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Lee J, Zarezadehmehrizi A, LaVoy EC, Markofski MM, Park Y. Exercise Training Improves Brachial Artery Endothelial Function, but Does Not Alter Inflammatory Biomarkers in Patients with Peripheral Artery Disease: a Systematic Review and Meta-analysis. J Cardiovasc Transl Res 2024; 17:585-597. [PMID: 37870688 DOI: 10.1007/s12265-023-10451-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/06/2023] [Indexed: 10/24/2023]
Abstract
The study aimed to systematically review the effects of exercise training (EX) on brachial artery flow-mediated dilation (FMD) and inflammatory biomarkers in patients with peripheral artery disease (PAD). Five electronic databases were searched: (i) patients with PAD aged ≥ 18; (ii) structured EX ≥ 2 weeks; (iii) measured brachial artery FMD; and (iv) measured blood inflammatory biomarkers. Eighteen studies met the inclusion criteria. EX increased FMD but had no effect on C-reactive protein, interleukin-6, and tumor necrosis factor-α. Subgroups with moderate intensity had a greater increase in FMD than subgroups with vigorous intensity. There was no difference in effect on FMD and three inflammatory biomarkers between subgroups training for ≤ 12 weeks and > 12 weeks of EX, < 50 min and ≥ 50 min of session duration, and < 150 min and ≥ 150 min of weekly volume, respectively. These results suggest that EX-induced improvement in vascular function can be independent of the improvement of systemic inflammation.
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Affiliation(s)
- Junghoon Lee
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, 3875 Holman St, Houston, TX, 77204-6015, USA
| | - Aliasghar Zarezadehmehrizi
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, 3875 Holman St, Houston, TX, 77204-6015, USA
| | - Emily C LaVoy
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, 3875 Holman St, Houston, TX, 77204-6015, USA
| | - Melissa M Markofski
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, 3875 Holman St, Houston, TX, 77204-6015, USA
| | - Yoonjung Park
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, 3875 Holman St, Houston, TX, 77204-6015, USA.
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Dynamic Resistance Exercise Alters Blood ApoA-I Levels, Inflammatory Markers, and Metabolic Syndrome Markers in Elderly Women. Healthcare (Basel) 2022; 10:healthcare10101982. [PMID: 36292427 PMCID: PMC9601716 DOI: 10.3390/healthcare10101982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/04/2022] Open
Abstract
Combined endurance and dynamic-resistance exercise has important anti-inflammatory effects, altering vascular endothelial function, and helping to prevent and treat aging-related metabolic syndrome (MS). We studied changes in 40 elderly women aged ≥ 65 years (control group (no MS), n = 20, mean age: 68.23 ± 2.56 years; MS group, n = 19, mean age: 71.42 ± 5.87 years; one left). The exercise program comprised dynamic-resistance training using elastic bands, three times weekly, for six months. We analyzed body composition, blood pressure, physical fitness, and MS-related blood variables including ApoA-I, antioxidant factors, and inflammatory markers. After the program, the MS group showed significant reductions in waist-hip ratio, waist circumference, diastolic blood pressure, blood insulin, and HOMA-IR, and a significant increase in HSP70 (p < 0.05). Both groups showed significant increases in ApoA-I levels, ApoA-I/HDL-C ratio, SOD2, IL-4, and IL-5 levels (p < 0.05). Active-resistance training-induced changes in ApoA-I were significantly positively correlated with changes in HDL-C and HSP70, and significantly negatively correlated with changes in triglycerides, C-reactive protein, and TNF-α (p < 0.05). Active-resistance training qualitatively altered HDL, mostly by altering ApoA-I levels, relieving vascular inflammation, and improving antioxidant function. This provides evidence that dynamic-resistance exercise can improve physical fitness and MS risk factors in elderly women.
