Leisure time physical activity is associated with improved HDL functionality in high cardiovascular risk individuals: a cohort study

Hernáez, Álvaro; Soria-Florido, Maria; Castañer, Olga; Pintó Sala, Xavier; Estruch, Ramón; Salas Salvadó, Jordi; Corella, Dolores; Alonso-Gómez, Ángel; Martínez-González, Miguel Ángel, 1957-; Schröder, Helmut, 1958-; Ros, Emilio; Serra Majem, Lluís; Fiol, Miquel; Lapetra, José; Gómez Gracia, Enrique; Fitó Colomer, Montserrat; Lassale, Camille

doi:http://dx.doi.org/10.1177/2047487320925625

Leisure time physical activity is associated with improved HDL functionality in high cardiovascular risk individuals: a cohort study

Citation

Hernáez Á, Soria-Florido MT, Castañer O, Pintó X, Estruch R, Salas-Salvadó J, Corella D, Alonso-Gómez Á, Martínez-González MÁ, Schröder H, Ros E, Serra-Majem L, Fiol M, Lapetra J, Gomez-Gracia E, Fitó M, Lassale C. Leisure time physical activity is associated with improved HDL functionality in high cardiovascular risk individuals: a cohort study. Eur J Prev Cardiol. 2021;28(12):1392-401. DOI: 10.1177/2047487320925625

Abstract

Aims: Physical activity has consistently been shown to improve cardiovascular health and high-density lipoprotein-cholesterol levels. However, only small and heterogeneous studies have investigated the effect of exercise on high-density lipoprotein functions. Our aim is to evaluate, in the largest observational study to date, the association between leisure time physical activity and a range of high-density lipoprotein functional traits. Methods: The study sample consisted of 296 Spanish adults at high cardiovascular risk. Usual leisure time physical activity and eight measures of high-density lipoprotein functionality were averaged over two measurements, one year apart. Multivariable linear regression models were used to explore the association between leisure time physical activity (exposure) and each high-density lipoprotein functional trait (outcome), adjusted for cardiovascular risk factors. Results: Higher levels of leisure time physical activity were positively and linearly associated with average levels over one year of plasma high-density lipoprotein-cholesterol and apolipoprotein A-I, paraoxonase-1 antioxidant activity, high-density lipoprotein capacity to esterify cholesterol and cholesterol efflux capacity in individuals free of type 2 diabetes only. The increased cholesterol esterification index with increasing leisure time physical activity reached a plateau at around 300 metabolic equivalents.min/day. In individuals with diabetes, the relationship with cholesteryl ester transfer protein followed a U-shape, with a decreased cholesteryl ester transfer protein activity from 0 to 300 metabolic equivalents.min/day, but increasing from there onwards. Increasing levels of leisure time physical activity were associated with poorer high-density lipoprotein vasodilatory capacity. Conclusions: In a high cardiovascular risk population, leisure time physical activity was associated not only with greater circulating levels of high-density lipoprotein-cholesterol, but also with better markers of high-density lipoprotein functionality, namely cholesterol efflux capacity, the capacity of high-density lipoprotein to esterify cholesterol and paraoxonase-1 antioxidant activity in individuals free of diabetes and lower cholesteryl ester transfer protein activity in individuals with type 2 diabetes.