Key result
Endurance exercise training increases HDL-specific phospholipid efflux, with the largest gains at the lowest baselines.
Why the study?
HDL-specific phospholipid efflux (HDL-SPE) is inversely associated with coronary artery disease, but the effect of exercise training on HDL-SPE was unknown.
Does 20 weeks of endurance exercise training improve HDL-specific phospholipid efflux in individuals free of overt disease?
Does 20 weeks of endurance exercise training improve HDL-specific phospholipid efflux in individuals free of overt disease?
Mean Difference: 0.023
p-value: p=0.002
Endurance exercise training improves HDL-specific phospholipid efflux, a novel biomarker of HDL function, particularly in individuals with low baseline levels.
May enhance HDL function in low-baseline individuals; hypothesis-generating, RCTs needed before practice change.
The HDL-specific phospholipid efflux (HDL-SPE) assay is a novel cell-free measure of HDL function that is inversely associated with coronary artery disease. However, the effect of exercise training on HDL-SPE is unknown. The purpose of this study was to examine the effect of exercise training on HDL-SPE in a large, diverse cohort free of overt disease. Clinical and functional measures of HDL were taken before and after 20 weeks of endurance exercise training in 508 participants from the HERITAGE Family Study. Associations of HDL-SPE with HDL-related traits were examined using Pearson's correlations at baseline and following exercise training (significance: P < 7.4 × 10−4). The effect of exercise training on HDL-SPE was examined using paired t-tests (significance: P < 0.05). Mean (SD) HDL-SPE was 1.40 (0.19) and higher in females compared with males and in White participants compared with Black participants. Baseline HDL-SPE was strongly associated with HDL-C (r = 0.45) and apoA-I (r = 0.43, both P < 6.9 × 10−24) but not with measures of cholesterol efflux. Mean HDL-SPE increased (0.023, P = 0.002) following exercise training, but these increases only occurred in those with the lowest baseline HDL-SPE levels. Change in HDL-SPE was associated with changes in HDL-C (r = 0.27), medium HDL concentration (r = 0.24), and apoA-I and HDL size (r = 0.17, all P < 1.3 ×10−4). HDL-SPE increased following regular exercise, and changes in HDL-SPE were related to changes in HDL size and subclass concentrations. Our findings demonstrate that individuals at higher risk for coronary artery disease may experience the largest benefits from exercise training as related to this novel biomarker of HDL function.
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Leszcynski et al. (2026) studied Free of overt disease (n=508). Endurance exercise training vs. Baseline (pre-training) was evaluated on Change in HDL-specific phospholipid efflux (HDL-SPE) (MD 0.023, p=0.002). 20 weeks of endurance exercise training significantly increased mean HDL-specific phospholipid efflux by 0.023 (P=0.002), with the largest increases occurring in those with the lowest baseline levels.
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