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Stanton KM, Kienzle V, Dinnes DLM, Kotchetkov I, Jessup W, Kritharides L, Celermajer DS, Rye KA. Moderate- and High-Intensity Exercise Improves Lipoprotein Profile and Cholesterol Efflux Capacity in Healthy Young Men. J Am Heart Assoc 2022; 11:e023386. [PMID: 35699182 PMCID: PMC9238648 DOI: 10.1161/jaha.121.023386] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Exercise is associated with a reduced risk of cardiovascular disease. Increased high‐density lipoprotein cholesterol (HDL‐C) levels are thought to contribute to these benefits, but much of the research in this area has been limited by lack of well‐controlled subject selection and exercise interventions. We sought to study the effect of moderate and high‐intensity exercise on HDL function, lipid/lipoprotein profile, and other cardiometabolic parameters in a homogeneous population where exercise, daily routine, sleep patterns, and living conditions were carefully controlled. Methods and Results Male Army recruits (n=115, age 22±0.3 years) completed a 12‐week moderate‐intensity exercise program. A subset of 51 subsequently completed a 15‐week high‐intensity exercise program. Fitness increased and body fat decreased after moderate‐ and high‐intensity exercise (P<0.001). Moderate‐intensity exercise increased HDL‐C and apolipoprotein A‐I levels (6.6%, 11.6% respectively), and decreased low‐density lipoprotein cholesterol and apolipoprotein B levels (7.2%, 4.9% respectively) (all P<0.01). HDL‐C and apolipoprotein A‐I levels further increased by 8.2% (P<0.001) and 6.3% (P<0.05) after high‐intensity exercise. Moderate‐intensity exercise increased ABCA‐1 (ATP‐binding cassette transporter A1) mediated cholesterol efflux by 13.5% (P<0.001), which was sustained after high‐intensity exercise. In a selected subset the ability of HDLs to inhibit ICAM‐1 (intercellular adhesion molecule‐1) expression decreased after the high (P<0.001) but not the moderate‐intensity exercise program. Conclusions When controlling for exercise patterns, diet, and sleep, moderate‐intensity exercise improved HDL function, lipid/lipoprotein profile, fitness, and body composition. A sequential moderate followed by high‐intensity exercise program showed sustained or incremental benefits in these parameters. Improved HDL function may be part of the mechanism by which exercise reduces cardiovascular disease risk.
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Affiliation(s)
- Kelly M Stanton
- Heart Research Institute Sydney New South Wales Australia.,The University of Sydney New South Wales Australia.,Royal Brisbane and Women's Hospital Herston Queensland Australia
| | - Vivian Kienzle
- Heart Research Institute Sydney New South Wales Australia
| | | | | | - Wendy Jessup
- The ANZAC Research Institute Concord New South Wales Australia
| | - Leonard Kritharides
- Heart Research Institute Sydney New South Wales Australia.,The ANZAC Research Institute Concord New South Wales Australia
| | - David S Celermajer
- Heart Research Institute Sydney New South Wales Australia.,The University of Sydney New South Wales Australia.,Royal Prince Alfred Hospital Sydney New South Wales Australia
| | - Kerry-Anne Rye
- The University of New South Wales Sydney New South Wales Australia
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Modification of High-Density Lipoprotein Functions by Diet and Other Lifestyle Changes: A Systematic Review of Randomized Controlled Trials. J Clin Med 2021; 10:jcm10245897. [PMID: 34945193 PMCID: PMC8707678 DOI: 10.3390/jcm10245897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 01/01/2023] Open
Abstract
High-density lipoprotein (HDL) functional traits have emerged as relevant elements that may explain HDL antiatherogenic capacity better than HDL cholesterol levels. These properties have been improved in several lifestyle intervention trials. The aim of this systematic review is to summarize the results of such trials of the most commonly used dietary modifications (fatty acids, cholesterol, antioxidants, alcohol, and calorie restriction) and physical activity. Articles were screened from the Medline database until March 2021, and 118 randomized controlled trials were selected. Results from HDL functions and associated functional components were extracted, including cholesterol efflux capacity, cholesteryl ester transfer protein, lecithin-cholesterol acyltransferase, HDL antioxidant capacity, HDL oxidation status, paraoxonase-1 activity, HDL anti-inflammatory and endothelial protection capacity, HDL-associated phospholipase A2, HDL-associated serum amyloid A, and HDL-alpha-1-antitrypsin. In mainly short-term clinical trials, the consumption of monounsaturated and polyunsaturated fatty acids (particularly omega-3 in fish), and dietary antioxidants showed benefits to HDL functionality, especially in subjects with cardiovascular risk factors. In this regard, antioxidant-rich dietary patterns were able to improve HDL function in both healthy individuals and subjects at high cardiovascular risk. In addition, in randomized trial assays performed mainly in healthy individuals, reverse cholesterol transport with ethanol in moderate quantities enhanced HDL function. Nevertheless, the evidence summarized was of unclear quality and short-term nature and presented heterogeneity in lifestyle modifications, trial designs, and biochemical techniques for the assessment of HDL functions. Such findings should therefore be interpreted with caution. Large-scale, long-term, randomized, controlled trials in different populations and individuals with diverse pathologies are warranted.
