Lifestyle intervention enhances high-density lipoprotein function among patients with metabolic syndrome only at normal low-density lipoprotein cholesterol plasma levels

J Clin Lipidol. 2016 Sep-Oct;10(5):1172-81. doi: 10.1016/j.jacl.2016.05.008. Epub 2016 May 14.

Abstract

Background: Metabolic syndrome (MetS) is associated with altered lipoprotein metabolism and impairment in the functionality of small, dense high-density lipoprotein (HDL) particles secondary to compositional alterations.

Objective: The objective of this study was to investigate the capacity of a lifestyle program to improve the composition and antioxidative function (AOX) of small dense HDL3c in MetS.

Methods: Patients with MetS (n = 33) not taking lipid-lowering drugs were recruited to follow a 12-week educational program to reduce caloric intake and to increase physical activity. HDL subfractions were preparatively isolated by isopycnic density-gradient ultracentrifugation. AOX of HDL3c was assessed as its capacity to inhibit low-density lipoprotein oxidation induced by an azoinitiator.

Results: AOX of HDL3c was significantly improved (mean reduction in the propagation rate of low-density lipoprotein oxidation by HDL3c, -6.8%, P = .03) and systemic oxidative stress, assessed as plasma levels of 8-isoprostanes, tended to decrease in normocholesterolemic MetS patients (low-density lipoprotein cholesterol [LDL-C] < 130 mg/dL) but not in patients with elevated LDL-C levels and in the whole study population. In both the whole study population and the normocholesterolemic subgroup, lifestyle intervention resulted in a significant degree of normalization of HDL3c composition, (enrichment in apolipoprotein A-I and cholesteryl esters, depletion in triglycerides), which was more pronounced at LDL-C < 130 mg/dL.

Conclusion: In patients with MetS, a lifestyle program improves AOX of small, dense HDL in subjects with normal LDL-C levels. Correction of HDL composition, involving partial normalization of apoA-I content and core lipid composition, 2 central features of the lipid hydroperoxide-inactivating capacity of HDL, may account for this effect.

Keywords: Antioxidative activity; High-density lipoprotein; Lifestyle intervention; Metabolic syndrome; Oxidative stress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Apolipoprotein A-I / blood
  • Cholesterol Esters / blood
  • Cholesterol, LDL / blood*
  • Diet, Fat-Restricted
  • Dinoprost / analogs & derivatives
  • Dinoprost / blood
  • Exercise
  • Female
  • Humans
  • Life Style
  • Lipoproteins, HDL / metabolism*
  • Lipoproteins, HDL3 / analysis
  • Lipoproteins, LDL / chemistry
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / diagnosis*
  • Middle Aged
  • Oxidation-Reduction
  • Oxidative Stress
  • Program Evaluation*
  • Triglycerides / blood

Substances

  • Apolipoprotein A-I
  • Cholesterol Esters
  • Cholesterol, LDL
  • Lipoproteins, HDL
  • Lipoproteins, HDL3
  • Lipoproteins, LDL
  • Triglycerides
  • 8-epi-prostaglandin F2alpha
  • Dinoprost