Effects of Exercise on Lipoprotein(a)

Abstract

Lipoprotein(a) [Lp(a)] is a unique lipoprotein complex in the blood. At high levels (> 30 mg/dl), Lp(a) is considered an independent risk factor for cardiovascular diseases. Serum Lp(a) levels are largely genetically determined, remain relatively constant within a given individual, and do not appear to be altered by factors known to influence other lipoproteins (e.g. lipid-lowering drugs, dietary modification and change in body mass). Since regular exercise is associated with favourable changes in lipoproteins in the blood, recent attention has focused on whether serum Lp(a) levels are also influenced by physical activity. Population and cross-sectional studies consistently show a lack of association between serum Lp(a) levels and regular moderate physical activity. Moreover, exercise intervention studies extending from 12 weeks to 4 years indicate that serum Lp(a) levels do not change in response to moderate exercise training, despite improvements in fitness level and other lipoprotein levels in the blood. However, recent studies suggest the possibility that serum Lp(a) levels may increase in response to intense load-bearing exercise training, such as distance running or weight lifting, over several months to years. Cross-sectional studies have reported abnormally high serum Lp(a) levels in experienced distance runners and body builders who train for 2 to 3 hours each day. However, the possible confounding influence of racial or ethnic factors in these studies cannot be discounted. Recent intervention studies also suggest that 9 to 12 months of intense exercise training may elevate serum Lp(a) levels. However, these changes are generally modest (10 to 15%) and, in most individuals, serum Lp(a) levels remain within the recommended range. It is unclear whether increased serum Lp(a) levels after intense exercise training are of clinical relevance, and whether certain Lp(a) isoforms are more sensitive to the effects of exercise training. Since elevation of both low density lipoprotein cholesterol (LDL-C) and Lp(a) levels in the blood exerts a synergistic effect on cardiovascular disease risk, attention should focus on changing lifestyle factors to decrease LDL-C (e.g. dietary intervention) and increase high density lipoprotein cholesterol (e.g. exercise) levels in the blood.

Minor changes in blood lipids after 6 weeks of high-volume low- intensity physical activity with strict energy balance control

“…The HDL increase in their study was not related to changes in VO 2max but to the total weekly physical activity duration (Sunami et al 1999). We did not observe an effect of physical activity on Lp(a), which is similar to other studies (Hubinger and Mackinnon 1996;Mackinnon and Hubinger 1999). We found differences in Apo-B/Apo-A1 ratio as well as a tendency for a difference in Apo-B concentrations between the protocols, suggesting a minor effect of physical activity on apo-lipoprotein concentration.…”

Decrease of Lp(a) during weight reduction in obese children is modified by the apo(a) kringle-IV copy number variation

“…Several population and cross-sectional studies showed a lack of association between serum Lp(a) levels and regular moderate physical activity or moderate exercise training. [20][21][22][23][24]29 The few studies that found a beneficial effect of exercise on Lp(a) were either confounded by ethnical issues 25 or included only men. 26 Therefore, it appears likely that the changes in Lp(a) levels observed in our study were caused by the dietary intervention rather than by the increased physical activity.…”

“…18,19 Similarly, the effect of physical exercise on Lp(a) levels is not fully understood, with several contradicting reports. [20][21][22][23][24][25][26][27][28][29] Only few studies were performed in children. 27,28 In this study, we therefore tested the possibility of lowering Lp(a) levels by a weight reduction program during a 3-week dietary camp for obese children.…”

New Cardiovascular Risk Factors and Physical Activity

“…The beneficial effects of exercise, leading to the reduction of levels of apolipoprotein B, have been widely reported, but this has not been the case with the relationship between exercise and levels of apolipoprotein A-I (57,58). Some authors have found that long-term, regular physical exercise does not seem to modify levels of apolipoproteins in comparison with sedentary groups (59).…”