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Wood G, Taylor E, Ng V, Murrell A, Patil A, van der Touw T, Wolden M, Andronicos N, Smart NA. Estimating the Effect of Aerobic Exercise Training on Novel Lipid Biomarkers: A Systematic Review and Multivariate Meta-Analysis of Randomized Controlled Trials. Sports Med 2023; 53:871-886. [PMID: 36862340 PMCID: PMC10036419 DOI: 10.1007/s40279-023-01817-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Aerobic exercise training (AET) prescribed as lipid management treatment positively affects the standard lipid profile and reduces cardiovascular disease (CVD) risk. Apolipoproteins, lipid and apolipoprotein ratios, and lipoprotein sub-fractions may more effectively predict CVD risk than the standard lipid profile but an AET response in these biomarkers has not been established. OBJECTIVES We conducted a quantitative systematic review of randomised controlled trials (RCTs) to (1) determine the effects of AET on lipoprotein sub-fractions, apolipoproteins and relevant ratios; and (2) identify study or intervention covariates associated with change in these biomarkers. METHODS We searched PubMed, EMBASE, all Web of Science and EBSCO health and medical online databases from inception to 31 December 2021. We included published RCTs of adult humans with ≥ 10 per group of participants; an AET intervention duration ≥ 12 weeks of at least moderate intensity (> 40% maximum oxygen consumption); and reporting pre/post measurements. Non-sedentary subjects, or those with chronic disease other than Metabolic Syndrome factors, or pregnant/lactating, as well as trials testing diet/medications, or resistance/isometric/unconventional training interventions, were excluded. RESULTS Fifty-seven RCTs totalling 3194 participants were analysed. Multivariate meta-analysis showed AET significantly raised antiatherogenic apolipoproteins and lipoprotein sub-fractions (mmol/L mean difference (MD) 0.047 (95% confidence interval (CI) 0.011, 0.082), P = .01); lowered atherogenic apoliproteins and lipoprotein sub-fractions (mmol/L MD - 0.08 (95% CI - 0.161, 0.0003), P = .05); and improved atherogenic lipid ratios (MD - 0.201 (95% CI - 0.291, - 0.111), P < .0001). Multivariate meta-regression showed intervention variables contributed to change in lipid, sub-fraction, and apoliprotein ratios. CONCLUSION Aerobic exercise training positively impacts atherogenic lipid and apolipoprotein ratios, alipoproteins, and lipoprotein sub-fractions; and antiatherogenic apolipoproteins and lipoprotein sub-fractions. Cardiovascular disease risk predicted by these biomarkers may be lowered when AET is prescribed as treatment or prevention. PROSPERO ID CRD42020151925.
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Affiliation(s)
- Gina Wood
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia.
- School of Allied Health, Curtin University, Bentley, WA, 6102, Australia.
| | - Emily Taylor
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Vanessa Ng
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Anna Murrell
- School of Rural Medicine in the Faculty of Medicine and Health, University of New England, Armidale, NSW, 2351, Australia
| | - Aditya Patil
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Tom van der Touw
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Mitch Wolden
- Physical Therapy Program, University of Jamestown, Fargo, ND, 58104, USA
| | - Nick Andronicos
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Neil A Smart
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
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Ulloque-Badaracco JR, Hernandez-Bustamante EA, Herrera-Añazco P, Benites-Zapata VA. Prognostic value of apolipoproteins in COVID-19 patients: A systematic review and meta-analysis. Travel Med Infect Dis 2021; 44:102200. [PMID: 34752921 PMCID: PMC8575373 DOI: 10.1016/j.tmaid.2021.102200] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Apolipoproteins are predictive biomarkers for cardiovascular, neoplasms and cerebrovascular diseases and are postulated as prognostic biomarkers in infectious diseases, as COVID-19. Thus, we assessed the prognosis value of apolipoproteins for COVID-19 severity and mortality. METHODS We conducted a systematic review and meta-analysis using observational studies that reported the association between apolipoproteins and severity or mortality in COVID-19 patients. Newcastle-Ottawa was used for the quality assessment of included studies. Effects measurements were shown as odds ratios (ORs) with 95% confidence intervals (CIs), and Egger-test was developed for assessing the risk of bias publication. RESULTS We analyzed 12 cohort studies (n = 3580). Patients with low ApoliproteinA1 (ApoA1) (OR 0.35; 95%CI 0.24 to 0.49; P < 0.001) and ApoliproteinB (ApoB) (OR = 0.78; 95%CI 0.69 to 0.87; P < 0.001) values had a higher risk of developing severe disease. ApoB/ApoA1 ratio showed no statistically significant association with higher odds of severity. Low ApoA1 levels were associated with higher odds of all-cause mortality (OR = 0.34; 95%CI 0.20 to 0.57; P < 0.001). ApoB values showed no statistically significant association with a high risk of all-cause mortality. CONCLUSION We suggest that adequate levels of ApoA1 and ApoB can be a protective factor for severity in COVID-19, and ApoB/ApoA1 ratio did not show predictive utility for severity.
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Affiliation(s)
| | - Enrique A Hernandez-Bustamante
- Sociedad Cientifica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru; Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Percy Herrera-Añazco
- Universidad Privada San Juan Bautista, Lima, Peru; Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru
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