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Cited by 436Lipoproteins and Cardiovascular HealthCardiovascular and exercise physiologyPhysical Activity and Health

Effects of aerobic exercise on lipids and lipoproteins

Open access
Wang, Yating, Xu, Danyan·2017·Lipids in Health and Disease
DOI 10.1186/s12944-017-0515-5PMC PMC5498979
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Abstract

Dyslipidemia is the risk of cardiovascular disease, and their relationship is clear. Lowering serum cholesterol can reduce the risk of coronary heart disease. At present, the main treatment is taking medicine, however, drug treatment has its limitations. Exercise not only has a positive effect on individuals with dyslipidemia, but can also help improve lipids profile. This review is intending to provide information on the effects of exercise training on both tranditional lipids, for example, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides and new lipids and lipoproteins such as non-high-density lipoprotein cholesterol, and postprandial lipoprotein. The mechanisms of aerobic exercise on lipids and lipoproteins are also briefly described.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review summarizes evidence that aerobic exercise favorably affects traditional and newer lipid/lipoprotein measures, especially raising HDL-C and lowering TG, with more inconsistent effects on LDL-C. It also outlines proposed mechanisms including LPL, ABCA1/LXR-mediated reverse cholesterol transport, and PCSK9.

Key findings

  • Aerobic exercise consistently increased HDL-C across human and rat studies; a meta-analysis of 25 randomized controlled trials found HDL-C increased by 2.53 mg/dL when aerobic exercise was 5.3 MET (64.8% maximal aerobic capacity).
  • HDL subfractions were also affected: a meta-analysis of 19 randomized controlled trials found HDL2-C increased by about 11%, while 24 weeks of aerobic exercise significantly reduced HDL3-C by 1.9 ± 0.5 mg/dL (p = 0.01).
  • LDL-C responses to exercise were inconsistent in humans, with some studies showing no change unless weight changed; each kilogram of body weight loss reduced LDL-C by about 0.8 mg/dL. In rats, LDL-C consistently decreased after exercise.
  • Exercise generally lowered plasma TG, but baseline TG level appeared to be a key factor: when baseline TG was high, reductions were significant, whereas lower baseline TG showed only slight decreases. Walking reduced adult non-HDL-C by 4% in one meta-analysis, but non-HDL-C did not change significantly in children/adolescents with essentially normal TC and HDL-C.

Methods

  • Design: narrative review of the effects of aerobic exercise on traditional lipids/lipoproteins (LDL-C, HDL-C, TG) and newer measures (non-HDL-C, postprandial lipoprotein), plus brief mechanisms.
  • Data/sample: summarizes human and rat studies, including randomized controlled trials, meta-analyses, and prospective cohort studies; Tables 1 and 2 list selected human and rat studies with exercise duration, frequency, intensity, and lipid changes.
  • Main analysis: narrative synthesis of published findings and proposed mechanisms; no new primary data or formal meta-analysis were conducted.

Limitations

  • The paper states that the mechanism of exercise-induced lipid changes is unclear and that additional mechanistic studies are required to directly link exercise-induced lipid lowering with reduced PCSK9 activity.
  • The paper states that more studies are needed on aerobic exercise and apoB, non-HDL-C, and LDL subfractions, and notes discrepant results across studies.
  • Evident from the text: as a narrative review, it does not report a systematic search strategy, formal study-quality assessment, or quantitative pooling of all included studies; findings are drawn from heterogeneous populations, exercise protocols, and outcome measures.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12944-017-0515-5

Cites

79 of 79 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 85 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    All studies focusing on the effects of exercise on HDL-C consistently indicate an increase in HDL-C more or less, in humans or rats.

    “all studies focusing on the effects of exercise on HDL-C seemed to consistently indicate that there was an increase in HDL-C more or less, no matter in human or in rats (Tables 1 and 2).”
    Quote in the paperSubstantial claim
  • Findingreasoning

    The effects of aerobic exercise on apoB concentration are not well confirmed.

