COMPOSITION OF LIPIDSCOMPOSITION OF LIPIDS

• Lipoproteins

• Apolipoproteins

• Lipoproteins

• Apolipoproteins

• Cholesterol• Cholesterol• Protein• Protein• Triglyceride• Triglyceride

• Phospholipid• Phospholipid

• Chylomicron

• Very Low Density Lipoprotein

• Low Density Lipoprotein

• Intermediate Density Lipoprotein

• High Density Lipoprotein

• Chylomicron

• Very Low Density Lipoprotein

• Low Density Lipoprotein

• Intermediate Density Lipoprotein

• High Density Lipoprotein

CHOLESTEROL METABOLISMCHOLESTEROL METABOLISM

• Exogenous

• Endogenous

• Reverse Cholesterol Transport

• LDL Uptake

• 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 & TRAININGTRIGLYCERIDES & TRAINING

IncreaseIncrease

Decrease

No ChangeNo Change

Numbers of Studies

Series1

0 5 10 15 20

Dufaux, International Journal of Sports Medicine, 1982

CHOLESTEROL & TRAININGCHOLESTEROL & TRAINING

Increase

Decrease

No Change

Numbers of Studies

Series1

0 5 10 15 20

Dufaux, International Journal of Sports Medicine, 1982

LDL & TRAININGLDL & TRAINING

IncreaseIncrease

Decrease

No Change

Numbers of Studies

Series1

0 5 10 15 20 25

Dufaux, International Journal of Sports Medicine, 1982

HDL & TRAININGHDL & 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

IncreaseIncrease

Decrease

No ChangeNo 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

IncreaseIncrease

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 TRAININGRESISTANCE TRAINING

-40

-30

-20

-10

0

10

20

30

Change in Lipid total

LDL

HDL

Hurley, B.F., MSSE 21:689-693, 1989.

Combined Normal Borderline High150

170

190

210

230

250

270

CHOLESTEROL & TRAININGCHOLESTEROL & 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

or R

isk

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

HD

L an

d 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

Acti

vity

How does HDL change with exercise?

Pre Post 24 hour 48 hour50

70

90

110

130

150

170

HyperNormo

Trig

lyce

ride

s (m

g/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 ac

tivity

(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

)