Exerc. 2017;49(8):1572-82. doi: 10.1249/MSS.0000000000001257

» https://doi.org/10.1249/MSS.0000000000001257

8- Ekelund U, Brown WJ, Steene-Johannessen J, Fagerland MW, Owen N, Powell KE, et al. Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? A systematic review and harmonised meta-analysis of data from 850 060 participants. Br J Sports Med. 2019;53(14):886-94. doi: 10.1136/bjsports-2017-098963

» https://doi.org/10.1136/bjsports-2017-098963

9- Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-95. doi: 10.1249/01.MSS.0000078924.61453.FB

» https://doi.org/10.1249/01.MSS.0000078924.61453.FB

10- Fan M, Lyu J, He P. Chinese guidelines for data processing and analysis concerning the International Physical Activity Questionnaire. Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35(8):961-4. Chinese. doi: 10.3760/cma.j.issn.0254-6450.2014.08.019

» https://doi.org/10.3760/cma.j.issn.0254-6450.2014.08.019

11- Choukroun J, Adda F, Schoeffler C, Vervelle A. Une opportunité en paro-implantologie: le PRF. Implantodontie. 2001;42:55-62. French.

12- Ghanaati S, Booms P, Orlowska A, Kubesch A, Lorenz J, Rutkowski J, et al. Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol. 2014;40(6):679-89. doi: 10.1563/aaid-joi-D-14-00138

» https://doi.org/10.1563/aaid-joi-D-14-00138

13- Dawson AA, Ogston D. Exercise-induced thrombocytosis. Acta Haematol. 1969;42(4):241-6. doi: 10.1159/000208784

» https://doi.org/10.1159/000208784

14- Möbius-Winkler S, Hilberg T, Menzel K, Golla E, Burman A, Schuler G, et al. Time-dependent mobilization of circulating progenitor cells during strenuous exercise in healthy individuals. J Appl Physiol (1985). 2009;107(6):1943-50. doi: 10.1152/japplphysiol.00516.2009

» https://doi.org/10.1152/japplphysiol.00516.2009

15- Hulmi JJ, Myllymäki T, Tenhumäki M, Mutanen N, Puurtinen R, Paulsen G, et al. Effects of resistance exercise and protein ingestion on blood leukocytes and platelets in young and older men. Eur J Appl Physiol. 2010;109(2):343-53. doi: 10.1007/s00421-009-1349-y

» https://doi.org/10.1007/s00421-009-1349-y

16- Heber S, Volf I. Effects of physical (in)activity on platelet function. Biomed Res Int. 2015;2015:165078. doi: 10.1155/2015/165078

» https://doi.org/10.1155/2015/165078

17- Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22(1):121-35. doi: 10.3109/00016356408993968

» https://doi.org/10.3109/00016356408993968

18- Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533-51. doi: 10.3109/00016356309011240

» https://doi.org/10.3109/00016356309011240

19- Wang X, Fok MR, Pelekos G, Jin L, Tonetti MS. In vitro and ex vivo kinetic release profile of growth factors and cytokines from leucocyte- and platelet-rich fibrin (L-PRF) preparations. Cells. 2022;11(13):2089. doi: 10.3390/cells11132089

» https://doi.org/10.3390/cells11132089

20- Su CY, Kuo YP, Tseng YH, Su CH, Burnouf T. In vitro release of growth factors from platelet-rich fibrin (PRF): a proposal to optimize the clinical applications of PRF. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(1):56-61. doi: 10.1016/j.tripleo.2009.02.004

» https://doi.org/10.1016/j.tripleo.2009.02.004

21- Kobayashi E, Flückiger L, Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Investig. 2016;20(9):2353-60. doi: 10.1007/s00784-016-1719-4

» https://doi.org/10.1007/s00784-016-1719-4

22- Miron RJ, Dham A, Dham U, Zhang Y, Pikos MA, Sculean A. The effect of age, gender, and time between blood draw and start of centrifugation on the size outcomes of platelet-rich fibrin (PRF) membranes. Clin Oral Investig. 2019;23(5):2179-85. doi: 10.1007/s00784-018-2661-3

» https://doi.org/10.1007/s00784-018-2661-3

23- Mochizuki T, Ushiki T, Watanabe S, Omori G, Kawase T. The levels of TGFß1, VEGF, PDGF-BB, and PF4 in platelet-rich plasma of professional soccer players: a cross-sectional pilot study. J Orthop Surg Res. 2022;17(1):465. doi: 10.1186/s13018-022-03362-4

» https://doi.org/10.1186/s13018-022-03362-4

24- Mochizuki T, Ushiki T, Suzuki K, Sato M, Ishiguro H, Suwabe T, et al. Characterization of leukocyte- and platelet-rich plasma derived from female college athletes: a cross-sectional cohort study focusing on growth factor, inflammatory cytokines, and anti-inflammatory cytokine levels. Int J Mol Sci. 2023;24(17):13592. doi: 10.3390/ijms241713592

» https://doi.org/10.3390/ijms241713592

25- Hamilton B, Tol JL, Knez W, Chalabi H. Exercise and the platelet activator calcium chloride both influence the growth factor content of platelet-rich plasma (PRP): overlooked biochemical factors that could influence PRP treatment. Br J Sports Med. 2015;49(14):957-60. doi: 10.1136/bjsports-2012-091916

» https://doi.org/10.1136/bjsports-2012-091916

26- Czarkowska-Paczek B, Bartlomiejczyk I, Przybylski J. The serum levels of growth factors: PDGF, TGF-beta and VEGF are increased after strenuous physical exercise. J Physiol Pharmacol. 2006;57(2):189-97.

