HDL cholesterol efflux capacity and cholesterol loading capacity in long-term fasting: Evidence from a prospective, single-arm interventional study in healthy individuals.

Autor: Grundler F; Buchinger Wilhelmi Clinic, Wilhelm-Beck-Straße 27, 88662, Überlingen, Germany. Electronic address: franziska.grundler@buchinger-wilhelmi.com., Palumbo M; Department of Food and Drug, University of Parma, Parma, Italy., Adorni MP; Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy., Zimetti F; Department of Food and Drug, University of Parma, Parma, Italy., Papotti B; Department of Food and Drug, University of Parma, Parma, Italy., Plonné D; MVZ Humangenetik Ulm, Karlstraße 31-33, 89073, Ulm, Germany., Holley A; Buchinger Wilhelmi Clinic, Wilhelm-Beck-Straße 27, 88662, Überlingen, Germany., Mesnage R; Buchinger Wilhelmi Clinic, Wilhelm-Beck-Straße 27, 88662, Überlingen, Germany; Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, SE1 9NH, London, UK., Ruscica M; Department of Pharmacological and Biomolecular Sciences 'Rodolfo Paoletti', Università degli Studi di Milano, Milan, Italy; Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: massimiliano.ruscica@unimi.it., Wilhelmi de Toledo F; Buchinger Wilhelmi Clinic, Wilhelm-Beck-Straße 27, 88662, Überlingen, Germany.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2024 Oct; Vol. 397, pp. 118548. Date of Electronic Publication: 2024 Aug 06.
DOI: 10.1016/j.atherosclerosis.2024.118548
Abstrakt: Background and Aims: Long-term fasting (LF) is increasingly emerging as a non-pharmacological approach to modulate risk factors associated with the development of atherosclerotic cardiovascular diseases (ASCVD). However, protection from ASCVD is more tied to the functionality of high-density lipoprotein (HDL) than its plasma levels. Our prospective interventional study focuses on the functional properties of lipoproteins in modulating cholesterol homeostasis on peripheral cells and examines how LF may influence this and lipoprotein subclass composition. For that purpose, we investigated its impact on HDL-cholesterol efflux capacity (CEC), and on serum cholesterol loading capacity (CLC).
Methods: Forty healthy subjects (50 % females) underwent medically supervised 9-day fasting (250 kcal/day) in a specialised facility. Thirty-two subjects had a follow-up examination after one month of food reintroduction.
Results: LF was well tolerated and increased self-reported energy levels. Fasting reduced triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and HDL cholesterol (HDL-C). Very-low-density lipoprotein cholesterol (VLDL-C) and LDL3-C showed sustained reductions at follow-up. Only HDL-C, specifically HDL2-C levels, increased at follow-up. Total HDL-CEC decreased during LF and increased above baseline at follow-up. Fasting decreased ATP binding cassette (ABC)A1-mediated HDL-CEC whereas ABCG1-mediated HDL-CEC remained unaffected. Aqueous diffusion increased at follow up. LF decreased serum CLC and then returned to baseline levels.
Conclusions: LF not only maintains lipoprotein functionality but also contributes to a favorable shift in the atherogenic risk profile, which persists even after food reintroduction. This further emphasizes the importance of considering HDL functionality alongside traditional lipid measurements to understand the potential for non-pharmacological interventions like LF to promote cardiovascular prevention and health.
Trial Registration Number: NCT05031598.
Competing Interests: Declaration of competing interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: FG, AH, RM and FWT are employees of the Buchinger Wilhelmi Development and Holding GmbH, Überlingen. The other authors have no competing interests to declare that are relevant to the content of this article.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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