de Oliveira Wilson Pascoalino Camargo, Tavoni Thauany Martins, Freitas Fatima Rodrigues, Silva Bruna Miranda Oliveira, Maranhão Raul Cavalcante
Lipid Metabolism Laboratory, Heart Institute (InCor), Medical School Hospital, University of São Paulo, São Paulo, Brazil.
Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.
Lipids. 2017 Aug;52(8):703-709. doi: 10.1007/s11745-017-4274-x. Epub 2017 Jun 28.
Plasma lipids have been extensively studied in sedentary and in subjects practicing exercise training, but not in extreme inactivity as occurs in bedridden patients. This is important for the care of bedridden patients and understanding the overall plasma lipid regulation. Here, we investigated plasma lipids, lipid transfers to HDL and inflammatory markers in bedridden patients. Fasting blood samples were collected from 23 clinically stable bedridden patients under long-term care (>90 days) and 26 normolipidemic sedentary subjects, paired for age and gender. In vitro transfer of four lipids to HDL was performed by incubating plasma with donor nanoparticles containing radioactive lipids. Total (193 ± 36 vs 160 ± 43, p = 0.005), LDL (124 ± 3 vs 96 ± 33 p = 0.003) and HDL-cholesterol (45 ± 10 vs 36 ± 13, p = 0.008), apolipoprotein A-I (134 ± 20 vs 111 ± 24, p = 0.001) and oxidized LDL (53 ± 13 vs 43 ± 12, p = 0.011) were lower in bedridden patients, whereas triglycerides, apolipoprotein B, CETP and LCAT were equal in both groups. Transfers of all lipids, namely unesterified cholesterol, cholesterol esters, triglycerides and phospholipids, to HDL were lower in bedridden patients, probably due to their lower HDL-cholesterol levels. Concentrations of IL-1β, IL-6, IL-8, HGF and NGF were higher in bedridden patients compared to sedentary subjects. In conclusion, inactivity had great impact on HDL, by lowering HDL-cholesterol, apolipoprotein A-I and thereby cholesterol transfers to the lipoprotein, which suggests that inactivity may deteriorate HDL protection beyond the ordinary sedentary condition.
血浆脂质在久坐不动的人群以及进行运动训练的人群中已得到广泛研究，但在像卧床患者那样的极度不活动状态下尚未进行研究。这对于卧床患者的护理以及理解整体血浆脂质调节至关重要。在此，我们调查了卧床患者的血浆脂质、脂质向高密度脂蛋白（HDL）的转移以及炎症标志物。从23名长期护理（>90天）的临床稳定卧床患者和26名血脂正常的久坐不动受试者中采集空腹血样，两组按年龄和性别配对。通过将血浆与含有放射性脂质的供体纳米颗粒孵育，进行四种脂质向HDL的体外转移。卧床患者的总胆固醇（193±36 vs 160±43，p = 0.005）、低密度脂蛋白（LDL，124±3 vs 96±33，p = 0.003）和高密度脂蛋白胆固醇（45±10 vs 36±13，p = 0.008）、载脂蛋白A-I（134±20 vs 111±24，p = 0.001）以及氧化型LDL（53±13 vs 43±12，p = 0.011）较低，而甘油三酯、载脂蛋白B、胆固醇酯转运蛋白（CETP）和卵磷脂胆固醇酰基转移酶（LCAT）在两组中相等。卧床患者中所有脂质，即游离胆固醇、胆固醇酯、甘油三酯和磷脂向HDL的转移较低，可能是由于其较低的HDL胆固醇水平。与久坐不动的受试者相比，卧床患者中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肝细胞生长因子（HGF）和神经生长因子（NGF）的浓度更高。总之，不活动对HDL有很大影响，通过降低HDL胆固醇、载脂蛋白A-I，从而降低胆固醇向脂蛋白的转移，这表明不活动可能会使HDL的保护作用在普通久坐状态之外进一步恶化。
