Effects of statin therapy and exercise on postprandial triglycerides in overweight individuals with hypercholesterolaemia

Abstract

Aims:To determine the effects of statins on postprandial lipaemia (PPL) and to study if exercise could enhance statin actions.Methods: Ten hypercholesteraemic (blood cholesterol 204 ± 36 mg dL −1 ; lowdensity lipoprotein-cholesterol 129 ± 32 36 mg dL −1 ) overweight (body mass index 30 ± 4 kg m −2 ), metabolic syndrome individuals chronically medicated with statins (>6 months) underwent 5-hour PPL tests in 4 occasions in a randomized order:(i) substituting their habitual statin medication by placebo for 96 hours (PLAC trial);(ii) taking their habitual statin medicine (STA trial); (iii) placebo combined with a bout of intense aerobic exercise (EXER+PLAC trial); and (iv) combining exercise and statin medicine (EXER+STA trial).Results: Before the fat meal, statin withdrawal (i.e. PLAC and EXER+PLAC) increased blood triglycerides (TG; 24%), low-density lipoprotein-cholesterol (31%) and total cholesterol (19%; all P < .05) evidencing treatment compliance. After the meal, statin withdrawal increased 5-hour postprandial TG (PPTG) compared to its matched trials (94% higher PLAC vs STA and 45% higher EXER+PLAC vs EXER+STA; P < .05). EXER +PLAC trial did not lower PPTG below PLAC (i.e. incremental AUC of 609 ± 152 vs 826 ± 190 mg dL −1 5 h; P = .09). Adding exercise to statin did not result in larger reductions in PPTG (i.e. EXER+STA vs STA incremental area under the curve of 421 ± 87 vs 421 ± 84 mg dL −1 5 h; P = .99). Conclusion:In hypercholesteraemic metabolic syndrome individuals, chronic statin therapy blunts the elevations in TG after a fat meal (i.e. incremental area under the curve of PPTG) reducing the cardiovascular risk associated to their atherogenic dyslipidaemia. However, a single bout of intense aerobic exercise before the high fat meal, does not reduce PPTG but also does not interfere with the effects of statin treatment. K E Y W O R D S aerobic exercise, hydroxymethylglutaryl-CoA reductase inhibitor, hypercholesterolaemia, metabolic syndrome X, postprandial lipaemia

High‐intensity interval exercise versus moderate‐intensity continuous exercise on postprandial glucose and insulin responses: A systematic review and meta‐analysis

“…If AUC was calculated using available individual time points, 120‐ or 180‐min AUC were calculated where possible. The majority of studies used glucose only 24,27–30,36,38,53–55,61–63 or MM 23,26,31,32,35,37,50,56,58,60 test‐meal protocols to determine glycemic AUC, where others used HFM meals 33,34,49,51,52,57,59 . In 10 studies, iAUC was calculated using individual time‐point data 35,37,49,51,53,55–58,61 .…”

“…The PPG and PPI outcome assessment durations ranged from 120 to 240 min; 17 studies used 120 min, 23,24,[27][28][29][30][31][32]36,38,50,[53][54][55][61][62][63] seven studies used 180 min, 26,[33][34][35]37,56,60 and six studies used 240 min. 49,51,52,[57][58][59] If AUC was calculated using available individual time points, 120-or 180-min AUC were calculated where possible.…”

“…The majority of studies used glucose only 24,[27][28][29][30]36,38,[53][54][55][61][62][63] or MM 23,26,31,32,35,37,50,56,58,60 test-meal protocols to determine glycemic AUC, where others used HFM meals. 33,34,49,51,52,57,59 In 10 studies, iAUC was calculated using individual time-point data. 35,37,49,51,53,[55][56][57][58]61 Additional PPG and PPI assessment details are summarized in Table 2.…”

“…33,34,49,51,52,57,59 In 10 studies, iAUC was calculated using individual time-point data. 35,37,49,51,53,[55][56][57][58]61 Additional PPG and PPI assessment details are summarized in Table 2. (See Figure S1).…”

Triglyceride and Triglyceride-Rich Lipoproteins in Atherosclerosis

“…However, statins decrease VLDL and CM and their remnants via improving hepatic clearance in patients with HTG ( Caslake and Packard, 2004 ). A previous study demonstrates that statin treatment decreases not only fasting TG but also postprandial TGs ( Mora-Rodriguez et al, 2020 ). However, a survey in United State adults (9593 participants) indicates that the prevalence of TG < 150, 150–199, and ≥200 mg/dl is 75.3%, 12.8%, and 11.9% in adults without statin treatment; among statin users, the ratios are 68.4%, 16.2%, and 15.4%, respectively.…”