COMPOSITION OF LIPIDS

COMPOSITION OF LIPIDS• Lipoproteins• Apolipoproteins

• Cholesterol• Protein• Triglyceride• Phospholipid

• Chylomicron• Very Low Density Lipoprotein• Low Density Lipoprotein• Intermediate Density

Lipoprotein• High Density Lipoprotein

CHOLESTEROL METABOLISM

• 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 & TRAINING

Increase

Decrease

No Change

Numbers of Studies

Series1

0 5 10 15 20

Dufaux, International Journal of Sports Medicine, 1982

CHOLESTEROL & TRAINING

Increase

Decrease

No Change

Numbers of Studies

Series1

0 5 10 15 20

Dufaux, International Journal of Sports Medicine, 1982

LDL & TRAINING

Increase

Decrease

No Change

Numbers of Studies

Series1

0 5 10 15 20 25

Dufaux, International Journal of Sports Medicine, 1982

HDL & 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

Increase

Decrease

No 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

Increase

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 TRAINING

-40

-30

-20

-10

0

10

20

30

Change in Lipid total

LDLHDL

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

Combined Normal Borderline High150

170

190

210

230

250

270CHOLESTEROL & 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 o

r Ris

k

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

HDL a

nd 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 A

ctivi

ty

How does HDL change with exercise?

Pre Post 24 hour 48 hour50

70

90

110

130

150

170

HyperNormo

Trig

lyce

rides

(mg/

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 acti

vity

(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

)