Homocysteine-lowering exercise effect is greater in hyperhomocysteinemic people living with HIV: a randomized clinical trial

Abstract

Elevated concentration of homocysteine has been identified as an independent risk factor for the development of cardiovascular disease and is frequently associated with oxidative stress. Moreover, studies have shown that people living with human immunodeficiency virus (PLHIV) present elevated concentration of homocysteine and oxidative stress compared with people without HIV. Our purpose was to describe blood homocysteine and oxidative stress markers in PLHIV and those without HIV infection, and to examine the effects of a 16-week combined training exercise program (CTE) on oxidative stress and homocysteine concentrations of PLHIV. We included 49 PLHIV (21 men, 28 women) and 33 people without HIV infection (13 men, 20 women). After baseline evaluations, 30 PLHIV were randomized to either CTE (trained group, n = 18) or the control group (n = 12); CTE consisted of aerobic and strength exercise sessions during 16 weeks, 3 times a week. Plasma homocysteine, oxidative damage markers, folate, and vitamin B12 were assessed pre- and post-training and by hyperhomocysteinemia (homocysteine ≥ 15 μmol/L) status. At baseline, PLHIV had higher levels of homocysteine and malondialdehyde, as well as reduced circulating folate when compared with people without HIV infection. CTE resulted in a 32% reduction (p < 0.05) in homocysteine concentration and a reduction in lipid hydroperoxide in PLHIV with hyperhomocysteinemia, which was not observed in those without hyperhomocysteinemia. Hyperhomocysteinemic participants experienced a 5.6 ± 3.2 μmol/L reduction in homocysteine after CTE. In summary, 16 weeks of CTE was able to decrease elevated homocysteine concentration and enhance redox balance of PLHIV with hyperhomocysteinemia, which could improve their cardiovascular risk.

The effect of vitamin B supplementation on neuronal injury in people living with HIV: a randomized controlled trial

“…The screening cohort had a P-homocysteine mean of 13.0 μmol/l, consistent with 13.1 and 15.1 μmol/l in previous studies of PLHIV on ART. 40,41 By way of confirmation of our findings, a study by Remacha et al 42 also showed that treatment with vitamin B 12 and folic acid decreased the levels of P-homocysteine and increased the levels of B 12 and folate in a cohort of PLHIV. This is a pattern well known from studies of HIV-negative elderly people with or without cognitive impairment receiving vitamin B supplementation.…”

Sarcopenia Related to Human Immunodeficiency Virus: Protective Effects of Exercise

“…Similar effects are seen in PWH, where exercise attenuates markers of inflammation, including high-sensitivity C-reactive protein, TNF-α, IL-6, and IL-1β (32–34). We, and others, have demonstrated that combined exercise attenuates ART-induced redox imbalance and alleviates oxidative damage in PWH (35,36). Exercise training promotes mitochondrial biogenesis and enhances mitochondrial dynamics (37) and can partially restore mitochondrial metabolism impaired by ART.…”

Effect of a single resistance exercise session on inflammatory markers and oxidative stress in women living with HIV

“…Acute exercise creates an inflammatory environment responsible for recovery and adaptation from an exercise session in healthy individuals 16 , but it is not known whether the magnitude of this damage is more exacerbated in HIV-infected individuals. Furthermore, there are few studies in the literature that aim to investigate the effects of resistance training on oxidative stress 17,18 and inflammatory markers in PLH 19 . Therefore, this study aims to investigate the effect of a single resistance exercise (RE) session on inflammatory markers and oxidative stress in women living with HIV.…”