Hospital del Mar Medical Research Institute (IMIM), Spain.
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain.
Eur J Prev Cardiol. 2021 Oct 13;28(12):1392-1401. doi: 10.1177/2047487320925625. Epub 2020 Jun 2.
Physical activity has consistently been shown to improve cardiovascular health and high-density lipoprotein-cholesterol levels. However, only small and heterogeneous studies have investigated the effect of exercise on high-density lipoprotein functions. Our aim is to evaluate, in the largest observational study to date, the association between leisure time physical activity and a range of high-density lipoprotein functional traits.
The study sample consisted of 296 Spanish adults at high cardiovascular risk. Usual leisure time physical activity and eight measures of high-density lipoprotein functionality were averaged over two measurements, one year apart. Multivariable linear regression models were used to explore the association between leisure time physical activity (exposure) and each high-density lipoprotein functional trait (outcome), adjusted for cardiovascular risk factors.
Higher levels of leisure time physical activity were positively and linearly associated with average levels over one year of plasma high-density lipoprotein-cholesterol and apolipoprotein A-I, paraoxonase-1 antioxidant activity, high-density lipoprotein capacity to esterify cholesterol and cholesterol efflux capacity in individuals free of type 2 diabetes only. The increased cholesterol esterification index with increasing leisure time physical activity reached a plateau at around 300 metabolic equivalents.min/day. In individuals with diabetes, the relationship with cholesteryl ester transfer protein followed a U-shape, with a decreased cholesteryl ester transfer protein activity from 0 to 300 metabolic equivalents.min/day, but increasing from there onwards. Increasing levels of leisure time physical activity were associated with poorer high-density lipoprotein vasodilatory capacity.
In a high cardiovascular risk population, leisure time physical activity was associated not only with greater circulating levels of high-density lipoprotein-cholesterol, but also with better markers of high-density lipoprotein functionality, namely cholesterol efflux capacity, the capacity of high-density lipoprotein to esterify cholesterol and paraoxonase-1 antioxidant activity in individuals free of diabetes and lower cholesteryl ester transfer protein activity in individuals with type 2 diabetes.
体力活动一直被证明可以改善心血管健康和高密度脂蛋白胆固醇水平。然而，只有小型且异质的研究调查了运动对高密度脂蛋白功能的影响。我们的目的是在迄今为止最大的观察性研究中，评估休闲时间体力活动与一系列高密度脂蛋白功能特征之间的关联。
研究样本由 296 名西班牙高心血管风险成年人组成。通常的休闲时间体力活动和高密度脂蛋白功能的八项指标在相隔一年的两次测量中平均。多变量线性回归模型用于探索休闲时间体力活动（暴露）与高密度脂蛋白功能特征（结果）之间的关联，调整了心血管危险因素。
更高水平的休闲时间体力活动与血浆高密度脂蛋白胆固醇和载脂蛋白 A-I、对氧磷酶-1 抗氧化活性、高密度脂蛋白胆固醇酯化能力和胆固醇流出能力的一年平均水平呈正线性相关，仅在没有 2 型糖尿病的个体中。随着休闲时间体力活动的增加，胆固醇酯化指数的增加达到约 300 代谢当量.min/天的平台。在糖尿病患者中，与胆固醇酯转移蛋白的关系呈 U 形，0 至 300 代谢当量.min/天的胆固醇酯转移蛋白活性降低，但从那时起增加。休闲时间体力活动水平的增加与高密度脂蛋白的血管舒张能力下降有关。
在高心血管风险人群中，休闲时间体力活动不仅与循环中高密度脂蛋白胆固醇水平升高有关，而且与高密度脂蛋白功能的更好标志物有关，即胆固醇流出能力、高密度脂蛋白胆固醇酯化能力和对氧磷酶-1 抗氧化活性在没有糖尿病的个体中，以及在 2 型糖尿病患者中胆固醇酯转移蛋白活性降低。
