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

Abstract

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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Abbreviations

apo:

Apolipoprotein

BMI:

Body mass index

CETP:

Cholesterol ester transfer protein

HDL:

High density lipoprotein

HGF:

Hepatocyte growth factor

IL:

Interleukin

LDL:

Low density lipoprotein

LCAT:

Lecithin-cholesterol acyltransferase

MCP-1:

Monocyte chemotactic protein

NGF:

Nerve growth factor

RCT:

Reverse cholesterol transport

TNF-α:

Tumor necrosis factor-α

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Acknowledgements

The authors are thankful to Mrs. Josefa M.H.S. Lima BSc, for her help with the experiments.

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Affiliations

Authors

Contributions

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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Funding

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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Cite this article

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). https://doi.org/10.1007/s11745-017-4274-x

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Keywords

  • High-density lipoproteins (HDL)
  • Lipid metabolism
  • Cholesterol ester transfer protein (CETP)
  • Exercise training
  • Nanoparticles