Effects of statins and exercise on postprandial lipoproteins in
metabolic syndrome vs metabolically healthy individuals
Abstract
Aims: To determine if the combination of exercise and statin could
normalize postprandial triglyceridemia (PPTG) in hypercholesteraemic
individuals. Mehods: Eight hypercholesteraemic (blood cholesterol 182±38
mg·dL-1; LDL-c 102±32 mg·dL-1) overweight (BMI 30±4 kg·m-2) individuals
with metabolic syndrome (i.e., Met Synd) were compared to a group of
eight metabolically healthy controls (i.e., MetH, blood cholesterol
149±23 mg·dL-1; LDL-c 77±23 mg·dL-1, and BMI 23±2 kg·m-2). Each group
underwent two PPTG tests, either 14-h after a bout of intense exercise
(EXER) or without previous exercise (REST). Additionally, Met Synd
individuals were tested 96 h after withdrawal of their habitual statin
medication (PLAC trials) to study medication effects. Results: A bout of
exercise before the test meal did not reduce PPTG in Met Synd (P=0.347),
but reduced PPTG by 46% in MetH (224±142 to 413±267 mg·dL-1·for 5 h
iAUC; P=0.02). In both trials (i.e., REST and EXER) statin withdrawal in
Met Synd greatly increased PPTG (average 65%; P<0.01), mean
LDL-c (average 25%; P<0.01), total cholesterol (average 16%;
P<0.01) and Apo B48 (24%; P<0.01), without
interference from exercise. However, Apo B100 was not affected by statin
withdrawal. Conclusions: Hypercholesteraemic Met Synd individuals
(compared to metabolically healthy controls) are resistant to the
effects of exercise on reducing PPTG. However, chronic statin medication
blunts the elevations in TG after a fat meal (i.e., iAUC of PPTG)
reducing their cardiovascular risk associated to their atherogenic
dyslipidemia. Statin decreases PPTG by reducing the secretion or
accelerating the catabolism of intestinal Apo B48.