Clinical associations between exercise and lipoproteins

Area of Science:

• Cardiovascular Health
• Exercise Physiology
• Lipid Metabolism

Background:

• Dyslipidemia (DLD) is a major global health concern and a significant risk factor for cardiovascular disease (CVD).
• Misconceptions in DLD management often overemphasize weight loss, neglecting the proven benefits of exercise.
• Exercise training compliance, independent of weight change, is increasingly recognized for improving CVD outcomes.

Approach:

• This review examines the relationship between exercise training, lipoprotein profiles, and CVD and all-cause morbidity and mortality.
• It synthesizes evidence on aerobic exercise training (aET) and resistance exercise training (rET) effects on cardiorespiratory fitness, muscular strength, and lipid levels.
• The review also considers the impact of exercise on Lipoprotein-a [Lp(a)] and its indirect modulation via PCSK-9 inhibition.

Key Points:

• Both aET and rET independently reduce mortality and improve lipid profiles, with rET showing higher compliance potential.
• Combined aET and rET yield more significant improvements in DLD and CVD mortality than single modes.
• While exercise lowers LDL-C, its effect on Lp(a) is indirect, potentially through PCSK-9 inhibition.

Conclusions:

• Active individuals, irrespective of weight, exhibit better CVD outcomes and lipid profiles than sedentary ones.
• Exercise training positively impacts longevity by improving lipoprotein levels and particle size.
• Wearable devices can enhance the prescription, quantification, and tracking of physical activity for DLD and inactivity-related morbidity.