title: Atherogenic subfractions of lipoproteins in the treatment of metabolic syndrome by physical activity and diet - the RESOLVE trial.
abstract: BACKGROUND
  We aimed to comprehensively evaluate lipoprotein profile including lipid particle size following a lifestyle intervention in metabolic syndrome (MetS) volunteers and to assess the associations between lipoprotein subfractions and carotid-intima-media-thickness (CIMT) - a surrogate indicator of atherogenesis.
  
  
  METHODS
  100 participants (50-70 years) from the RESOLVE trial, underwent a one-year follow-up beginning with a three-week residential program combining high exercise volume (15-20 h/week), restrictive diet (-500 kcal/day), and education. For baseline references, 40 aged-matched healthy controls were recruited. Independent associations between subfractions of lipoproteins and CIMT were evaluated using a generalized estimating equations model accounting for variation in correlations between repeated measures. The lipoprotein subfractions profile was assessed using Lipoprint® electrophoresis allowing to separate: the very low-density lipoprotein (VLDL) fraction, then the intermediate-density lipoprotein (IDL) C, B and A, the low-density lipoprotein (LDL) with subfractions 1 and 2 as large LDL and subfractions 3 to 7 as small dense LDL (sdLDL), and the high density lipoprotein (HDL) subfractions categorized into large, intermediate, and small HDL. Apolipoproteins A1 and B were also measured.
  
  
  RESULTS
  78 participants completed the program. At baseline, apolipoproteins B/A1, VLDL, sdLDL and small HDL were higher in MetS than in healthy controls; IDL, LDL size, large and intermediate HDL were lower. Despite time-related regains during the follow-up, lipoprotein subfractions traditionally involved in cardiovascular risk, such as sdLDL, improved immediately after the residential program with values closest to those of healthy controls. CIMT improved throughout the lifestyle intervention. Using a generalized estimating equations model, none of the subfractions of lipoproteins nor apolipoproteins were linked to CIMT.
  
  
  CONCLUSIONS
  Lipoprotein subfractions traditionally involved in CVR, decreased after the 3-week residential program. During a 12 month follow-up, the time-related regains remained closer to the values of healthy controls than they were at baseline. CIMT improved throughout the lifestyle intervention. However, we failed to demonstrate a link between some lipoprotein subfractions and the atherogenicity directly measured from the wall thickness of arteries (CIMT). Further investigations are required to explore the atherogenicity of lipoprotein subfractions.
  
  
  BACKGROUND
  NCT00917917.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dutheil
authors.forename: Guillaume
authors.initials: G
authors.lastname: Walther
authors.forename: Robert
authors.initials: R
authors.lastname: Chapier
authors.forename: George
authors.initials: G
authors.lastname: Mnatzaganian
authors.forename: Bruno
authors.initials: B
authors.lastname: Lesourd
authors.affiliation: School of Exercise Science, Australian Catholic University, East Melbourne, VIC, Australia. geraldine.naughton@acu.edu.au.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Naughton
authors.forename: Julien
authors.initials: J
authors.lastname: Verney
authors.forename: Anne
authors.initials: A
authors.lastname: Fogli
authors.forename: Vincent
authors.initials: V
authors.lastname: Sapin
authors.forename: Martine
authors.initials: M
authors.lastname: Duclos
authors.forename: Agnès
authors.initials: A
authors.lastname: Vinet
authors.forename: Philippe
authors.initials: P
authors.lastname: Obert
authors.forename: Daniel
authors.initials: D
authors.lastname: Courteix
authors.forename: Gérard
authors.initials: G
authors.lastname: Lac
mesh_terms: D000368:Aged; D031204:Caloric Restriction; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D008074:Lipoproteins