Longitudinal Changes in Cholesterol Efflux Capacities in Patients With Coronary Artery Disease Undergoing Lifestyle Modification Therapy

Abstract

BackgroundOur objective was to identify the determinants of high‐density lipoprotein cholesterol efflux capacity (HDL‐CEC) changes in patients with coronary artery disease who participated in a lifestyle modification program aimed at increasing physical activity levels and improving diet quality.Methods and ResultsA total of 86 men with coronary artery disease aged between 35 and 80 years participated in a 1‐year lifestyle modification program that aimed to achieve a minimum of 150 minutes of aerobic physical activity weekly and improve diet quality. HDL‐CECs were measured before and after the 1‐year intervention using 3H‐cholesterol–labeled J774 and HepG2 cells. Visceral, subcutaneous, and cardiac adipose tissue levels were assessed before and after the intervention using magnetic resonance imaging. Lipoprotein particle size and concentrations were measured by proton nuclear magnetic resonance spectroscopy and a complete lipoprotein‐lipid profile was obtained. At baseline, the best correlate of HDL‐CECs were apolipoprotein AI (R 2=0.35, P<0.0001) and high‐density lipoprotein cholesterol (R 2=0.21, P<0.0001) for J774‐HDL‐CECs and HepG2‐HDL‐CECs, respectively. Baseline and longitudinal changes in HDL‐CECs were associated with several lipoprotein size and concentration indices, although high‐density lipoprotein cholesterol was the best predictor of longitudinal changes in J774‐HDL‐CECs (R 2=0.18, P=0.002) and apolipoprotein AI was found to be the best predictor of longitudinal changes in HepG2 cholesterol efflux capacities (R 2=0.21, P=0.002).ConclusionsResults of this study suggest that increases in high‐density lipoprotein cholesterol and apolipoprotein AI levels typically observed in patients with coronary artery disease undergoing healthy lifestyle modification therapy may be indicative of higher plasma concentrations of functional high‐density lipoprotein particles.

Lipoprotein Particle Predictors of Arterial Stiffness after 17 Years of Follow Up: The Malmö Diet and Cancer Study

“…Variation in the relative phospholipid and cholesterol content in large particles in a lean cohort as compared to persons with obesity or type 2 diabetes, has been linked to the inverse association of large HDL with c-fPWV [29]. Recent longitudinal analyses in men with CVD undergoing lifestyle modification therapy also suggest that HDL-c and the closely associated large HDL-P levels best predict ex vivo HDL cholesterol efflux capacity [30].…”

Health and Wellness Coaching: Providers and Practice—A Commentary on Sforzo and Colleagues (2018)

“…Physical activity has been associated with an increase high-density lipoprotein (HDL) cholesterol, decreased triglycerides, and decreased non-HDL. 29,30 Hypertension has also been improved through physical activity, including lowering of both systolic and diastolic measures. 31 The recent narrative review complied 27 random control trials, results indicated moderate-to-vigorous physical activity led to the greatest reduction of blood pressure compared with resistance training.…”