    “The effects of aerobic exercise on apoB concentration are not well confirmed.”
    Quote in the paperSubstantial claim
  • Findingnone given

    Different from humans, LDL-C consistently decreased after exercise in rats.

    “different from the human being, LDL-C consistently decreased after exercise in rats (Table 2).”
    Quote in the paperNot a substantial claim
  • Findingreasoning

    In rats, changes in HDL-C are almost the most obvious among the lipid changes.

    “In rats, the changes of HDL-C are almost the most obviously one than others.”
    Quote in the paperNot a substantial claim
  • Findingnone given

    Few studies have focused on the relationship between aerobic exercise and non-HDL-C levels.

    “few studies have focused on the relationship between aerobic exercise and non-HDL-C levels.”
    Quote in the paperSubstantial claim
  • May combine two claims. 24
  • Classified as probably not a substantial claim. 10
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingnone given

    HDL-C levels are more sensitive to aerobic exercise than both LDL-C and triglycerides.

    “HDL-C levels are more sensitive to aerobic exercise than both LDL-C and TG.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Vigorous exercise training can significantly reduce postprandial lipids, which is more common in healthy and non-obese individuals.

    “Vigorous exercise training can significantly reduce postprandial lipids, which is more common in healthy and non-obese individuals.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    The effect of exercise on LDL-C is inconsistent in humans, with even completely contrary results.

    “the effect of exercise on LDL-C is inconsistent in human and there are even completely contrary results (Table 1).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Triglycerides can enter the arterial wall with a mild to moderate increase in concentration (2-10 mmol/L) and accumulate there, causing the possibility of atherosclerosis.

    “triglycerides (TG) can enter the arterial wall with a mild to moderate increase concentration (2–10 mmol/L), and then accumulate at there, thus causing the possibility of atherosclerosis [4]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Nordestgaard BG, Wootton R, Lewis B. Selective retention of VLDL, ODL, and LDL in the arterial intima of genetically hyperlipidemic rabbits in vivo. Molecular size as a determinant of fractional loss from the intima-inner media. Arterioscler Thromb Vasc Biol. 1995;15:534–42. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Prolonged sitting could increase all-cause mortality, but a certain amount of exercise per day seemed to counteract this effect to some extent.

    “prolonged sitting could indeed increase all-cause mortality, but a certain amount of exercise per day seemed to counteract this effect to some extent.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] Eklund U, Steene-Johannessen J, Broun WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonized meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):1302–10. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Pedersen and Saltin concluded that exercise can have a positive impact on symptoms and physical health via investigation of multiple meta-analyses about exercise and lipid profiles.

    “Pedersen and Saltin [16] concluded that exercise can have a positive impact on symptoms and physical health via investigation of multiple meta-analyses about exercise and lipid profiles.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Pedersen B, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports. 2006;16(Suppl1):3–63. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Drugs such as fibrates, fish oil and niacin are effective for triglyceride reduction.

    “Of course, drugs are also effective [14], such as fibrates, fish oil and niacin [15].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] Reiner Z, Catapano AL, De Backer G, et al. ESC/EAS guidelines for the management of dyslipidaemias: the Task for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European atherosclerosis Society (EAS). Eur Heart J. 2011;32:1769–818. source

      Not checked in the free run.

    • cites [15] Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease. Lancet. 2014;384:626–35. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    For reduction of triglycerides, more advice comes from lifestyle changes such as sugar and the Mediterranean diet.

    “For the reduction of TG, more advice comes from changes in lifestyle, such as sugar and the Mediterranean diet [12, 13].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [12] Hegele RA, Ginsberg HN, Chapman MJ, et al. The polygenic nature of hypertriglyceridaemia: implications for definition, diagnosis, and management. Lancet Diabetes Endocrinol. 2014;2(8):655–66. source

      Not checked in the free run.

