Effects Of Intervention By Different Types Of Exercise On Blood Lipids And Serum ANGPTL3 And 8 In Obese Adults

ObjectiveStudies on the propensity of different exercises to improve lipids have not reached consensus,and the mechanism by which exercise improves lipids involves changes in lipoprotein lipase and endothelial lipase activities,and the activities of both lipases are inhibited by angiopoietin-like protein 3（ANGPTL3）and angiopoietin-like protein 8（ANGPTL8）,which affect the regulation of lipids.Exercise down-regulates serum ANGPTL3 and ANGPTL8 levels and increases the activity of both lipases,but no studies have reported whether the possible mechanism of the effect of exercise on lipids is related to changes in serum ANGPTL3 and ANGPTL8 levels and serum LPL and EL activity.This thesis investigates whether there are differences in the effects of low-intensity aerobic exercise,high-intensity aerobic exercise and moderate-intensity resistance exercise on body composition,blood lipids,ANGPTL3,ANGPTL8 levels,LPL,and EL activity in obese patients and analyzes the possible mechanisms to provide a reference for research on the mechanisms of different exercise regimens to improve lipid metabolism.MethodsEighty eligible obese adults with mean age:43.97±8.41 years and body fat percentage:37.78±7.02%were recruited and screened in Beijing and randomly divided into a control group,a maximum fat oxidation intensity exercise group(FAT_maxexercise group),a high intensity aerobic intermittent exercise group（HIAIT exercise group）,and a resistance exercise group（RT exercise group）.Subjects in all four groups were controlled with normal dietary calories and balanced dietary principles,and the exercise group underwent a 12-week,5-day/week exercise intervention.The FAT_maxgroup performed 60 min of low-intensity(FAT_maxintensity)continuous aerobic exercise each time,the HIAIT group performed 28 min of high-intensity(high-intensity:90%VO_2max,intermittent intensity:60%VO_2max)aerobic interval exercise each time,the RT group performed 40 min of moderate-intensity（8-12 RM）elastic band and self-weight loading each time resistance exercise,and no exercise intervention in the control group.Subjects’weight,body composition,waist circumference,hip circumference,blood lipids,serum LPL and EL activity,and serum ANGPTL3 and ANGPTL8 levels were measured before and after the intervention.SPSS26.0 statistical software was used to statistically analyze the data before and after the intervention in each group to observe and compare the effects of different intensity aerobic exercise and moderate intensity resistance exercise on serum ANGPLT3,ANGPTL8 levels,serum LPL,EL activity,blood lipids and body composition in obese adults.Results（1）Compared to the pre-intervention period,subjects in the FAT_max,HIAIT and RT groups had significantly lower body weight,waist circumference,waist-to-hip ratio,total body fat percentage,abdominal fat percentage,total body fat mass and serum triglycerides（TG）and apolipoprotein B（ApoB）（P<0.05）and significantly increased serum LPL activity（P<0.05）after the 12-week intervention.Serum ANGPTL3,ANGPTL8 levels and low-density lipoprotein cholesterol（LDL-C）were significantly lower in the FAT_maxgroup（P<0.05）;hip circumference was significantly lower in the HIAIT group（P<0.01）,serum EL activity was significantly increased（P<0.01）,and serum ANGPTL8 levels,serum total cholesterol（TC）and high-density lipoprotein cholesterol（HDL-C）were significantly decreased（P<0.05）;the RT group had significantly lower hip circumference（P<0.01）,significantly lower serum ANGPTL3 level,serum LDL-C（P<0.05）and significantly increased serum HDL-C（P<0.05）.（2）Compared with the control group,the rate of decrease in body weight and body fat percentage in the FAT_max,HIAIT and RT groups were significantly different from the rate of change in the control group（body weight-5.60%,-4.89%,-5.21%vs.-0.29%and body fat percentage-7.59%,-9.56%,-7.98%vs.-0.22%,P<0.05）;the rates of decrease in serum TG,LDL-C,ApoB,ANGPTL3 levels and increase in serum LPL activity in subjects in the FAT_maxgroup were significantly different from those in the control group（TG-16.29%vs.4.28%,LDL-C-14.56%vs.-0.45%,ApoB-15.14%vs.-0.73%,and ANGPTL3-16.61%vs.4.95%,LPL 33.90%vs.8.47%,P<0.05）;the rates of decrease in serum TC and ANGPTL8 levels and increase in serum EL activity in the HIAIT group were significantly different from those in the control group（TC-6.29%vs.2.33%,ANGPTL8-15.86%vs.5.21%,EL 32.56%vs.0.03%,P<0.05）;the rates of decrease in serum TG,TC,ApoB,serum ANGPTL3 levels and increase in serum LPL activity in the RT group subjects were significantly different from the control group（TC-6.46%vs.2.33%,TG-16.16%vs.4.28%,LDL-C-12.71%vs.-0.45%,ApoB-13.40%vs.-0.73%,ANGPTL3-14.87%vs.4.95%,LPL30.16%vs.8.47%,P<0.05）.（3）The rate of change of serum ANGPTL3 level was significantly positively correlated with the rate of change of TG and ApoB（P<0.01,r=0.467;P<0.01,r=0.504）and negatively correlated with the rate of change of serum LPL activity（P<0.01,r=-0.440）;the rate of change of serum ANGPTL8 level was significantly negatively correlated with the rate of change of serum EL activity（P<0.05,r=-0.324）.Conclusion（1）The effects of different intensity aerobic exercise on blood lipids were different.Low-intensity aerobic exercise was more effective in lowering serum TG,LDL-C and ApoB levels,probably due to its ability to more significantly lower serum ANGPTL3 levels and increase serum LPL activity;high-intensity aerobic exercise was more effective in lowering serum TC and HDL-C levels,probably due to its ability to more significantly lower serum ANGPTL8 levels and increase serum LPL activity.The effect of high-intensity aerobic exercise on reducing serum TC and HDL-C levels was more significant,probably due to its ability to more significantly reduce serum ANGPTL8 levels and increase EL activity,thus enhancing the uptake of HDL-C and HDL reorganization by the liver.（2）Moderate intensity resistance exercise significantly reduced serum ANGPTL3 levels,increased serum LPL activity,and led to a significant decrease in serum TG levels,compared with aerobic exercise,moderate intensity resistance exercise significantly increased serum HDL-C level and significantly decreased serum LDL-C level,which was conducive to inhibiting cholesterol transport and promoting reversal of transport process,resulting in a significant decrease in serum TC level.