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Sanllorente A, Soria-Florido MT, Castañer O, Lassale C, Salas-Salvadó J, Martínez-González MÁ, Subirana I, Ros E, Corella D, Estruch R, Tinahones FJ, Hernáez Á, Fitó M. A lifestyle intervention with an energy-restricted Mediterranean diet and physical activity enhances HDL function: a substudy of the PREDIMED-Plus randomized controlled trial. Am J Clin Nutr 2021; 114:1666-1674. [PMID: 34582548 DOI: 10.1093/ajcn/nqab246] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/30/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Consumption of a Mediterranean diet, adequate levels of physical activity, and energy-restricted lifestyle interventions have been individually associated with improvements in HDL functions. Evidence of intensive interventions with calorie restriction and physical activity is, however, scarce. OBJECTIVES To determine whether an intensive lifestyle intervention with an energy-restricted Mediterranean diet plus physical activity enhanced HDL function compared to a non-hypocaloric Mediterranean eating pattern without physical activity. METHODS In 391 older adults with metabolic syndrome (mean age, 65 years; mean BMI, 33.3 kg/m2) from 1 of the Prevención con Dieta Mediterránea-Plus trial centers, we evaluated the impact of a 6-month intervention with an energy-restricted Mediterranean diet plus physical activity (intensive lifestyle; n = 190) relative to a nonrestrictive Mediterranean diet without physical activity (control; n = 201) on a set of HDL functional traits. These included cholesterol efflux capacity, HDL oxidative/inflammatory index, HDL oxidation, and levels of complement component 3, serum amyloid A, sphingosine-1-phosphate, triglycerides, and apolipoproteins A-I, A-IV, C-III, and E in apoB-depleted plasma. RESULTS The intensive-lifestyle intervention participants displayed greater 6-month weight reductions (-3.83 kg; 95% CI: -4.57 to -3.09 kg) but no changes in HDL cholesterol compared with control-diet participants. Regarding HDL functional traits, the intensive lifestyle decreased triglyceride levels (-0.15 mg/g protein; 95% CI: -0.29 to -0.014 mg/g protein) and apoC-III (-0.11 mg/g protein; 95% CI: -0.18 to -0.026 mg/g protein) compared to the control diet, with weight loss being the essential mediator (proportions of mediation were 77.4% and 72.1% for triglycerides and apoC-III levels in HDL, respectively). CONCLUSIONS In older adults with metabolic syndrome, an energy-restricted Mediterranean diet plus physical activity improved the HDL triglyceride metabolism compared with a nonrestrictive Mediterranean diet without physical activity. This trial is registered at isrctn.com as ISRCTN89898870.
