Atherogenic subfractions of lipoproteins in the treatment of metabolic syndrome by physical activity and diet – the RESOLVE trial

Abstract

BackgroundWe aimed to comprehensively evaluate lipoprotein profile including lipid particle size following a lifestyle intervention in metabolic syndrome (MetS) volunteers and to assess the associations between lipoprotein subfractions and carotid-intima-media-thickness (CIMT) – a surrogate indicator of atherogenesis.Methods100 participants (50–70 years) from the RESOLVE trial, underwent a one-year follow-up beginning with a three-week residential program combining high exercise volume (15-20 h/week), restrictive diet (-500 kcal/day), and education. For baseline references, 40 aged-matched healthy controls were recruited. Independent associations between subfractions of lipoproteins and CIMT were evaluated using a generalized estimating equations model accounting for variation in correlations between repeated measures. The lipoprotein subfractions profile was assessed using Lipoprint® electrophoresis allowing to separate: the very low-density lipoprotein (VLDL) fraction, then the intermediate-density lipoprotein (IDL) C, B and A, the low-density lipoprotein (LDL) with subfractions 1 and 2 as large LDL and subfractions 3 to 7 as small dense LDL (sdLDL), and the high density lipoprotein (HDL) subfractions categorized into large, intermediate, and small HDL. Apolipoproteins A1 and B were also measured.Results78 participants completed the program. At baseline, apolipoproteins B/A1, VLDL, sdLDL and small HDL were higher in MetS than in healthy controls; IDL, LDL size, large and intermediate HDL were lower. Despite time-related regains during the follow-up, lipoprotein subfractions traditionally involved in cardiovascular risk, such as sdLDL, improved immediately after the residential program with values closest to those of healthy controls. CIMT improved throughout the lifestyle intervention. Using a generalized estimating equations model, none of the subfractions of lipoproteins nor apolipoproteins were linked to CIMT.ConclusionsLipoprotein subfractions traditionally involved in CVR, decreased after the 3-week residential program. During a 12 month follow-up, the time-related regains remained closer to the values of healthy controls than they were at baseline. CIMT improved throughout the lifestyle intervention. However, we failed to demonstrate a link between some lipoprotein subfractions and the atherogenicity directly measured from the wall thickness of arteries (CIMT). Further investigations are required to explore the atherogenicity of lipoprotein subfractions.Trial registrationNCT00917917

Lipoprotein profiling in early multiple sclerosis patients: effect of chronic inflammation?

“…In our study, significantly increased levels of total HDL-C and small HDL-C subfractions were found in male MS patients when compared to their healthy counterparts, but not in women. These findings cannot be explained by a favorable effect of physical activity [7,43], since the male MS patients in our study had comparable, even slightly lower physical activity level than controls. Therefore, the indicated gender differences in small HDL-C subfraction as well as the presented opposing correlations of large HDL-C and intermediate HDL-C subfractions may suggest a difference in the HDL-C response to inflammation in individuals with higher (women) and lower (men) normal levels of HDL-C, or at least the gender related time-dependence of the development of observed changes since the onset of the disease.…”

“…LDL-C and HDL-C represent a heterogeneous group of particles that differ in density, migration characteristics, apoprotein content and relationships to disease and these subfractions vary in their risk profile. In particular, small dense LDL-C particles are associated with increased cardiovascular risk, metabolic syndrome and type 2 diabetes, while large LDL-C subfractions were not found to be associated with cardiovascular risk [7,8]. Although the role of HDL-C subfractions in cardioprotective, anti-inflammatory and anti-oxidative mechanisms is less clear, the majority of studies consider large HDL-C subfractions more protective than the small HDL-C [6,[8][9][10][11][12][13].…”

A Larger Body Mass Index is Associated with Increased Atherogenic Dyslipidemia, Insulin Resistance, and Low-Grade Inflammation in Individuals with Metabolic Syndrome

“…10 Assessment of various lipoprotein subclasses, in addition to standard plasma lipid measurements, is an important approach to further characterize the risk factors of MetS. 11 In addition to concomitant presentation with additional parameters of MetS, dyslipidemias often coincide with insulin resistance and inflammation. Hypertension, a defined parameter of MetS, results from the resistance to insulin at the muscle level, which leads to alterations in the activation of the renin-angiotensin-aldosterone system.…”

Effects of microcurrents and physical exercise on the abdominal fat in patients with coronary artery disease

“…An additional limitation is the short duration of the CR program that might not be sufficient to more structural changes in the abdominal fat. Fat loss is more noticeable after one year of intervention at home [50]. This is small study and may not be representative.…”

“…The current guidelines of the American College of Sports Medicine recommend 150 min of moderate activity per week as sufficient for beneficial effects on abdominal fat [48] and [49]. One randomized control trial [50] showed that the loss of visceral fat is associated with a high volume of training (15-20 h per week) over a long period of time [50]. However, in this study there was a significant loss of visceral fat in both intervention groups; nonetheless, the reduction was not greater in the microcurrent protocol when compared with only exercise protocol.…”