The Relationship Between Low-density Lipoprotein Discordance And Exercise Training Induced Changes In Multiple Cardiovascular Disease Risk Factors In The HERITAGE Family Study

Discordance between low-density lipoprotein cholesterol (LDL-C) and particle (LDL-P) concentrations may be associated with exercise induced changes in cardiovascular disease (CVD) risk factors. PURPOSE: To investigate the relationship between baseline LDL-C/LDL-P discordance and exercise induced changes in CVD risk factors. METHODS: Adults from the HERITAGE family study (N = 715, 34% Black, 55% Female) completed a 20-week progressive endurance training program. Multiple CVD risk factors (VO2max, lipid panel, lipoprotein subclasses, body composition, blood pressure, insulin, C-reactive protein) were measured before and after training. Four exclusive LDL discordance groups were created based on baseline sex-specific median LDL-C/LDL-P concentrations as follows: 1) Low/Low (< median for both LDL-C and LDL-P. N (male/female) = 133/160), 2) Low/High (< median LDL-C, ≥ median LDL-P. . N = 28/35), 3) High/Low (N = 23/36), and 4) High/High (N = 138/162). The association between LDL discordance and training induced changes in multiple CVD risk factors was assessed via multivariable linear regression. All models were adjusted for age, sex, baseline BMI, and baseline trait. RESULTS: In males, both High/Low and High/High LDL groups increased total LDL-P concentration [Mean (standard error): 45.1 (28.7), 27.3 (19.0) nmol/L respectively], as opposed to decreased concentrations in Low/Low and Low/High groups [-24.8 (19.5), -72.0 (31.6) nmol/L respectively; p < 0.01 for trend between groups]. The Low/Low concordant group was the only group to display an overall mean decrease in Large LDL-P [-15.1 (12.4) nmol/L; p < 0.001 for trend). In females the High/High concordant group was the only group to have a mean increase in triglycerides [5.0 (2.5) mg/dL; p = 0.02 for trend], while the Low/Low concordant group was the only to decrease small LDL-P with training [-44.9 (14.7) nmol/L; p < 0.01 for trend). All groups except the Low/High discordant group [-17.6 (20.7) nmol/L; p = 0.02 for trend] increased large LDL-P concentration. No other significant trends between groups were found. CONCLUSIONS: LDL discordance status is primarily associated with exercise training induced changes in LDL specific lipoprotein subclass measures. Individuals that started with low LDL-C levels experienced favorable changes in their LDL profile.