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Affiliation(s)
- Albert Sanllorente
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,PhD Program in Biomedicine, Universitat Pompeu Fabra, Barcelona, Spain.,Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Olga Castañer
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Camille Lassale
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Pere Virgili, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Miguel Ángel Martínez-González
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Isaac Subirana
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Emilio Ros
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Dolores Corella
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, Universidad de Valencia, Valencia, Spain
| | - Ramón Estruch
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.,Department of Internal Medicine, Hospital Clínic, Barcelona, Spain
| | - Francisco J Tinahones
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Virgen de la Victoria Hospital, Department of Endocrinology, Biomedical Research Institute of Málaga, University of Málaga, Málaga, Spain
| | - Álvaro Hernáez
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.,Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Cholesterol Efflux Capacity Associates with the Ankle-Brachial Index but Not All-Cause Mortality in Patients with Peripheral Artery Disease. Diagnostics (Basel) 2021; 11:diagnostics11081407. [PMID: 34441341 PMCID: PMC8394478 DOI: 10.3390/diagnostics11081407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Cholesterol efflux is an important mechanism by which high-density lipoproteins (HDLs) protect against cardiovascular disease. As peripheral artery disease (PAD) is associated with high mortality rates, mainly due to cardiovascular causes, we investigated whether cholesterol efflux capacity (CEC) of apolipoprotein B (apoB)-depleted plasma, a widely used surrogate of HDL function, may serve as a predictive marker for mortality in this patient population. Methods: In this prospective single-center study (median follow-up time: 9.3 years), apoB-containing lipoproteins were precipitated from plasma of 95 patients with PAD and incubated with J744-macrophages, which were loaded with radiolabeled cholesterol. CEC was defined as the fractional radiolabel released during 4 h of incubation. Results: Baseline CEC was lower in PAD patients that currently smoked (p = 0.015) and had a history of myocardial infarction (p = 0.011). Moreover, CEC showed a significant correlation with HDL-cholesterol (p = 0.003) and apolipoprotein A-I levels (p = 0.001) as well as the ankle-brachial index (ABI, p = 0.018). However, CEC did not differ between survivors and non-survivors. Neither revealed Kaplan–Meier and Cox regression analyses any significant association of CEC with all-cause mortality rates. Conclusion: Taken together, CEC is associated with ABI but does not predict all-cause mortality in patients with PAD.
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High-Density Lipoprotein Subfractions: Much Ado about Nothing or Clinically Important? Biomedicines 2021; 9:biomedicines9070836. [PMID: 34356900 PMCID: PMC8301429 DOI: 10.3390/biomedicines9070836] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/24/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023] Open
Abstract
High-density lipoproteins (HDL) are a heterogenous group of plasma molecules with a large variety in composition. There is a wide specter in lipid content and the number of different proteins that has been associated with HDL is approaching 100. Given this heterogeneity and the fact that the total amount of HDL is inversely related to the risk of coronary heart disease (CHD), there has been increasing interest in the function of specific HDL subgroups and in what way measuring and quantifying these subgroups could be of clinical importance in determining individual CHD risk. If certain subgroups appear to be more protective than others, it may also in the future be possible to pharmacologically increase beneficial and decrease harmful subgroups in order to reduce CHD risk. In this review we give a short historical perspective, summarize some of the recent clinical findings regarding HDL subclassifications and discuss why such classification may or may not be of clinical relevance.
