Plasma lipids have been extensively studied in sedentary and in subjects practicing exercise training, but not in extreme inactivity as occurs in bedridden patients. This is important for the care of bedridden patients and understanding the overall plasma lipid regulation. Here, we investigated plasma lipids, lipid transfers to HDL and inflammatory markers in bedridden patients. Fasting blood samples were collected from 23 clinically stable bedridden patients under long-term care (>90 days) and 26 normolipidemic sedentary subjects, paired for age and gender. In vitro transfer of four lipids to HDL was performed by incubating plasma with donor nanoparticles containing radioactive lipids. Total (193 ± 36 vs 160 ± 43, p = 0.005), LDL (124 ± 3 vs 96 ± 33 p = 0.003) and HDL-cholesterol (45 ± 10 vs 36 ± 13, p = 0.008), apolipoprotein A-I (134 ± 20 vs 111 ± 24, p = 0.001) and oxidized LDL (53 ± 13 vs 43 ± 12, p = 0.011) were lower in bedridden patients, whereas triglycerides, apolipoprotein B, CETP and LCAT were equal in both groups. Transfers of all lipids, namely unesterified cholesterol, cholesterol esters, triglycerides and phospholipids, to HDL were lower in bedridden patients, probably due to their lower HDL-cholesterol levels. Concentrations of IL-1β, IL-6, IL-8, HGF and NGF were higher in bedridden patients compared to sedentary subjects. In conclusion, inactivity had great impact on HDL, by lowering HDL-cholesterol, apolipoprotein A-I and thereby cholesterol transfers to the lipoprotein, which suggests that inactivity may deteriorate HDL protection beyond the ordinary sedentary condition.
High-density lipoproteins (HDL) Lipid metabolism Cholesterol ester transfer protein (CETP) Exercise training Nanoparticles
Body mass index
Cholesterol ester transfer protein
High density lipoprotein
Hepatocyte growth factor
Low density lipoprotein
Monocyte chemotactic protein
Nerve growth factor
Reverse cholesterol transport
Tumor necrosis factor-α
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The authors are thankful to Mrs. Josefa M.H.S. Lima BSc, for her help with the experiments.
WPCO: patient selection, data collection, analysis and interpretation of data, manuscript writing. TMT: performance of experiments, analysis of data, manuscript writing. FRF: analysis of data, interpretation of results, manuscript writing. BMOS: performance of experiments. RCM: design and conduction of the study, manuscript writing, intellectual content. All authors read and approved the final manuscript.
Compliance with ethical standards
This study was supported by the São Paulo State Research Support Foundation (FAPESP, São Paulo, Brazil; Grant 14/03742-0). Dr. Maranhão has a Research Carrier Award from the National Council for Scientific and Technological Development (CNPq, Brasilia, Brazil).
Conflict of interest
The authors declare have no conflicts of interest.
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