Atherosclerotic-related cardiovascular disease (ASCVD) claims the lives of over 600,000 Americans yearly. Current methodologies of assessment do not distinguish lipoprotein density distributions and instead measure lipoprotein cholesterol, with lowdensity lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDLC) of primary clinical relevance.
Furthermore, the distinction between the effects of diet and exercise interventions on lipoproteins is frequently indiscernible due to the effects of energy deficit induced by interventions. High- performance lipoprotein density profiling (HPLDP) provides a cost-effective way to rapidly assess the efficacy of diet or exercise interventions. The purpose of this study is to characterize density distribution of HDL subclasses in response to diet or exercise using HPLDP.
Eighty-eight untrained subjects (74% male, average age of 54 years) were pooled from two lifestyle intervention studies that met the inclusion criteria. Following 12 weeks of diet or exercise interventions (750 kcal expenditure or 750 kcal deficit), subjects lost an average of 3.72 kg weight (-3.9%), lost 3.9 kg of body fat (-11.6%), increased lean mass 0.62 kg (+1.1%), and reduced body fat percentage by 3.41% (-9.1%). Average absolute VO2 max increased 0.16 liters O2/min (+7.1%) (p<0.05). Several lipoprotein density distributions were significantly different (p<0.05) between diet and exercise interventions (expressed as percent change from baseline): triglyceride-rich lipoproteins (TRL) (-17.14 vs 19.65), low-density lipoprotein subfraction 5 (LDL5) (-26.06 vs 8.14), high-density lipoprotein subfraction 3b (HDL3b) (-21.24 vs -0.71), and high-density lipoprotein subfraction 3c (HDL3c) (-17.88 vs 7.94). To elucidate the effects of cardiorespiratory fitness, subjects were further divided into categories of increased absolute VO2 max and decreased absolute VO2 max, with no changes between groups at baseline. Associations between absolute VO2 max percent change on TRL, LDL-5, HDL-3b, and HDL-3c percent change remained significant after controlling for age, gender, and fat mass percent change. A regression equation was constructed from significant correlations and effectively predicted HDL-3c changes using absolute VO2 max measurements.
A significant linear relationship between improved absolute VO2 max and increased HDL-3c subfraction AUC exists; lipoprotein subfraction quantification may reveal positive effects of exercise overlooked using traditional clinical cholesterol assessment techniques
