Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea; Department of Medicine, Graduate School, Yonsei University, Seoul 03722, Republic of Korea.
Molecular Recognition Research Center, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea.
Metabolism. 2019 Apr;93:52-60. doi: 10.1016/j.metabol.2019.01.002. Epub 2019 Jan 4.
The objective of this pilot randomized controlled trial was to investigate the effect of alternate day fasting (ADF) and exercise on serum sterol signatures, which are surrogate markers of cholesterol absorption and biosynthesis.
We randomly assigned 112 overweight or obese participants to four groups: 1) ADF and exercise (E-ADF); 2) ADF; 3) exercise; and 4) control. We studied 31 completers in this exploratory analysis and measured their serum sterol signatures using gas chromatography-mass spectrometry.
After intervention, most serum sterol signatures that correspond to cholesterol metabolism were significantly different between groups (p < 0.05 by analysis of covariance [ANCOVA]). We found no differences in plant sterols, which are markers of cholesterol absorption. In the exercise group, desmosterol, cholesteryl esters, and oxysterols decreased significantly. Furthermore, only changes in physical activity levels negatively correlated with changes in the metabolic ratios of desmosterol and 7-dehydrocholesterol to cholesterol, which reflect cholesterol biosynthesis (r = -0.411; p = 0.030, and r = -0.540; p = 0.003, respectively).
These findings suggest that exercise with or without ADF improves cholesterol metabolism as measured by serum sterol signatures, and increased physical activity has a greater effect on cholesterol biosynthesis than weight reduction or calorie restriction.
本先导随机对照试验的目的在于研究隔日禁食（ADF）和运动对甾醇特征的影响，甾醇特征是胆固醇吸收和生物合成的替代标志物。
我们将 112 名超重或肥胖参与者随机分为 4 组：1）ADF 联合运动（E-ADF）；2）ADF；3）运动；4）对照组。我们对 31 名完成试验者进行了探索性分析，并使用气相色谱-质谱法测量了他们的血清甾醇特征。
干预后，大多数与胆固醇代谢相关的血清甾醇标志物在组间存在显著差异（协方差分析[ANCOVA]，p<0.05）。我们未发现植物甾醇存在差异，植物甾醇是胆固醇吸收的标志物。在运动组中，desmosterol、胆固醇酯和氧化固醇显著下降。此外，只有身体活动水平的变化与 desmosterol 和 7-脱氢胆固醇与胆固醇的代谢比值的变化呈负相关，这反映了胆固醇的生物合成（r=-0.411；p=0.030，r=-0.540；p=0.003）。
这些发现表明，无论是否结合 ADF，运动都可以改善胆固醇代谢，可通过血清甾醇特征来衡量，而增加身体活动对胆固醇生物合成的影响大于体重减轻或热量限制。
