Effects of statins and exercise on postprandial lipoproteins in metabolic syndrome vs metabolically healthy individuals

Abstract

Aims To determine if the combination of exercise and statin could normalize postprandial triglyceridaemia (PPTG) in hypercholesteraemic individuals. Methods Eight hypercholesteraemic (blood cholesterol 182 ± 38 mg dL−1; low‐density lipoprotein–cholesterol [LDL‐c] 102 ± 32 mg dL−1) overweight (body mass index 30 ± 4 kg m−2) individuals with metabolic syndrome (MetS) were compared to a group of 8 metabolically healthy (MetH) controls (blood cholesterol 149 ± 23 mg dL−1; LDL‐c 77 ± 23 mg dL−1, and body mass index 23 ± 2 kg m−2). Each group underwent 2 PPTG tests, either 14 hours after a bout of intense exercise or without previous exercise. Additionally, MetS individuals were tested 96 hours after withdrawal of their habitual statin medication to study medication effects. Results A bout of exercise before the test meal did not reduce PPTG in MetS (P = .347), but reduced PPTG by 46% in MetH (413 ± 267 to 224 ± 142 mg dL−1 for 5 h incremental area under the curve; P = .02). In both trials (i.e., either after a bout of intense exercise or without previous exercise), statin withdrawal in MetS greatly increased PPTG (average 65%; P < .01), mean LDL‐c (average 25%; P < .01), total cholesterol (average 16%; P < .01) and apolipoprotein (Apo) B48 (24%; P < .01), without interference from exercise. However, Apo B100 was not affected by statin withdrawal. Conclusion Hypercholesteraemic MetS individuals (compared to MetH controls) fail to show an effect of exercise on reducing PPTG. However, chronic statin medication blunts the elevations in triglyceride after a fat meal (i.e., incremental area under the curve of PPTG) reducing their cardiovascular risk associated with their atherogenic dyslipidaemia. Statin decreases PPTG by reducing the secretion or accelerating the catabolism of intestinal Apo B48.

Effectiveness of statins vs. exercise on reducing postprandial hypertriglyceridemia in dyslipidemic population: A systematic review and network meta-analysis

“… 11 Publications on the effects of statins on PPTG levels have been accumulating in the past 2 decades, and now there are enough studies to assess the strength of this secondary but clinically relevant effect of statins. 12 , 13 , 14 …”

Statins effect on insulin resistance after a meal and exercise in hypercholesterolemic pre‐diabetic individuals

“…This blood sample was used as a baseline for the calculations of fasted metabolite levels. After 65 min of lying in a quiet room, (22 ± 1 °C and 25 ± 6% humidity) resting metabolic rate was assessed for 20 min, using indirect calorimetry (Quark b 2 , Cosmed, Italy). Fat oxidation was calculated according to Frayn's equations 20 with protein oxidation considered negligible.…”

“…Statins are very effective in lowering cholesterol levels and are one of the safest drugs in clinical practice. Furthermore, statins can reduce postprandial hypertriglyceridemia 1–3 decreasing the risk of atherogenic plaque formation. Thus, in adults with a 10‐year atherosclerotic cardiovascular disease risk (Framingham Heart Study 4 ) of 20% or higher, statin therapy is indicated to reduce low‐density cholesterol levels (i.e., LDL‐c 5 ).…”

“…hypertriglyceridemia [1][2][3] decreasing the risk of atherogenic plaque formation. Thus, in adults with a 10-year atherosclerotic cardiovascular disease risk (Framingham Heart Study 4 ) of 20% or higher, statin therapy is indicated to reduce low-density cholesterol levels (i.e., LDL-c 5 ).…”

Exercise to Lower Postprandial Lipemia: Why, When, What and How

“…TAG reduction of 22% (range 4 to 35%) [14,28,[37][38][39][40][41][42][43][44][45][46]29,[47][48][49][50][51][52][53][54][55][56]30,[57][58][59][60][61][62][63][64][65][66]31,67,68,[32][33][34][35][36]. iv.…”