COMPOSITION OF LIPIDS
• Lipoproteins
• Apolipoproteins
• Cholesterol
• Protein
• Triglyceride
• Phospholipid
• Chylomicron
• Very Low Density Lipoprotein
• Low Density Lipoprotein
• Intermediate Density
Lipoprotein
• High Density Lipoprotein
CHOLESTEROL METABOLISM
• Exogenous
• Endogenous
• Reverse Cholesterol Transport
• LDL Uptake
HMG CoA Reductase Inhibitors
Fibric Acids
• ↓ TG synthesis
• ↓ lipoprotein synthesis
• ↓ excretion of
lipoproteins from liver;
primarily VLDL
• ↓ synthesis of
cholesterol
• ↑ production of sterols
• ↑ HDL
Nicotinic Acid
Bile Acid Binding
Resins
• Bind bile salts in gut
• Cholesterol eliminated
in the feces
• Liver uses other sources
of cholesterol (LDL) to
make more bile
Nicotinic Acid
• Inhibits liver secretion
of VLDL
• Reduced serum LDL
• Inhibits removal of HDL
• Increases excretion of
sterols in the feces
HMG CoA Reductase
Inhibitors
Fibric Acids
• ↓ LDL
• ↓ VLDL
• ↓ TG
• ↓ LDL
• ↓ VLDL
• ↓ TG
Nicotinic Acid
• ↑ HDL
Bile Acid
Binding Resins
• ↓ LDL
TRIGLYCERIDES & TRAINING
Decrease
No Change
Increase
0
5
10
15
20
Numbers of Studies
Dufaux, International Journal of Sports Medicine, 1982
CHOLESTEROL & TRAINING
Decrease
Increase
No Change
0
5
10
15
Numbers of Studies
Dufaux, International Journal of Sports Medicine, 1982
20
LDL & TRAINING
Decrease
Increase
No Change
0
5
10
15
Numbers of Studies
Dufaux, International Journal of Sports Medicine, 1982
20
HDL & TRAINING
Increase
Decrease or
No Change
0
5
10
15
20
25
Numbers of Studies
Dufaux, International Journal of Sports Medicine, 1982
Pediatric Triglyceride response to Exercise
Decrease
No Change
Increase
0
2
4
6
8
Tolfrey K, et al Sports Medicine 29:99-112, 2000
10
12
Pediatric Total Cholesterol response to Exercise
Decrease
Increase
No Change
0
5
10
15
Numbers of Studies
Tolfrey K, et al Sports Medicine 29:99-112, 2000
20
Pediatric LDL response to Exercise
Decrease
Increase
No Change
0
5
10
15
Numbers of Studies
Tolfrey K, et al Sports Medicine 29:99-112, 2000
20
Pediatric HDL response to Exercise
Increase
Decrease
No Change
0
2
4
6
Numbers of Studies
Tolfrey K, et al Sports Medicine 29:99-112, 2000
8
RESISTANCE TRAINING
30
20
10
Change in 0
Lipid -10
-20
-30
VL
Ri
s
M
od k
Ri
s
VL k
Ri
s
M
od k
Ri
s
M
od k
Ri
s
VL k
Ri
s
Hi
gh k
R
is
M
od k
Ri
sk
-40
Hurley, B.F., MSSE 21:689-693, 1989.
total
LDL
HDL
Hurley, B.F., MSSE 21:689-693, 1989.
CHOLESTEROL & TRAINING
Total Cholesterol
270
250
230
210
190
170
Pre Post
150
Combined
Normal
Borderline
High
Whaley et al, J Cardiopulm Rehab 12:42-50, 1992
Reduction in Risk related to Reduction in Cholesterol
Change in Values or Risk
10
5
0
-5
Change
Risk
-10
-15
-20
Total
Cholesterol
LDL
HDL
Lipid Research Clinics, JAMA 251:356-374, 1984.
Risk reduction associated with a 20.7 mg/dL
reduction in Total Cholesterol
LRC
Seven Countries
US Railroad
Tacumseh
Chicago Electric
Chicago Gas
Albany
Framingham
-35
-30
-25
-20
-15
Risk Reduction
-10
-5
Lipid Research Clinics, JAMA 251:356-374, 1984.
0
HDL Subfractions and Physical Activity
HDL and subfractions (mmol/L)
1.4
1.2
1
0.8
Pre
0.6
Post
0.4
0.2
0
Total HDL
HDL2
HDL3
Lehmann, R, et al. European J Clin Invest 31:37-44, 2001.
HDL Subfractions and Physical Activity
90
80
Percent Increase
70
60
50
40
30
20
10
0
Hepatic Lipase
LPL
LCAT
Lehmann, R, et al. European J Clin Invest 31:37-44, 2001.
Lipid Concentration (mg/dL
Exercise & Lipid Subfractions
220
200
180
160
140
120
100
80
60
40
20
0
Pre
Post
Choleterol
LDL
HDL
Kraus, WE, et al. N Eng J Med 347:1483-1492, 2002
Exercise & Lipid Subfractions
Concentration of Particles
(mg/dL)
40
35
30
25
20
Pre
15
Post
10
5
0
Small LDL
Large LDL
Kraus, WE, et al. N Eng J Med 347:1483-1492, 2002
HDL Subfractions and Physical Activity
Concentration (mg/dL)
250
200
150
Pre
Post
100
50
0
Total C VLDL
LDL
HDL
HDL2 HDL3
Seip, RL. Et al. Arteriosclerosis and Thrombosis 13:1359-1367, 1993.
HDL Subfractions and Physical Activity
Concentration (mg/dL)
60
50
40
Pre
30
Post
20
10
0
HDL
HDL2
HDL3
Seip, RL. Et al. Arteriosclerosis and Thrombosis 13:1359-1367, 1993.
Lp(a) and Physical Activity
12
Lp(a) (mg/dL)
10
8
6
4
2
0
Pre
Post
Seip, RL. Et al. Arteriosclerosis and Thrombosis 13:1359-1367, 1993.
How does HDL change with exercise?
340
330
320
310
Pre
300
Post
290
280
270
260
alpha lipoprotein
Lopez, A, et al Atherosclerosis 20:1-9, 1974.
How does HDL change with exercise?
0.6
LCAT Activity
0.5
0.4
0.3
0.2
0.1
0
Pre
Post
Lopez, A, et al Atherosclerosis 20:1-9, 1974.
Triglycerides (mg/dL)
170
150
130
Hyper
110
Normo
90
70
50
Pre
Post
24 hour
48 hour
Grandjean, et al J Applied Physiology 89:472-480, 2000
LPL activity (μmol/ml hr)
19
17
Hyper
15
Normo
13
11
9
7
5
Pre
Post
24 hour
48 hours
Grandjean, et al J Applied Physiology 89:472-480, 2000
CETP and Physical Activity
2.7
CETP (ug/dL)
2.5
2.3
2.1
1.9
1.7
1.5
Pre
Post
Seip, RL. Et al. Arteriosclerosis and Thrombosis 13:1359-1367, 1993.