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Kosmas CE, Sourlas A, Guzman E, Kostara CE. Environmental Factors Modifying HDL Functionality. Curr Med Chem 2021; 29:1687-1701. [PMID: 34269662 DOI: 10.2174/0929867328666210714155422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/27/2021] [Accepted: 05/06/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Currently, it has been recognized that High-Density Lipoproteins (HDL) functionality plays a much more essential role in protection from atherosclerosis than circulating HDL-cholesterol (HDL-C) levels per se. Cholesterol efflux from macrophages to HDL, cholesterol efflux capacity (CEC) has been shown to be a key metric of HDL functionality. Thus, quantitative assessment of CEC may be an important tool for the evaluation of HDL functionality, as improvement of HDL function may lead to a reduction of the risk for Cardiovascular disease (CVD). INTRODUCTION Although the cardioprotective action of HDLs is exerted mainly through their involvement in the reverse cholesterol transport (RCT) pathway, HDLs also have important anti-inflammatory, antioxidant, antiaggregatory and anticoagulant properties that contribute to their favorable cardiovascular effects. Certain genetic, pathophysiologic, disease states and environmental conditions may influence the cardioprotective effects of HDL either by inducing modifications in lipidome and/or protein composition or in the enzymes responsible for HDL metabolism. On the other hand, certain healthy habits or pharmacologic interventions may actually favorably affect HDL functionality. METHOD The present review discusses the effects of environmental factors, including obesity, smoking, alcohol consumption, dietary habits, various pharmacologic interventions, as well as aerobic exercise, on HDL functionality. RESULT Experimental and clinical studies or pharmacological interventions support the impact of these environmental factors in the modification of HDL functionality, although the mechanisms that are mediated are poorly understood. CONCLUSION Further research should be conducted to unreal the underlying mechanisms of these environmental factors and to identify new pharmacologic interventions, capable of enhancing CEC, improving HDL functionality and potentially improving cardiovascular risk.
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Affiliation(s)
- Constantine E Kosmas
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, United States
| | | | - Eliscer Guzman
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, United States
| | - Christina E Kostara
- Laboratory of Clinical Chemistry, Medical Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece
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Li H, Liu W, Su W, Yang Z, Chen Y, Fu Y, Zhang T, Fu W, Chen W, Sun Y. Changes in plasma HDL and its subcomponents HDL2b and HDL3 regulate inflammatory response by modulating SOCS1 signaling to affect severity degree and prognosis of sepsis. INFECTION GENETICS AND EVOLUTION 2021; 91:104804. [PMID: 33684569 DOI: 10.1016/j.meegid.2021.104804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/25/2021] [Accepted: 03/03/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To explore if SOCS1 is regulated by plasma HDL and its subcomponents HDL2b and HDL3 to affect inflammatory reaction then to influence the severity degree and prognosis of sepsis. METHODS One hundred sepsis patients in ICU and 85 normal control persons from October 2018 to October 2019 in our hospital were enrolled. Adult male C57BL/6 mice were used to establish sepsis model by CLP method. HDL, CRP, and WBC count of human were measured using an auto-analyzer. Plasma HDL, IL-1β, and TNF-α proteins levels of mice were measured with ELISA. Microfluidic chip was used for plasma HDL2b and HDL3 detections. SOCS1 in liver and spleen of mice were measured by qRT-PCR. The relationship between plasma HDL//HDL2b and inflammatory indices/SOCS1 in liver/spleen was analyzed with spearman correlation coefficient method. The sepsis patients/mice were divided into non-survival and survival groups. The sepsis patients were divided into severe and mild sepsis patients based on the SOFA score or divided into high and low score groups according to the APACHE II score. The sepsis mice were divided into high and low score group based on the modified sepsis severity score criterion. RESULTS Plasma HDL and HDL2b levels were significantly declined (P < 0.01), while HDL3 was normal in both sepsis patients and mice (P > 0.05). Plasma HDL and HDL2b were negatively associated with the serum CRP concentration and positively correlated with the prognosis and severity in sepsis patients (P < 0.05). Moreover, the downregulated plasma HDL but not HDL2b was negatively related to increased SOCS1 mRNA levels in liver and spleen of mice, which were positively connected with TNF-α and IL-1β protein levels (P < 0.05). CONCLUSIONS Plasma HDL is downregulated in sepsis, which may facilitate inflammatory reaction then activate the SOCS1 signaling to regulate the severity and affect prognosis of sepsis. The decline of plasma HDL2b content could aggravate the severity and poor prognosis of sepsis through facilitating inflammatory reaction. The plasma HDL3 is not involved in sepsis. The more and further explorations may be needed.
