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Dyslipoproteinämie und körperliche Aktivität

Dyslipoproteinemia and physical activity

  • Leitthema
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Zusammenfassung

Der westliche Lebensstil ist durch Bewegungsarmut, Zufuhr von hyperkalorischer Nahrung sowie steigende Inzidenz von kardiovaskulären Risikofaktoren (Dyslipidämie, Insulinresistenz und arterielle Hypertonie) geprägt. Lebensstilinterventionsprogramme mit Erhöhung der körperlichen Aktivität und Ernährungsumstellung nehmen zunehmend einen Stellenwert in der Prävention und Therapie von kardiometabolischen Erkrankungen ein. Patienten mit Fettstoffwechselstörungen profitieren längerfristig durch ein regelmäßiges Training; körperliche Aktivität begünstigt das Lipidprofil durch Reduktion von Triglyzeridkonzentrationen und Erhöhung von High-density-Lipoprotein-Cholesterin(HDL-C)-Spiegeln, wohingegen das laborchemisch bestimmte Low-density-Lipoprotein-Cholesterin (LDL-C) und das Gesamtcholesterin nicht wesentlich beeinflussbar zu sein scheinen. Jedoch zeigt sich hierbei eine begünstigende Wirkung der sportlichen Aktivität durch Änderung der LDL-Partikel-Größe und Reduktion der als besonders atherogen geltenden „small-dense-LDL“-Partikel. Die positiven Effekte der körperlichen Aktivität scheinen primär durch eine Erhöhung des Trainingsumfangs und nicht durch die Trainingsintensität bedingt zu sein.

Abstract

Cardiovascular disease is a major health problem in developed countries. A sedentary lifestyle and unhealthy diet increase cardiovascular risk factors, such as dyslipidemia, hypertension and insulin resistance. Life style modification is strongly recommended for prevention and therapy of cardiometabolic diseases and dyslipidemia. Regular physical activity can positively influence the lipoprotein profile by reducing triglycerides and increasing high-density lipoprotein cholesterol (HDL-C). Exercise seems to have little effect on total cholesterol and low-density lipoprotein cholesterol (LDL-C) but improves LDL subfractions by reducing small dense -LDL particles and increases the average size of LDL particles. The beneficial effect of physical activity on the lipoprotein profile seems to be more dependent on the amount of exercise than on the intensity. High-intensity training seems to have less effect than moderate aerobic exercise training on lipoproteins but is superior or equal in improving other metabolic risk factors.

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Literatur

  1. Blair SN, Kohl HW III, Barlow CE et al (1995) Changes in physical fitness and all-cause mortality: a prospective study of healthy and unhealthy men. JAMA 273:1093–1098

    Article  PubMed  CAS  Google Scholar 

  2. Blair SN, Kohl HW III, Paffenbarger RS Jr et al (1989) Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 262:2395–2401

    Article  PubMed  CAS  Google Scholar 

  3. Bouillon K, Singh-Manoux A, Jokela M et al (2011) Decline in low-density lipoprotein cholesterol concentration: lipid-lowering drugs, diet, or physical activity? Evidence from the Whitehall II study. Heart 97:923–930

    Article  PubMed  CAS  Google Scholar 

  4. Carroll S, Dudfield M (2004) What is the relationship between exercise and metabolic abnormalities? A review of the metabolic syndrome. Sports Med 34:371–418

    Article  PubMed  Google Scholar 

  5. Catapano AL, Reiner Z, De Backer G et al (2011) ESC/EAS guidelines for the management of dyslipidaemias. The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 217:3–46

    Article  PubMed  CAS  Google Scholar 

  6. Colberg SR, Sigal JR, Fernhall B et al (2010) Exercise and type 2 diabetes. The American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care 33:e147–e167

    Article  PubMed  Google Scholar 

  7. Durstine JL, Grandjean PW, Cox CA, Thompson PD (2002) Lipids, lipoproteins, and exercise. J Cardiopulm Rehabil 22:385–398

    Article  PubMed  Google Scholar 

  8. Durstine JL, Grandjean PW, Davis PG et al (2001) Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis. Sports Med 31:1033–1062

    Article  PubMed  CAS  Google Scholar 

  9. Fletcher B, Berra K, Ades P et al (2005) Managing abnormal blood lipids: a collaborative approach. Circulation 112:3184–3209

    Article  PubMed  Google Scholar 

  10. Gibala MJ, McGee SL (2008) Metabolic adaptations to short-term high-intensity interval training: a little pain for a lot of gain? Exerc Sport Sci Rev 36:58–63

    Article  PubMed  Google Scholar 

  11. Graham I, Atar D, Borch-Johnsen K, Boysen G et al (2007) European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 14(Suppl 2):1–113

    Article  Google Scholar 

  12. Grundy SM (1996) Lipids, nutrition and coronary heart disease. In: Fuster V, Ross R, Topol EJ (Hrsg) Atherosclerosis and coronary artery disease. Lippincott-Raven, Philadelphia