    • cites [13] Berglund L, Brunzell JD, Goldberg AC, et al. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:2969–89. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In individuals taking statins, higher fitness after 10 years was associated with lower mortality risk; the hazard ratio for highly fit (>9 MET) versus least fit (<5 MET) was 0.3.

    “After 10 years, for individuals who took statins, the mortality risk decreased, while their fitness increased; the hazard ratio in patients who were in highly fit for highly fit (>9 MET) was 0.3 when compared with those who were in least fit (<5 MET).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [17] Kokkinos PF, Faselis C, Myers J, et al. Interactive effects of fitness and statin treatment on mortality risk in veterans with dyslipidaemia: a cohort study. Lancet. 2013;381:394–9. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    ApoB is a major component of LDL particles and is essential for the removal of LDL particles in the circulation.

    “ApoB is a major component of LDL particles and is essential for the removal of LDL particles in the circulation.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] Shelness GS, Sellers JA. Very-low-density lipoprotein assembly and secretion. Curr Opin Lipidol. 2001;2:151–7. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    There was no significant change in postprandial HDL-C after exercise, but some HDL-C subfractions were altered, including a statistically significant reduction in small and medium HDL particles in the postprandial state after exercise training.

    “there was no significant change in postprandial HDL-C, but some HDL-C subfractions were altered. For example, the authors noted a statistically significant reduction in small and medium HDL particles in the postprandial state after exercise training.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [54] Sabaka P, Kruzliak P, Balaz D, et al. Effect of short term aerobic exercise on fasting and postprandial lipoprotein subfractions in healthy sedentary men. Lipids Health Dis. 2015;14:151–8. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Leon et al. found that 20 weeks of aerobic exercise did not affect the concentration of apoB.

    “Leon et al. [46] found that 20 weeks of aerobic exercise did not affect the concentration of apoB.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [46] Leon AS, Rice T, Mandel S, et al. Blood lipid response to 20 weeks of supervised exercise in a large biracial population: the HERITAGE family study. Metabolism. 2000;4:513–20. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In some patients with mild to moderate dyslipidemia, after a few months of aerobic exercise, LDL-C did not change significantly, but the concentration of atherogenic small LDL particles decreased and the average size of LDL particles increased.

    “after a few months of aerobic exercise, LDL-C did not change significantly, but the concentration of atherogenic small LDL particles decreased, and the average size of LDL particles increased [39].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39] Varady KA, St-Pierre AC, Lamarche B, Jones PJ. Effect of plant sterols and endurance training on LDL particle size and distribution in previously sedentary hypercholesterolemic adults. Eur J Clin Nutr. 2005;59:518–25. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Low-fitness people only need to use low-intensity aerobic exercise.

    “low-fitness people only need to use low-intensity aerobic exercise [57].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] Dekker MJ, Graham TE, Ool T, et al. Exercise prior to fat ingestion lowers fasting and postprandial VLDL and decreases adipose tissue IL-6 and GIP receptor mRNA in hypertriacylglycerolemic men. J Nutr Biochem. 2010;21:983–90. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Plasma Lp(a) is genetically influenced, unaffected by motion, and cannot be improved by any form of exercise.

    “Lp (a) is genetically influenced, unaffected by motion, and cannot be improved by any form of exercise [41].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Durstine JL, Grandjean PW, Cox CA, Thompson PD. Lipids, lipoproteins, and exercise. J Cardpulm Rehabil. 2002;22:385–98. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    About 95% of apoB binds to LDL particles, and each LDL particle binds to only one apoB molecule.

    “About 95% of apoB binds to LDL particles, and each LDL particle binds to only one apoB molecule [42].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [42] Shelness GS, Sellers JA. Very-low-density lipoprotein assembly and secretion. Curr Opin Lipidol. 2001;2:151–7. source

      Not checked in the free run.

  • The quote only partly states this claim.

    Premisecitation

    Substantial lowering of postprandial triglyceride level occurred when subjects exercised before a high-fat diet, for longer periods and more intensively.

