Lipoprotein Cholesterol And Particle Discordance: Associations With Exercise Induced Cardiovascular Disease Risk Factor Changes.

Differences between lipoprotein cholesterol and particle concentration (lipoprotein discordance) are associated with cardiovascular disease (CVD) risk as well as multiple CVD risk factors. However, the relationship between baseline lipoprotein discordance and exercise induced changes in CVD risk factors is sparse. PURPOSE: To investigate the association between baseline lipoprotein discordance and exercise induced changes in multiple CVD risk factors among adults with type 2 diabetes. METHODS: We analyzed data from the exercise groups of the HART-D trial where participants were randomized into one of three training groups (Aerobic, Resistance, or Combination; N = 180, 62.2% female total for all training groups) for 9 months. Standard lipid panels, lipoprotein cholesterol, and lipoprotein subclass profiles were measured pre and post intervention. Lipoprotein cholesterol and particle concentrations were rank ordered into sex specific percentiles.Continuous lipoprotein discordance was defined by subtracting the lipoprotein particle percentile from lipoprotein cholesterol percentile. Associations between baseline lipoprotein discordance and exercise induced changes in CVD risk factors were assessed via multivariable linear regression adjusting for age, race, sex, baseline BMI, cholesterol medication, and baseline CVD risk factor. RESULTS: Baseline HDL discordance was significantly (all p < 0.05) associated with exercise induced changes in 1) triglycerides (Parameter estimate (PE) = -0.515), 2) continuous HDL discordance (PE = -0.273), 3) mean HDL-P size (PE = 0.003), 4) total and 5) large HDL-P (PE = 0.016 and 0.007 respectively) and 6) small LDL-P concentrations (PE = -2.163). Continuous LDL discordance was significantly (p < 0.05) associated with exercise induced changes in continuous 1) LDL discordance (PE = -0.495), 2) LDL-C concentration (PE = -0.266), and 3) body fat (PE = -0.014). No training group or interaction effects were found. CONCLUSIONS: Among individuals with type 2 diabetes, baseline lipoprotein discordance is primarily predictive of exercise induced changes in lipoprotein cholesterol and particle-based metrics. Lipoprotein discordance may not be a valuable predictor of exercise induced changes in common CVD risk factors outside of lipoprotein specific outcomes.