Progress in CardiologyExercise-mediated changes in high-density lipoprotein: Impact on form and function
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.
References (64)
- et al.
European Guidelines on cardiovascular disease prevention in clinical practice (version, 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts)
Atherosclerosis
(2012) - et al.
High-density lipoprotein cholesterol, high-density lipoprotein particle size, and apolipoprotein A-I: significance for cardiovascular risk: the IDEAL and EPIC-Norfolk studies
J Am Coll Cardiol
(2008) The protein cargo of HDL: implications for vascular wall biology and therapeutics
J Clin Lipidol
(2010)- et al.
Comparison of effects of dietary saturated, monounsaturated, and polyunsaturated fatty acids on plasma lipids and lipoproteins in man
J Lipid Res
(1985) - et al.
The effects of low cholesterol, high polyunsaturated fat, and low fat diets on plasma lipid and lipoprotein cholesterol levels in normal and hypercholesterolemic subjects
Am J Clin Nutr
(1981) - et al.
Aerobic exercise and lipids and lipoproteins in men: a meta-analysis of randomized controlled trials
J Mens Health Gend
(2006) - et al.
Polyunsaturated fatty acids modulate the effects of the APOA1 G-A polymorphism on HDL-cholesterol concentrations in a sex-specific manner: the Framingham Study
Am J Clin Nutr
(2002) - et al.
Genetic analysis of a polymorphism in the human apolipoprotein A-I gene promoter: effect on plasma HDL-cholesterol levels
J Lipid Res
(1994) - et al.
Apolipoprotein A1 genotype affects the change in high density lipoprotein cholesterol subfractions with exercise training
Atherosclerosis
(2006) - et al.
Hepatic lipase mutations, elevated high-density lipoprotein cholesterol, and increased risk of ischemic heart disease: the Copenhagen City Heart Study
J Am Coll Cardiol
(2003)
Concordant lipoprotein and weight responses to dietary fat change in identical twins with divergent exercise levels 1
Am J Clin Nutr
Changes in high density lipoprotein subfractions and other lipoproteins by exercise
Clin Chim Acta
Continuous and intermittent walking alters HDL(2)-C and LCATa
Atherosclerosis
Regulation of skeletal muscle transcriptome in elderly men after 6 weeks of endurance training at lactate threshold intensity
Exp Gerontol
Effect of exercise training on plasma levels and functional properties of high-density lipoprotein cholesterol in the metabolic syndrome
Am J Cardiol
Clinical utility of inflammatory markers and advanced lipoprotein testing: advice from an expert panel of lipid specialists
J Clin Lipidol
A single session of circuit-resistance exercise effects on human peripheral blood lymphocyte ABCA1 expression and plasma HDL-C level
Regul Pept
Impact of progressive resistance training on lipids and lipoproteins in adults: a meta-analysis of randomized controlled trials
Prev Med
Physical activity and its impact on health outcomes. Paper 1: the impact of physical activity on cardiovascular disease and all-cause mortality: an historical perspective
Obes Rev
AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee
Circulation
Exercise and the cardiovascular system
Cardiol Res Pract
Physical Activity Guidelines Advisory Committee report, 2008. To the Secretary of Health and Human Services. Part A: executive summary
Nutr Rev
Effects of the amount and intensity of exercise on plasma lipoproteins
N Engl J Med
Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis
Lancet
Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy
N Engl J Med
HDL and CETP inhibition: will this DEFINE the future?
Curr Treat Options Cardiovasc Med
Role of HDL, ABCA1, and ABCG1 transporters in cholesterol efflux and immune responses
Arterioscler Thromb Vasc Biol
Cholesterol efflux and atheroprotection: advancing the concept of reverse cholesterol transport
Circulation
HDL and cardiovascular disease: atherogenic and atheroprotective mechanisms
Nat Rev Cardiol
Exercise training decreases plasma cholesteryl ester transfer protein
Arterioscler Thromb Vasc Biol
Blood pressure–lowering effects of lifestyle modification: possible involvement of nitric oxide bioavailability
Hypertens Res
The influence of exercise on the concentrations of triglyceride and cholesterol in human plasma
Exerc Sport Sci Rev
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Aerobic training reduces blood pressure and waist circumference and increases HDL-c in metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials
2018, Journal of the American Society of HypertensionHigh density lipoprotein and metabolic disease: Potential benefits of restoring its functional properties
2016, Molecular MetabolismCitation Excerpt :In contrast to a study in humans where an acute bout of exercise did indeed raise HDL-C levels [29], an experimental study in rats running at 3 different intensities (18, 24 and 30 m/min for 30 min) could not detect an increase in HDL-C levels at any time point measured after exercise (before running, immediately after running, 30 min and 5 h post-running) [44]. Although even in the few human studies that did not detect an effect of exercise on HDL-C levels, the researchers still found evidence that exercise improved HDL function [32,45], e.g. by increasing antioxidant activity (paraoxonase) to inhibit LDL and cellular oxidation in vitro [45]; by enhancing HDL particle maturation through loading of cholesterol and proteins [46]; by increasing RCT and increasing lecithin cholesterol acyl-transferase (LCAT) activity [47,48]; or by raising nitric oxide (NO) bioavailability, which, in turn, reduces oxidative modification of HDL [49–51]. Besides these classic HDL functions, a novel mechanism by which HDL may reduce endothelial dysfunction in chronic diseases is emerging.
National lipid association recommendations for patient-centered management of dyslipidemia: Part 2
2015, Journal of Clinical LipidologyCitation Excerpt :There are reports that 6 to 9 weeks of resistance training (8 to 10 exercises, 3 times/week) can significantly increase HDL-C 4 to 9% in men and women.259,260 Moreover, the HDL-C response to exercise training is under considerable genetic influence, with underlying genetic polymorphisms (e.g., lipoprotein lipase and hepatic lipase) explaining up to 50% of the variation in HDL-C.261,262 Exercise programs have the best chance of reducing LDL-C when there is associated body fat reduction.24,238,263,264
High-Density Lipoprotein Function Measurement in Human Studies: Focus on Cholesterol Efflux Capacity
2015, Progress in Cardiovascular DiseasesCitation Excerpt :Only one small study testing exercise and CEC had a control arm,41 suggesting no improvement with exercise training among patients with DM. Other uncontrolled published studies on exercise and CEC have been summarized in a recent review.42 The largest of these included 100 overweight women and found that reduction in caloric intake by 500 kcal and increase in physical activity by 5000 steps/day led to a 6% decrease in HDL-C and a 10% decrease in ABCA1-CEC (p = 0.006) which was attenuated when adjusted for apoA-I levels.43
Variations in high density cholesterol levels based on apolipoprotein E variant and exercise type
2023, Frontiers in GeneticsEarly Midlife Cardiovascular Health Influences Future HDL Metrics in Women: The SWAN HDL Study
2022, Journal of the American Heart Association