    “there was substantial lowering of postprandial TG level.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [55] Gill JM, Al-Mamari A, Ferrell WR, et al. Effects of prior moderate exercise on postprandial metabolism and vascular function in lean and centrally obese men. J Am Coll Cardiol. 2004;44:2375–82. source

      Not checked in the free run.

    • cites [56] Peddie MC, Rehrer NJ, Perry TL. Physical activity and postprandial lipidemia: are energy expenditure and lipoprotein lipase activity the real modulators of the positive effect? Prog Lipid Res. 2012;51:11–22. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The subjects were children and adolescents whose TC and HDL-C levels were essentially normal, and both were critical factors in the calculation of non-HDL-C, thus the study did not achieve the desired positive results.

    “The subjects were children and adolescent whose TC and HDL-C levels were essentially normal, and both of which were critical factors in the calculation of non-HDL-C, thus did not achieve the desired positive results.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Elosua et al. suggested that aerobic exercise had no effect on LDL particle diameter.

    “Elosua et al. [40] suggested that aerobic exercise had no effect on LDL particle diameter.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Elosua R, Molina L, Fito M, et al. Response of oxidative stress biomarkers to a 16-week aerobic physical activity program, and to acute physical activity, in healthy young men and women. Atherosclerosis. 2003;167:327–34. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Kelley et al.'s meta-analysis of 19 randomized controlled trials found HDL2-C increased by about 11% in subjects undergoing aerobic exercise, and the results were statistically significant.

    “They included 19 randomized controlled trials and found that HDL2-C increased by about 11% in subjects undergoing aerobic exercise, and the results were statistically significant.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Kelley GA, Kelley KS. Aerobic exercise and HDL2-C: a meta-analysis of randomized controlled trials. Atherosclerosis. 2006;184:207–15. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Only 4 days of physical exercise can lead to significant positive changes in postprandial lipid profile, suggesting that short-term aerobic exercise can improve postprandial lipid distribution.

    “only 4 days of physical exercise can lead to significant positive changes in postprandial lipid profile, suggesting that short-term aerobic exercise can improve postprandial lipid distribution.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [54] Sabaka P, Kruzliak P, Balaz D, et al. Effect of short term aerobic exercise on fasting and postprandial lipoprotein subfractions in healthy sedentary men. Lipids Health Dis. 2015;14:151–8. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A previous meta-analysis reported that walking reduced adult non-HDL-C by 4%.

    “previous meta-analysis reported that walking reduced adult non-HDL-C by 4% [58].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] Kelley GA, Kelley KS, Tran ZV. Walking and non-HDL-C in adults: a meta-analysis of randomized controlled trials. Prev Cardiol. 2005;8:102–7. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Välimäki IA et al. and Tiainen et al. found that exercise could increase oxidized HDL and oxHDL/HDL and decrease oxLDL at the same time.

    “Välimäki IA et al. [35] and Tiainen et al. [36] found that exercise could increase oxidized HDL (oxHDL) and oxHDL/HDL and decrease oxLDL at the same time.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [35] Välimäki IA, Vuorimaa T, Ahotupa M, et al. Strenuous physical exercise accelerates the lipid peroxide clearing transport by HDL. Eur J Appl Physiol. 2016;116(9):1683–91. source

      Not checked in the free run.

    • cites [36] Tiainen S, Luoto R, Ahotupa M, et al. 6-mo aerobic exercise intervention enhances the lipid peroxide transport function of HDL. Free Radic Res. 2016;50(11):1279–85. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Total energy consumption and exercise intensity are the main factors affecting lipid changes.

    “Kraus et al. [23] observed that the total energy consumption and exercise intensity was the main factor affecting lipid changes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Kraus W, Houmard J, Duscha B, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med. 2002;347(19):1483–92. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Peter et al. noted that after 2 days at the end of aerobic exercise, triglycerides decreased with an HDL-C increase approximated to 14%.