27- Wallén NH, Goodall AH, Li N, Hjemdahl P. Activation of haemostasis by exercise, mental stress and adrenaline: effects on platelet sensitivity to thrombin and thrombin generation. Clin Sci (Lond). 1999;97(1):27-35. doi: 10.1042/cs0970027

» https://doi.org/10.1042/cs0970027

28- Wang JS, Cheng LJ. Effect of strenuous, acute exercise on alpha2-adrenergic agonist-potentiated platelet activation. Arterioscler Thromb Vasc Biol. 1999;19(6):1559-65. doi: 10.1161/01.ATV.19.6.1559

» https://doi.org/10.1161/01.ATV.19.6.1559

29- Eliakim A, Wolach B, Kodesh E, Gavrieli R, Radnay J, Ben-Tovim T, et al. Cellular and humoral immune response to exercise among gymnasts and untrained girls. Int J Sports Med. 1997;18(3):208-12. doi: 10.1055/s-2007-972621

» https://doi.org/10.1055/s-2007-972621

30- Wardyn GG, Rennard SI, Brusnahan SK, McGuire TR, Carlson ML, Smith LM, et al. Effects of exercise on hematological parameters, circulating side population cells, and cytokines. Exp Hematol. 2008;36(2):216-23. doi: 10.1016/j.exphem.2007.10.003

» https://doi.org/10.1016/j.exphem.2007.10.003

31- Durmus I, Kalaycioglu E, Çetin M, Sahin HB, Kiris T. Exercise-based cardiac rehabilitation has a strong relationship with mean platelet volume reduction. Arq Bras Cardiol. 2021;116(3):434-40. doi: 10.36660/abc.20190514

» https://doi.org/10.36660/abc.20190514

32- Boyali E, Sevindi T, Yüksel MF, Demir H. The effects of preparation period exercises on the hematological parameters of the taekwondo athletes. Phys Educ Stud. 2019;23(1):9-15. doi: 10.15561/20755279.2019.0102

» https://doi.org/10.15561/20755279.2019.0102

33- Bachero-Mena B, Pareja-Blanco F, González-Badillo JJ. Enhanced strength and sprint levels, and changes in blood parameters during a complete athletics season in 800 m high-level athletes. Front Physiol. 2017;8:637. doi: 10.3389/fphys.2017.00637

» https://doi.org/10.3389/fphys.2017.00637

34- Coppola L, Grassia A, Coppola A, Tondi G, Peluso G, Mordente S, et al. Effects of a moderate-intensity aerobic program on blood viscosity, platelet aggregation and fibrinolytic balance in young and middle-aged sedentary subjects. Blood Coagul Fibrinolysis. 2004;15(1):31-7. doi: 10.1097/00001721-200401000-00006

» https://doi.org/10.1097/00001721-200401000-00006

35- Slingsby MH, Nyberg M, Egelund J, Mandrup CM, Frikke-Schmidt R, Kirkby NS, et al. Aerobic exercise training lowers platelet reactivity and improves platelet sensitivity to prostacyclin in pre- and postmenopausal women. J Thromb Haemost. 2017;15(12):2419-31. doi: 10.1111/jth.13866

» https://doi.org/10.1111/jth.13866

36- Heber S, Fischer B, Sallaberger-Lehner M, Hausharter M, Ocenasek H, Gleiss A, et al. Effects of high-intensity interval training on platelet function in cardiac rehabilitation: a randomised controlled trial. Heart. 2020;106(1):69-79. doi: 10.1136/heartjnl-2019-315130

» https://doi.org/10.1136/heartjnl-2019-315130

37- Kirbas S, Tetik S, Aykora E, Duran B. An examination of the impact of regular exercise participation on blood platelet parameters. World J Med Sci. 2015;12(2):79-82. doi: 10.5829/idosi.wjms.2015.12.2.9348

» https://doi.org/10.5829/idosi.wjms.2015.12.2.9348

38- Demircioglu S, Tekinalp A, Korkmaz C, Alkan Baylan F, Merter M. Changes in body composition and their association with erythrocyte mass in regular exercisers: a cross-sectional study. Medicine (Baltimore). 2025;104(33):e44065. doi: 10.1097/MD.0000000000044065

» https://doi.org/10.1097/MD.0000000000044065

39- Mairbäurl H. Red blood cells in sports: effects of exercise and training on oxygen supply by red blood cells. Front Physiol. 2013;4:332. doi: 10.3389/fphys.2013.00332

» https://doi.org/10.3389/fphys.2013.00332

40- Sabetta A, Lombardi L, Stefanini L. Sex differences at the platelet-vascular interface. Intern Emerg Med. 2022;17(5):1267-76. doi: 10.1007/s11739-022-02994-y

» https://doi.org/10.1007/s11739-022-02994-y

41- Xiong G, Lingampalli N, Koltsov JC, Leung LL, Bhutani N, Robinson WH, et al. Men and women differ in the biochemical composition of platelet-rich plasma. Am J Sports Med. 2018;46(2):409-19. doi: 10.1177/0363546517740845

» https://doi.org/10.1177/0363546517740845

42- Schulze A, Busse M. Sports diet and oral health in athletes: a comprehensive review. Medicina (Kaunas). 2024;60(2):319. doi: 10.3390/medicina60020319

» https://doi.org/10.3390/medicina60020319

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Published

2026-07-17

Issue

Vol. 34 (2026)

Section

Original Articles

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How to Cite

Yucel, E., Hendek, M. K., Yapici, H., Gulu, M., Caglayan, O., & Olgun, E. (2026). The effect of physical activity on growth factor concentrations in platelet-rich fibrin: a cross-sectional study. Journal of Applied Oral Science, 34, e20260128. https://doi.org/10.1590/