Effect Of Exercise Training On HDL Apolipoproteomic Score In Adults With Prediabetes Or Type 2 Diabetes

PURPOSE: Previous studies have validated a high-density lipoprotein (HDL) apolipoproteomic score (pCAD) as a biomarker of coronary artery disease. However, the effect of regular exercise on pCAD has not been examined in adults with prediabetes or type 2 diabetes (T2D). Thus, the purpose of this study was to examine the effect of different types and doses of exercise on pCAD in two unique exercise cohorts of adults with prediabetes and T2D. METHODS: Adults from two exercise trials (STRRIDE-PD: n = 119, adults with prediabetes; HART-D: n = 142, adults with T2D) engaged in one of seven exercise interventions, including various doses of aerobic training (AT), resistance training (RT), or a combination of both (AT+RT). HDL-associated apolipoproteins were measured in APOA1-tagged plasma via LC-MS at baseline and following training. The pCAD score was calculated at each timepoint by a weighted composite of five apolipoproteins. An independent samples t-test was used to compare baseline pCAD between the two cohorts, while paired t-tests were used to test whether within exercise group changes in pCAD were significant. Differences in pCAD change between exercise groups were tested with general linear models adjusted for age, sex, race, and baseline pCAD within each study. RESULTS: STRRIDE-PD participants had lower baseline pCAD scores compared to those in HART-D (STRRIDE-PD: 0.5 ± 0.2, HART-D: 3.3 ± 0.2, p < 0.0001). The STRRIDE-PD group engaging in low doses of moderate AT had a significant decrease in pCAD score (-0.7 ± 0.2, p = 0.008). There were no differences in pCAD changes within or between the other STRRIDE-PD exercise groups. HART-D participants in the AT+RT group had a significant decrease in pCAD score (-0.6 ± 0.2, p = 0.006), which was significantly different (p = 0.04) than the change in the AT group (0.1 ± 0.2). CONCLUSIONS: Adults with prediabetes and T2D experienced reductions in pCAD score following a low amount of moderate AT and AT+RT, respectively. The results of our analysis demonstrate that AT alone may improve the HDL apolipoproteomic biomarker of coronary artery disease in adults with prediabetes, but adults with T2D may need to engage in both AT and RT to experience reductions in pCAD. However, since the same exercise mode/dose was not employed across studies, further studies are needed to validate these findings. R01HL146462