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Affiliation(s)
- Hui Li
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Wenfeng Liu
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China.
| | - Wei Su
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Zhi Yang
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Yonghua Chen
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Yonghong Fu
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Tingting Zhang
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Wei Fu
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Weiming Chen
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Yuncong Sun
- Department of Intensive Care Unit, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
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Riggs KA, Rohatgi A. HDL and Reverse Cholesterol Transport Biomarkers. Methodist Debakey Cardiovasc J 2019; 15:39-46. [PMID: 31049148 DOI: 10.14797/mdcj-15-1-39] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
High-density lipoprotein (HDL) is a protein-lipid nanoparticle that has predominately been characterized by its cholesterol concentration (HDL-C). Recent studies have challenged the presumed inverse association between HDL-C and cardiovascular events, suggesting a more U-shaped association. This has opened new opportunities to evaluate more novel measures of HDL metabolism, such as HDL particle number (HDL-P) and one of HDL's key functions, cholesterol efflux. Both HDL-P and cholesterol efflux are inversely associated with incident cardiovascular events and may perhaps be better targets for intervention. This review includes recent research on the emerging U-shaped association between HDL-C and cardiovascular events, recent observational studies related to HDL-P, and the effects of established and novel interventions on cholesterol efflux.
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Affiliation(s)
- Kayla A Riggs
- THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER, DALLAS, TEXAS
| | - Anand Rohatgi
- THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER, DALLAS, TEXAS
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11
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Pagonas N, Vlatsas S, Bauer F, Seibert FS, Sasko B, Buschmann I, Ritter O, Kelesidis T, Westhoff TH. The impact of aerobic and isometric exercise on different measures of dysfunctional high-density lipoprotein in patients with hypertension. Eur J Prev Cardiol 2019; 26:1301-1309. [PMID: 31067131 DOI: 10.1177/2047487319848199] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Exercise training increases high-density lipoprotein (HDL) cholesterol, but its effect on HDL function is unclear. In hypertensives, exercise improves endothelial dysfunction, which is related to HDL function. In the present study, we assess for the first time the effects of different exercise modalities on two cell-free assays of HDL function. DESIGN The study was conducted as a prospective randomized controlled trial in 75 hypertensive patients. METHODS Patients were randomized in three groups: (a) handgrip isometric training five times weekly; (b) placebo-handgrip; and (c) aerobic exercise training at least three times per week. HDL function was assessed in serum samples at baseline and after 12 weeks of training by two independent assays that determine the proinflammatory phenotype (haptoglobin content) of a specific amount of HDL (Haptoglobin-HDL [HPHDL]) and oxidized HDL (HDLox) as a measure of reduced antioxidant function of HDL. HDL function measures were normalized by the measures of a pooled control of sera from healthy participants and by HDL-C levels (normalized ratio, no units). RESULTS Aerobic exercise led to significant reduction of the HDLox from 0.99 ± 0.27 to 0.90 ± 0.29 (no units, p = 0.03). The HPHDL did not change in any training group. Changes of HDLox correlated with reduction of the systolic blood pressure only after aerobic exercise (R = 0.64, p = 0.03). CONCLUSIONS Aerobic but not isometric exercise improves the antioxidant function of HDL in patients with hypertension. This improvement correlates positively with reductions of blood pressure.