  13. Hu F, Willett WC (2002) Optimal diets for prevention of coronary heart disease. JAMA 288:2569–2578

    Article  PubMed  CAS  Google Scholar 

  14. Jae SY, Heffernan KS, Lee MK et al (2008) Relation of cardiorespiratory fitness to inflammatory markers, fibrinolytic factors, and lipoprotein(a) in patients with type 2 diabetes mellitus. Am J Cardiol 102:700–703

    Article  PubMed  CAS  Google Scholar 

  15. Katcher HI, Hill AM, Lanford JL et al (2009) Lifestyle approaches and dietary strategies to lower LDL-cholesterol and triglycerides and raise HDL-cholesterol. Endocrinol Metab Clin North Am 38:45–78

    Article  PubMed  CAS  Google Scholar 

  16. Kelley GA, Kelley KS, Vu Tran Z et al (2005) Aerobic exercise, lipids and lipoproteins in overweight and obese adults: a meta-analysis of randomized controlled trials. Int J Obes (Lond) 29:881–893

    Google Scholar 

  17. Kessler HS, Sisson SB, Short KR (2012) The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Med 42:489–509

    Article  PubMed  Google Scholar 

  18. Knowler WC, Barrett-Connor E, Fowler SE et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403

    Article  PubMed  CAS  Google Scholar 

  19. Kodama S, Tanaka S, Saito K et al (2007) Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch Intern Med 167:999–1008

    Article  PubMed  CAS  Google Scholar 

  20. Kraus WE, Houmard JA, Duscha BD et al (2002) Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med 347:1483–1492

    Article  PubMed  CAS  Google Scholar 

  21. Leon AS, Sanchez OA (2001) Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 33(Suppl 6):502–515

    Article  Google Scholar 

  22. Mente A, Koning L de, Shannon HS, Anand SS (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart diseases. Arch Intern Med 169:659–669

    Article  PubMed  CAS  Google Scholar 

  23. Miller M, Stone NJ, Ballantyne C et al (2011) Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 123:2292–2333

    Article  PubMed  Google Scholar 

  24. Mora S, Cook N, Buring JE et al (2007) Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation 116:2110–2118

    Article  PubMed  CAS  Google Scholar 

  25. Must A, Spadano J, Coakley EH et al (1999) The disease burden associated with overweight and obesity. JAMA 282:1523–1529

    Article  PubMed  CAS  Google Scholar 

  26. NCEP (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285:2486–2497

    Article  Google Scholar 

  27. Park YW, Zhu S, Palaniappan L, Heshka S et al (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 163:427–436

    Article  PubMed  Google Scholar 

  28. Pi-Sunyer X, Blackburn G, Brancati FL et al (2007) Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care 30:1374–1383

    Article  PubMed  Google Scholar 

  29. Reichert FF, Barros AJ, Domingues MR et al (2007) The role of perceived personal barriers to engagement in leisure-time physical activity. Am J Public Health 97:515–519

    Article  PubMed  Google Scholar 

  30. Satoh N, Wada H, Ono K, Yamakage H et al (2008) Small dense LDL-cholesterol relative to LDL-cholesterol is a strong independent determinant of hypoadiponectinemia in metabolic syndrome. Circ J 72:932–939

    Article  PubMed  CAS  Google Scholar 

  31. Scanu AM (1992) Lipoprotein(a). A genetic risk factor for premature coronary heart disease. JAMA 267:3326–3329

    Article  PubMed  CAS  Google Scholar 

  32. Tambalis K, Panagiotakos DB, Kavouras SA et al (2009) Responses of blood lipids to aerobic, resistance, and combined aerobic with resistance exercise training: a systematic review of current evidence. Angiology 60:614–632

    Article  PubMed  Google Scholar 

  33. Tjonna AE, Lee SJ, Rognmo O et al (2008) Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation 118:346–354

    Article  PubMed  Google Scholar 

  34. Tuomilehto J, Lindstrom J, Eriksson JG et al (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344:1343–1350

    Article  PubMed  CAS  Google Scholar 

  35. U.S. Department of Health and Human Services (2008) Physical activity guidelines for Americans. U.S. Department of Health and Human Services, Hyattsville. http://www. health.gov/paguidelines/guidelines/chapter4.aspx. Zugegriffen: 10. Juli 2008

  36. Wing RR, Bahnson JL, Bray GA et al (2010) Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med 170:1566–1575

    Article  PubMed  CAS  Google Scholar 

  37. Wing RR, Lang W, Wadden TA et al (2011) Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 34:1481–1486

    Article  PubMed  CAS  Google Scholar 

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  1. Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, Technische Universität München, Georg-Brauchle-Ring 56 (Campus C), 80992, München, Deutschland

    V. Freiberger & M. Halle

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  1. V. Freiberger
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  2. M. Halle
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Correspondence to V. Freiberger.

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Freiberger, V., Halle, M. Dyslipoproteinämie und körperliche Aktivität. Diabetologe 8, 562–567 (2012). https://doi.org/10.1007/s11428-012-0893-2

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