    “Peter et al. noted that after 2 days at the end of the aerobic exercise, the TG decreased with an HDL-C increase approximated to 14%.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Grandjean PW, Crouse SF, Rohack JJ. Influence of cholesterol status on blood lipid and lipoprotein enzyme responses to aerobic exercise. J Appl Physiol. 2000;89(2):472–80. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Exercise time, exercise volume and exercise intensity all have an effect on exercise-induced changes in blood lipids.

    “The results of these studies suggest that exercise time, exercise volume and exercise intensity all have an effect on exercise-induced changes in blood lipids.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Exercise may increase blood lipid consumption, thereby decreasing lipid levels.

    “Although the mechanism of exercise-induced lipid changes is unclear, exercise itself may increase blood lipid consumption hence to decrease lipids levels [60].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [60] Earnest CP, Artero EG, Sui X, et al. Maximal estimated cardiorespiratory fitness, cardiometabolic risk factors, and metabolic syndrome in the aerobics center longitudinal study. Mayo Clin Proc. 2013;88(3):259–70. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Knowledge about the effects of aerobic exercise on lipids should aid in preventing and treating dyslipidemia while reducing the risks of myocardial infarctions and CAD.

    “Such knowledge should aid in preventing and treating dyslipidemia while reducing the risks of myocardial infarctions and CAD.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Clinicians may be excessively reliant on lipid-lowering drugs (i.e., statins) to treat patients with dyslipidemias.

  • May combine two claims.

    Premisecitation

    Most catalytically active LPL is located in the vessel wall and is released into the blood after intravenous injection of heparin.

    “Most of the catalytically active LPL is located in the vessel wall and then isolated from the endothelium surface and released in the blood after intravenous injection of heparin [62].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Miyashita M, Eto M, Sasai H, et al. Twelve-week jogging training increases pre-heparin serum lipoprotein lipase concentrations in overweight/obese middle-aged men. J Atheroscler Thromb. 2010;17:21–9. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Daily exercise is independently associated with a decrease in PCSK9 levels over time; after 3 months exercise, mean PCSK9 and LDL-C levels decreased in volunteers.

    “Kamani et al. [72] found a significant decrease in mean PCSK9 levels and mean LDL-C levels in volunteers after 3 months exercise, and concluded that daily exercise is independently associated with a decrease in PCSK9 levels over time.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [72] Kamani CH, Gencer B, Montecucco F, et al. Stairs instead of elevators at the workplace decreases PCSK9 levels in a healthy population. Eur J Clin Investig. 2015 Oct;45(10):1017–24. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Exercise-induced LPL changes are time-delayed; LPL mRNA peak level occurs at 4 h after exercise.

    “Exercise-induced LPL changes were time-delayed, for example, LPL mRNA peak level occurred at 4 h after exercise [62].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Miyashita M, Eto M, Sasai H, et al. Twelve-week jogging training increases pre-heparin serum lipoprotein lipase concentrations in overweight/obese middle-aged men. J Atheroscler Thromb. 2010;17:21–9. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both plasma PCSK9 and cholesterol were reduced by 14% in mice with both high-fat diet and exercise training, while no change occurred in those only with high-fat diet.

    “In addition, both plasma PCSK9 and cholesterol were reduced by 14% in mice with both high-fat diet and exercise training, while no change with those only with high-fat diet.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [73] Rocco DD, Okuda LS, Pinto RS, et al. Aerobic exercise improves reverse cholesterol transport in cholesteryl ester transfer protein transgenic mice. Lipids. 2011;46:617–25. source

      Not checked in the free run.

32 of 32

  • The paper relies on this without support.

    Many people cannot tolerate statins, and statins are contraindicated in pregnant women.

    “However, many people cannot tolerate statins, and statins are contraindicated in pregnant women.”

  • The paper relies on this without support.

    Fasting LDL-C is strongly associated with an increased risk of coronary artery disease.

    “Fasting LDL-C is strongly associated with an increased risk of coronary artery disease (CAD)”

  • The paper relies on this without support.

    Non-HDL-C is a better indicator of cardiovascular disease risk than traditional lipids such as HDL-C, LDL-C, and triglycerides.