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Affiliation(s)
- Nikolaos Pagonas
- 1 Department of Cardiology, Medical University of Brandenburg, Germany.,2 Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Germany
| | - Stergios Vlatsas
- 3 Department of Nephrology, Charité - Campus Benjamin Franklin, Berlin, Germany
| | - Frederic Bauer
- 2 Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Germany
| | - Felix S Seibert
- 2 Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Germany
| | - B Sasko
- 1 Department of Cardiology, Medical University of Brandenburg, Germany
| | - I Buschmann
- 4 Department of Angiology, Medical University of Brandenburg, Germany
| | - O Ritter
- 1 Department of Cardiology, Medical University of Brandenburg, Germany
| | - Theodoros Kelesidis
- 5 Department of Medicine, David Geffen School of Medicine, University of California, LA, USA
| | - Timm H Westhoff
- 2 Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Germany
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12
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Abstract
PURPOSE OF REVIEW Low HDL-cholesterol (HDL-C) levels are a strong predictor of cardiovascular disease risk and can be improved with regular exercise. However, raising HDL-C levels pharmacologically has not shown convincing clinical benefits. Thus, research has recently focused on identifying therapies that improve HDL function, with exercise representing such a potential therapy. The purpose of this review is to summarize the effects of exercise interventions on HDL function. RECENT FINDINGS The effects of exercise and lifestyle interventions on the primary atheroprotective functions of HDL are reviewed, namely, cholesterol efflux, antioxidative, and anti-inflammatory properties. Differences in study design, study population, and assays are discussed to aid in the interpretation of the reviewed studies. SUMMARY There is mixed evidence that regular aerobic exercise improves cholesterol efflux capacity, with recent research suggesting an exercise dose threshold needs to be exceeded to produce beneficial effects. There is preliminary evidence that exercise improves the antioxidative and anti-inflammatory properties of HDL. Although exercise represents a potential therapeutic approach to improve HDL function, the heterogeneity and/or lack of findings warrants more and larger studies to determine what HDL function(s) are most responsive to regular exercise and what dose of exercise elicits the greatest improvements in HDL functionality.
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Affiliation(s)
- Jonathan J Ruiz-Ramie
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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13
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Boyer M, Lévesque V, Poirier P, Marette A, Mitchell PL, Mora S, Mathieu P, Després JP, Larose É, Arsenault BJ. Longitudinal Changes in Cholesterol Efflux Capacities in Patients With Coronary Artery Disease Undergoing Lifestyle Modification Therapy. J Am Heart Assoc 2018; 7:JAHA.118.008681. [PMID: 29858367 PMCID: PMC6015361 DOI: 10.1161/jaha.118.008681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Our objective was to identify the determinants of high-density lipoprotein cholesterol efflux capacity (HDL-CEC) changes in patients with coronary artery disease who participated in a lifestyle modification program aimed at increasing physical activity levels and improving diet quality. METHODS AND RESULTS A total of 86 men with coronary artery disease aged between 35 and 80 years participated in a 1-year lifestyle modification program that aimed to achieve a minimum of 150 minutes of aerobic physical activity weekly and improve diet quality. HDL-CECs were measured before and after the 1-year intervention using 3H-cholesterol-labeled J774 and HepG2 cells. Visceral, subcutaneous, and cardiac adipose tissue levels were assessed before and after the intervention using magnetic resonance imaging. Lipoprotein particle size and concentrations were measured by proton nuclear magnetic resonance spectroscopy and a complete lipoprotein-lipid profile was obtained. At baseline, the best correlate of HDL-CECs were apolipoprotein AI (R2=0.35, P<0.0001) and high-density lipoprotein cholesterol (R2=0.21, P<0.0001) for J774-HDL-CECs and HepG2-HDL-CECs, respectively. Baseline and longitudinal changes in HDL-CECs were associated with several lipoprotein size and concentration indices, although high-density lipoprotein cholesterol was the best predictor of longitudinal changes in J774-HDL-CECs (R2=0.18, P=0.002) and apolipoprotein AI was found to be the best predictor of longitudinal changes in HepG2 cholesterol efflux capacities (R2=0.21, P=0.002). CONCLUSIONS Results of this study suggest that increases in high-density lipoprotein cholesterol and apolipoprotein AI levels typically observed in patients with coronary artery disease undergoing healthy lifestyle modification therapy may be indicative of higher plasma concentrations of functional high-density lipoprotein particles.
