Elsevier

American Heart Journal

Volume 166, Issue 3, September 2013, Pages 392-400
American Heart Journal

Progress in Cardiology
Exercise-mediated changes in high-density lipoprotein: Impact on form and function

https://doi.org/10.1016/j.ahj.2013.05.021Get rights and content

The goal of this systematic review was to assess the current understanding of the effects of exercise intervention on high-density lipoprotein (HDL) cholesterol (HDL-C) and changes in HDL function as well as modification of these effects by genomic factors. The reviewed studies demonstrate that exercise has modest effects on HDL-C with limited data suggesting an effect on HDL function. Genetic polymorphisms in proteins associated with HDL metabolism play a role in modifying the HDL-C response to exercise and possibly its function. Exercise as an intervention for patients at risk for cardiovascular events can lead to small improvements in HDL-C and potential changes in HDL function. There is an important modifier effect of genetics in determining these changes.

Section snippets

High-density lipoprotein and cardiovascular benefits

Epidemiologic studies have consistently shown that HDL-C is inversely associated with cardiovascular risk independent of other atherogenic lipoproteins (low-density lipoprotein [LDL] cholesterol [LDL-C] and non-HDL-C), with each SD increase in HDL-C in the Emerging Risk Factors Cohort (15 mg/dL) equating to a 22% decrease in coronary heart disease risk.7 Clinical events are, however, quite common in patients with normal HDL-C levels, with as much as 44% of events in men and 43% of events in

Studies on exercise and HDL

Studies of exercise on lipid parameters have been confounded by a number of variables that independently exert effects on lipid parameters. These include genetics and changes in diet as well as a multitude of environmental factors. Collectively, these make ascribing effects to exercise alone challenging. It may also be very difficult to tease out the hemodynamic effects of exercise from its effects on weight loss and body fat composition, especially when trials are conducted over longer

Summary

Exercise has modest effects on HDL-C and may modulate its function. Multiple gaps exist in the relationship between exercise and HDL function. Figure summarizes current pathways that may be influenced by exercise. The following areas could be important in defining the role of exercise in improving functional aspects of HDL: (1) development of assays for assessing dysfunctional HDL; (2) the mechanisms that produce dysfunctional HDL and how exercise may delay transition to a dysfunctional state;

Disclosures

Funding support: No extramural funding was used to support this work. The authors are solely responsible for the design and conduct of this study, study analyses, the drafting and editing of the manuscript, and its final contents.

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