Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada.
Department of Medicine, Faculty of Medicine, Université Laval, Québec, Canada.
J Am Heart Assoc. 2018 Jun 1;7(11):e008681. doi: 10.1161/JAHA.118.008681.
Our objective was to identify the determinants of high-density lipoprotein cholesterol efflux capacity (HDL-CEC) changes in patients with coronary artery disease who participated in a lifestyle modification program aimed at increasing physical activity levels and improving diet quality.
A total of 86 men with coronary artery disease aged between 35 and 80 years participated in a 1-year lifestyle modification program that aimed to achieve a minimum of 150 minutes of aerobic physical activity weekly and improve diet quality. HDL-CECs were measured before and after the 1-year intervention using H-cholesterol-labeled J774 and HepG2 cells. Visceral, subcutaneous, and cardiac adipose tissue levels were assessed before and after the intervention using magnetic resonance imaging. Lipoprotein particle size and concentrations were measured by proton nuclear magnetic resonance spectroscopy and a complete lipoprotein-lipid profile was obtained. At baseline, the best correlate of HDL-CECs were apolipoprotein AI (=0.35, <0.0001) and high-density lipoprotein cholesterol (=0.21, <0.0001) for J774-HDL-CECs and HepG2-HDL-CECs, respectively. Baseline and longitudinal changes in HDL-CECs were associated with several lipoprotein size and concentration indices, although high-density lipoprotein cholesterol was the best predictor of longitudinal changes in J774-HDL-CECs (=0.18, =0.002) and apolipoprotein AI was found to be the best predictor of longitudinal changes in HepG2 cholesterol efflux capacities (=0.21, =0.002).
Results of this study suggest that increases in high-density lipoprotein cholesterol and apolipoprotein AI levels typically observed in patients with coronary artery disease undergoing healthy lifestyle modification therapy may be indicative of higher plasma concentrations of functional high-density lipoprotein particles.
本研究旨在探讨接受旨在提高体力活动水平和改善饮食质量的生活方式改变计划的冠心病患者高密度脂蛋白胆固醇流出能力（HDL-CEC）变化的决定因素。
共有 86 名年龄在 35 至 80 岁之间的冠心病男性患者参与了为期 1 年的生活方式改变计划，该计划旨在每周至少进行 150 分钟的有氧运动，并改善饮食质量。在 1 年干预前后，使用 H-胆固醇标记的 J774 和 HepG2 细胞测量 HDL-CEC。使用磁共振成像在干预前后评估内脏、皮下和心脏脂肪组织水平。使用质子磁共振波谱测量脂蛋白颗粒大小和浓度，并获得完整的脂蛋白脂质谱。在基线时，J774-HDL-CEC 和 HepG2-HDL-CEC 的 HDL-CEC 的最佳相关因素分别为载脂蛋白 AI（=0.35，<0.0001）和高密度脂蛋白胆固醇（=0.21，<0.0001）。尽管高密度脂蛋白胆固醇是 J774-HDL-CEC 纵向变化的最佳预测因子（=0.18，=0.002），但 HDL-CEC 的基线和纵向变化与几种脂蛋白大小和浓度指数相关，载脂蛋白 AI 被发现是 HepG2 胆固醇流出能力纵向变化的最佳预测因子（=0.21，=0.002）。
这项研究的结果表明，接受健康生活方式改变治疗的冠心病患者中通常观察到的高密度脂蛋白胆固醇和载脂蛋白 AI 水平的升高可能表明功能性高密度脂蛋白颗粒的血浆浓度更高。