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Affiliation(s)
- Marjorie Boyer
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada.,Department of Medicine, Faculty of Medicine, Université Laval, Québec, Canada
| | - Valérie Lévesque
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada.,Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
| | - Paul Poirier
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada.,Faculty of Pharmacy, Université Laval, Québec, Canada
| | - André Marette
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada.,Department of Medicine, Faculty of Medicine, Université Laval, Québec, Canada
| | - Patricia L Mitchell
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada
| | - Samia Mora
- Center for Lipid Metabolomics, Divisions of Preventive and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Patrick Mathieu
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada.,Department of Surgery, Faculty of Medicine, Université Laval, Québec, Canada
| | - Jean-Pierre Després
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada.,Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
| | - Éric Larose
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada.,Department of Medicine, Faculty of Medicine, Université Laval, Québec, Canada
| | - Benoit J Arsenault
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada .,Department of Medicine, Faculty of Medicine, Université Laval, Québec, Canada
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14
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Sarzynski MA, Ruiz-Ramie JJ, Barber JL, Slentz CA, Apolzan JW, McGarrah RW, Harris MN, Church TS, Borja MS, He Y, Oda MN, Martin CK, Kraus WE, Rohatgi A. Effects of Increasing Exercise Intensity and Dose on Multiple Measures of HDL (High-Density Lipoprotein) Function. Arterioscler Thromb Vasc Biol 2018; 38:943-952. [PMID: 29437573 PMCID: PMC5864525 DOI: 10.1161/atvbaha.117.310307] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/24/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Measures of HDL (high-density lipoprotein) function are associated with cardiovascular disease. However, the effects of regular exercise on these measures is largely unknown. Thus, we examined the effects of different doses of exercise on 3 measures of HDL function in 2 randomized clinical exercise trials. APPROACH AND RESULTS Radiolabeled and boron dipyrromethene difluoride-labeled cholesterol efflux capacity and HDL-apoA-I (apolipoprotein A-I) exchange were assessed before and after 6 months of exercise training in 2 cohorts: STRRIDE-PD (Studies of Targeted Risk Reduction Interventions through Defined Exercise, in individuals with Pre-Diabetes; n=106) and E-MECHANIC (Examination of Mechanisms of exercise-induced weight compensation; n=90). STRRIDE-PD participants completed 1 of 4 exercise interventions differing in amount and intensity. E-MECHANIC participants were randomized into 1 of 2 exercise groups (8 or 20 kcal/kg per week) or a control group. HDL-C significantly increased in the high-amount/vigorous-intensity group (3±5 mg/dL; P=0.02) of STRRIDE-PD, whereas no changes in HDL-C were observed in E-MECHANIC. In STRRIDE-PD, global radiolabeled efflux capacity significantly increased 6.2% (SEM, 0.06) in the high-amount/vigorous-intensity group compared with all other STRRIDE-PD groups (range, -2.4 to -8.4%; SEM, 0.06). In E-MECHANIC, non-ABCA1 (ATP-binding cassette transporter A1) radiolabeled efflux significantly increased 5.7% (95% CI, 1.2-10.2%) in the 20 kcal/kg per week group compared with the control group, with no change in the 8 kcal/kg per week group (2.6%; 95% CI, -1.4 to 6.7%). This association was attenuated when adjusting for change in HDL-C. Exercise training did not affect BODIPY-labeled cholesterol efflux capacity or HDL-apoA-I exchange in either study. CONCLUSIONS Regular prolonged vigorous exercise improves some but not all measures of HDL function. Future studies are warranted to investigate whether the effects of exercise on cardiovascular disease are mediated in part by improving HDL function. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifiers: NCT00962962 and NCT01264406.
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Affiliation(s)
- Mark A Sarzynski
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.).
| | - Jonathan J Ruiz-Ramie
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Jacob L Barber
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Cris A Slentz
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - John W Apolzan
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Robert W McGarrah
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Melissa N Harris
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Timothy S Church
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Mark S Borja
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Yumin He
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Michael N Oda
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Corby K Martin
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - William E Kraus
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
| | - Anand Rohatgi
- From the Department of Exercise Science, University of South Carolina, Columbia (M.A.S., J.J.R.-R., J.L.B.); Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (C.A.S., R.W.M., W.E.K.); Ingestive Behavior and Preventive Medicine Laboratories, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA (J.W.A., M.N.H., T.S.C., C.K.M.); Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, Children's Hospital Oakland Research Institute, Oakland, CA (M.S.B., Y.H., M.N.O.); and Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.R.)
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