    “Recent evidence suggested that non-HDL-C was a better indicator of CVD risk than traditional lipids such as HDL-C, LDL-C, and TG.”

  • The paper relies on this without support.

    Non-HDL-C is more persuasive than LDL-C as a predictor of future cardiovascular risk to some extent.

    “as a predictor of future cardiovascular risk, non-HDL-C was more persuasive than LDL-C to some extent.”

  • The paper relies on this without support.

    Dyslipidemia is a risk factor for cardiovascular disease and their relationship is clear.

    “Dyslipidemia is the risk of cardiovascular disease, and their relationship is clear.”

  • The paper relies on this without support.

    Increased expression of ABCA1 in macrophages has a strong effect on RCT, plasma HDL-C formation, and protection against atherosclerosis.

    “Increased expression of ATP-binding cassette transporter A-1 (ABCA1) in macrophages has a strong effect on RCT, plasma HDL-C formation, and protection against atherosclerosis.”

  • The paper relies on this without support.

    LXR is a transcription factor that plays a key role in liver cholesterol metabolism.

    “Liver X receptor (LXR) is one of the transcription factors of nuclear receptor superfamily that play a key role in liver cholesterol metabolism.”

  • The paper relies on this without support.

    LXR regulates the expression of ABCA1.

    “LXR has been proved involving in regulating the expression of ABCA1.”

  • The paper relies on this without support.

    PCSK9 is a new biomarker of LDL clearance and a new target of CVD therapy.

    “PCSK9 is a hot spot in the field of cardiovascular research in recent years as it is a new biomarker of LDL clearance and a new target of CVD therapy.”

  • The paper relies on this without support.

    Exercise can reduce plasma LDL-C levels.

    “Exercise can reduce plasma LDL-C levels, and PCSK9 plays an important role on the regulation of LDL receptor.”

  • The paper relies on this without support.

    PCSK9 plays an important role in the regulation of LDL receptor.

    “Exercise can reduce plasma LDL-C levels, and PCSK9 plays an important role on the regulation of LDL receptor.”

  • The paper relies on this without support.

    Clinicians may be excessively reliant on lipid-lowering drugs (i.e., statins) to treat patients with dyslipidemias.

    “Currently, clinicians may be excessively reliant on lipid-lowering drugs (i.e., statins) to treat patients with dyslipidemias.”
12 of 12

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Previous works were not systematic or included non-randomized trials, and limited pooled data analyses have been previously published.

    “Previous works were not systematic [14] or included non-randomized trials [13, 15]; limited pooled data analyses have been previously published [16, 17].”

    From The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis (2025) · cites this paper as [13]

    The ‘Aerobic exercise and non–HDL-C’ section (page unavailable) reports a previous meta-analysis and says few studies have examined aerobic exercise and non–HDL-C. This supports the existence of earlier pooled analyses, but not a general claim that pooled analyses were limited; the passage does not address whether previous works were systematic or included non-randomized trials. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

  • An improved lipid profile is more likely when accompanied by weight loss.

    “Wang et al. [13] found an improved lipid profile is more likely when accompanied by weight loss.”

    From The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis (2025) · cites this paper as [13]

    The 'Aerobic exercise and LDL-C' section says exercise-related LDL-C improvements may depend on weight change and reports that LDL-C fell with weight loss. That supports the claim for LDL-C, but not for the lipid profile as a whole: the 'Aerobic exercise and HDL-C' section says some HDL changes were independent of changes in body weight or fat. Page numbers are unavailable in our copy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Our findings and those of some others contradict the suggestion that a weekly expenditure of 900 kcal or 120 min is the energy volume threshold required to elicit favourable changes in HDL.

    “Our findings and those of some others contradict this [9, 13].”

