J Lipid Res：锻炼增加好胆固醇

近日，美国Methodist Hospital等处的研究人员发现，少量的锻炼和节食即可提高脂联素和高密度脂蛋白胆固醇（HDL cholesterol ，HDL-C）的水平。相关论文发表在Journal of Lipid Research上。

脂肪组织功能异常在二型糖尿病（type 2 diabetes，T2DM）的发病过程中发挥重要作用，而患T2DM的肥胖者体内脂联素水平也下降。此项研究发现，通过改变生活方式减肥（intensive lifestyle intervention for weight loss ，ILI）可增加脂联素的水平，并且HDL-C的水平也升高。

共有1397个肥胖并患有T2DM的人参加了此项研究，参与者需坚持锻炼并保持健康的饮食，研究人员定期检测包括通过HDL-C 和脂联素在内的多个标志物。一年之后，参与者的脂肪总量、血浆葡萄糖水平等都得到显著改善，LDL的水平并未发生改变。ILI可将HDL-C的水平提高9.7%，脂联素水平提高11.9%。

脂联素(Adiponectin) 是脂肪细胞分泌的一种内源性生物活性多肽或蛋白质，是一种胰岛素增敏激素(An Insulin-sensitizing Hormone)，能改善小鼠的胰岛素抗性(Insulin resistance)和动脉硬化症；对人体的研究发现，脂联素水平能预示II型糖尿病和冠心病的发展，并在临床试验表现出抗糖尿病、抗动脉粥样和炎症的潜力。（生物谷Bioon.com）

编译自With a little exercise, your fat cells may coax liver to produce 'good' cholesterol

doi:10.1194/jlr.M030213
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Adiponectin and the mediation of HDL cholesterol change with improved lifestyle: The Look AHEAD Study

L. Maria Belalcazar1, Wei Lang2, Steven M. Haffner3, Ron C. Hoogeveen4, F. Xavier Pi-Sunyer5, Dawn C. Schwenke6, Ashok Balasubramanyam4, Russell P. Tracy7, Andrea P. Kriska8 and Christie M. Ballantyne

Adipose tissue dysfunction plays a key role in the development of the metabolic abnormalities characteristic of type 2 diabetes (T2DM) and participates actively in lipid metabolism. Adiponectin, found abundantly in circulation and a marker of adipose health, is decreased in obese persons with T2DM. We investigated if the changes in adiponectin with an intensive lifestyle intervention for weight loss (ILI) could potentially mediate the increase in low HDL cholesterol (HDL-C) with ILI. Adiponectin and its fractions were determined using an ELISA with selective protease treatment in 1,397 participants from Look AHEAD, a trial examining whether ILI will reduce cardiovascular events in overweight/obese subjects with T2DM when compared to a control arm, Diabetes Support and Education arm (DSE). Multivariable regression and mediational analyses were performed for adiponectin and its high molecular weight (HMW) and non-HMW fractions. ILI increased baseline HDL-C by 9.7% and adiponectin by 11.9%; changes with DSE were 1.3% and 0.2%, respectively (p<0.0001). In a model including changes in weight, fitness, triglycerides and glucose control and that adjusted for demographics and medical history, adiponectin changes remained significantly associated with HDL-C change. Data supported the contribution of changes in both HMW- and non-HMW-adiponectin to the improvement in HDL-C with ILI.

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