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Lipid transfers to HDL are diminished in long-term bedridden patients: association with low HDL-cholesterol and increased inflammatory markers

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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.

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Body mass index


Cholesterol ester transfer protein


High density lipoprotein


Hepatocyte growth factor




Low density lipoprotein


Lecithin-cholesterol acyltransferase


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.

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Authors contribution

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.

Corresponding author

Correspondence to Raul Cavalcante Maranhão.

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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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de Oliveira, W.P.C., Tavoni, T.M., Freitas, F.R. et al. Lipid transfers to HDL are diminished in long-term bedridden patients: association with low HDL-cholesterol and increased inflammatory markers. Lipids 52, 703–709 (2017).

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