    From The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis (2025) · cites this paper as [13]

    The “Aerobic exercise and HDL-C” section reports that aerobic exercise can increase HDL-C. However, neither that section nor “Related influencing factors of aerobic exercise on lipids” establishes that HDL improves below 900 kcal or 120 minutes per week, so the cited review does not substantiate the claimed contradiction of that threshold. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • European and USA treatment targets suggest LDL should be maintained around or below 115 mg/dL or 3.0 mmol/L and in those with raised LDL a 50% reduction should be achieved, where possible, with lipid-lowering medication.

    “European [41] and USA [3] treatment targets suggest LDL should be maintained around or below 115 mg/dL or 3.0 mmol/L [13] and in those with raised LDL a 50% reduction should be achieved, where possible, with lipid-lowering medication.”

    From The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis (2025) · cites this paper as [13]

    The Background (page unavailable) says US and European guidelines emphasize statins for LDL-C reduction, which supports the general treatment context. It does not give an LDL-C target of 115 mg/dL (3.0 mmol/L) or recommend a 50% reduction for people with raised LDL-C; searches for both figures found no supporting passage. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • The specific physiological mechanisms of change may involve increased activity of lipoprotein lipase responsible for hydrolysis of chylomicrons, VLDL and triglycerides.

    “The specific physiological mechanisms of change may involve increased activity of lipoprotein lipase (LPL) responsible for hydrolysis of chylomicrons, VLDL and TG [13].”

    From The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis (2025) · cites this paper as [13]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Varady study is assigned the Elosua reference number

    Minor

    The text attributes a finding to Varady et al. [40], but reference [40] is by Elosua et al.; Varady et al. is listed as reference [39].

  • Study [26] is described as using mice, but its reference describes rats

    Minor

    The text says study [26] used CETP-transgenic mice, whereas reference [26] identifies the study as one of rat liver. The species attributed to the cited study is inconsistent.

  • Jogging-training study is cited as a bezafibrate study

    Minor

    The text attributes a 12-week jogging-training result to Tanaka et al. [67], but reference [67] is by Totsuka et al. and concerns bezafibrate administration. The jogging-training study appears under reference [62].

  • Rideout study is assigned the Rocco reference number

    Minor

    The text identifies study [73] as Rideout et al., but reference [73] is by Rocco et al. and describes a CETP-transgenic mouse study.

  • Ghanbari-Niaki finding is assigned the Tofighi reference number

    Minor

    The text attributes the finding to Ghanbari-Niaki et al. [70], but reference [70] is by Tofighi et al. Ghanbari-Niaki et al. is listed as reference [26].

  • Ferguson study is assigned the Kobayashi reference number

    Minor

    The text names Ferguson et al. as reference [63], but reference [63] is by Kobayashi et al. A Ferguson et al. study is listed as reference [64].

6 of 6

Cites

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Related

Authors
Wang, Y., & Xu, D.
Affiliations
Central South University (CN)
Corresponding author
Xu, Danyan
ORCID
Venue
Lipids in Health and Disease
Publisher
Springer Science and Business Media LLC
Published
2017-07-05
Volume
16
Issue
1
Pages
132-132
ISSN
1476-511X (ISSN-L)
DOI
10.1186/s12944-017-0515-5
PMC
PMC5498979
OpenAlex
W2733723944
Semantic Scholar
c050e91a02a049c5354fb44ffdbc208692f6db0a
Cited by
436
References
79
Citations by year
2026: 31 · 2025: 61 · 2024: 50 · 2023: 53 · 2022: 74 · 2021: 61 · 2020: 54 · 2019: 32 · 2018: 18 · 2017: 2
FWCI
6.15
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Lipids in Health and Disease (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Nature Scientific Funding of China (No.81372117, 81672264)
  • the Fundamental Research Funds for the Central Universities of Central South University (No.2016zzts536)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
aerobic exercise, exercise training, dyslipidemia, lipoproteins, serum cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, non-HDL cholesterol, postprandial lipoproteins, cardiovascular risk, lipid profile
MeSH terms
Coronary Disease, Humans, Lipoproteins, Risk Factors, Exercise, Dyslipidemias

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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