54
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
Bile Acid Binding Resins
Nicotinic Acid• 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
Fibric Acids
• ↓ LDL• ↓ VLDL• ↓ TG
Bile Acid Binding Resins
• ↑ HDL
• ↓ LDL
• ↓ LDL• ↓ VLDL• ↓ TG
HMG CoA ReductaseInhibitors
Nicotinic Acid
Series1
0 2 4 6 8 10 12 14 16 18 20
Dufaux, International Journal of Sports Medicine, 1982
TRIGLYCERIDES & TRAINING
Increase
Decrease
No Change
Numbers of Studies
Series1
0 5 10 15 20
Dufaux, International Journal of Sports Medicine, 1982
CHOLESTEROL & TRAINING
Increase
Decrease
No Change
Numbers of Studies
Series1
0 5 10 15 20
Dufaux, International Journal of Sports Medicine, 1982
LDL & TRAINING
Increase
Decrease
No Change
Numbers of Studies
Series1
0 5 10 15 20 25
Dufaux, International Journal of Sports Medicine, 1982
HDL & TRAINING
Increase
Decrease orNo Change
Numbers of Studies
Tolfrey K, et al Sports Medicine 29:99-112, 2000
Pediatric Triglyceride response to Exercise
Series1
0 2 4 6 8 10 12
Increase
Decrease
No Change
Series1
0 5 10 15 20
Increase
Decrease
No Change
Numbers of Studies
Pediatric Total Cholesterol response to Exercise
Tolfrey K, et al Sports Medicine 29:99-112, 2000
Series1
0 5 10 15 20
Increase
Decrease
No Change
Numbers of Studies
Pediatric LDL response to Exercise
Tolfrey K, et al Sports Medicine 29:99-112, 2000
Series1
0 1 2 3 4 5 6 7
Increase
Decrease
No Change
Numbers of Studies
Pediatric HDL response to Exercise
Tolfrey K, et al Sports Medicine 29:99-112, 2000
Hurley, B.F., MSSE 21:689-693, 1989.
RESISTANCE TRAINING
-40
-30
-20
-10
0
10
20
30
Change in Lipid total
LDLHDL
Hurley, B.F., MSSE 21:689-693, 1989.
Combined Normal Borderline High150
170
190
210
230
250
270CHOLESTEROL & TRAINING
Whaley et al, J Cardiopulm Rehab 12:42-50, 1992
Pre Post
Tota
l Cho
lest
erol
Total Cholesterol
LDL HDL-20
-15
-10
-5
0
5
10
ChangeRisk
Chan
ge in
Val
ues o
r Ris
k
Lipid Research Clinics, JAMA 251:356-374, 1984.
Reduction in Risk related to Reduction in Cholesterol
Framingham
Albany
Chicago Gas
Chicago Electric
Tacumseh
US Railroad
Seven Countries
LRC
-35 -30 -25 -20 -15 -10 -5 0
Risk Reduction
Risk reduction associated with a 20.7 mg/dL reduction in Total Cholesterol
Lipid Research Clinics, JAMA 251:356-374, 1984.
Lehmann, R, et al. European J Clin Invest 31:37-44, 2001.
Total HDL HDL2 HDL30
0.2
0.4
0.6
0.8
1
1.2
1.4
PrePost
HDL a
nd su
bfra
ction
s (m
mol
/L)
HDL Subfractions and Physical Activity
Lehmann, R, et al. European J Clin Invest 31:37-44, 2001.
Hepatic Lipase LPL LCAT0
10
20
30
40
50
60
70
80
90Pe
rcen
t Inc
reas
e
HDL Subfractions and Physical Activity
Choleterol LDL HDL0
20406080
100120140160180200220
PrePost
Lipi
d Co
ncen
trati
on (m
g/dL
Kraus, WE, et al. N Eng J Med 347:1483-1492, 2002
Exercise & Lipid Subfractions
Kraus, WE, et al. N Eng J Med 347:1483-1492, 2002
Small LDL Large LDL0
5
10
15
20
25
30
35
40
PrePost
Conc
entr
ation
of P
artic
les
(mg/
dL)
Exercise & Lipid Subfractions
Total C
VLDL LDL HDL HDL2 HDL30
50
100
150
200
250
PrePost
Conc
entr
ation
(mg/
dL)
Seip, RL. Et al. Arteriosclerosis and Thrombosis 13:1359-1367, 1993.
HDL Subfractions and Physical Activity
HDL HDL2 HDL30
10
20
30
40
50
60
PrePost
Conc
entr
ation
(mg/
dL)
Seip, RL. Et al. Arteriosclerosis and Thrombosis 13:1359-1367, 1993.
HDL Subfractions and Physical Activity
Pre Post0
2
4
6
8
10
12Lp
(a) (
mg/
dL)
Lp(a) and Physical Activity
Seip, RL. Et al. Arteriosclerosis and Thrombosis 13:1359-1367, 1993.
Lopez, A, et al Atherosclerosis 20:1-9, 1974.
alpha lipoprotein260
270
280
290
300
310
320
330
340
PrePost
How does HDL change with exercise?
Lopez, A, et al Atherosclerosis 20:1-9, 1974.
Pre Post0
0.1
0.2
0.3
0.4
0.5
0.6LC
AT A
ctivi
ty
How does HDL change with exercise?
Pre Post 24 hour 48 hour50
70
90
110
130
150
170
HyperNormo
Trig
lyce
rides
(mg/
dL)
Grandjean, et al J Applied Physiology 89:472-480, 2000
Pre Post 24 hour 48 hours5
7
9
11
13
15
17
19LP
L acti
vity
(μm
ol/m
l hr)
Hyper
Normo
Grandjean, et al J Applied Physiology 89:472-480, 2000
CETP and Physical Activity
Seip, RL. Et al. Arteriosclerosis and Thrombosis 13:1359-1367, 1993.
Pre Post1.5
1.7
1.9
2.1
2.3
2.5
2.7CE
TP (u
g/dL
)
