Statin treatment and exercise: Is there an additive anti -inflammatory effect?

Paul Martin Coen, Purdue University

Abstract

Purpose. When administered separately, statin treatment and exercise training have anti-inflammatory effects. The purpose of this study was to determine the effect of combined rosuvastatin treatment and exercise training on markers/mediators of inflammation and lipid profile. Methods. 33 hypercholesterolemic and physically inactive subjects were randomly assigned to rosuvastatin (R; 8F, 9M) and rosuvastatin/exercise (RE; 9F, 7M) groups. A third group of physically active hypercholesterolemic subjects served as a control (AC; 9F, 7M). R and RE groups received rosuvastatin treatment (10 mg/d) for 20 weeks. The RE group completed 10-weeks of combined endurance (20 min @ 60-70% est. heart rate reserve) and resistive exercise training (80% 1 repetition maximum (RM)) from week 10 to week 20, while the R group remained sedentary. The AC group received no treatment and maintained habitual physical activity. Subjects consumed a prescribed diet 24 h prior to blood sampling and arrived at the laboratory (0600-0700 h) following an 8 h fast and three days of inactivity. Resting blood samples were obtained, and lipid profile and inflammatory mediators determined for all subjects, at week 0 (Pre), week 10 (Mid–prior to exercise training), and week 20 (Post–upon completion of exercise training program). Blood levels of creatine kinase (CK), and the liver enzyme alanine aminotransferase (ALT), were measured at two stages during the experimental trial; (1) at week 0 (Pre), after 5 and 10 weeks following the start of rosuvastatin treatment (R and RE groups), and (2) 48 hours after the 1st and 5th exercise bout (RE group only). Results. The RE group improved aerobic fitness (VO2max: 29±6%). Strength measures also increased significantly for all exercises (8 RM Range: 30±4 – 57±10%; 1 RM Range: 16±3 - 20±17%). For example, 8 RM for the leg press increased by 47.6 kg in the RE group after the exercise training program. Total and low-density lipoprotein (LDL) cholesterol were lower in the RE and R groups at Mid and Post time points when compared to Pre (p < 0.05). Oxidized LDL (OxLDL) was lower in the R and RE groups at the Mid (R; 56±5 U/L, RE; 52±4 U/L) and Post (R; 63±6 U/L, RE; 48±2 U/L) time points, compared to Pre (R; 89±5 U/L, RE 83±4 U/L) (p<0.05). Also, at the Post time point, RE had lower oxLDL than R (48±2 U/L vs. 63±6 U/L, p<0.05). When groups were collapsed, high-density lipoprotein (HDL) was increased across time (p < 0.05). CK was significantly increased in the RE group 48 hours following the 1st exercise bout (p < 0.05), and returned to baseline levels 48 hours after the 5th exercise bout. There were no significant changes in ALT. Toll-like receptor (TLR) 4 expression on CD14+ monocytes was higher in the R group at the Post time point, compared to Pre (1.74±0.09 vs. 1.51±0.03 mean fluorescent intensity (MFI), p<0.05). The percentage of inflammatory monocytes was significantly lower in the RE group at the Post time point, compared to Pre (2.4±0.45% vs. 3.7±0.5%, p<0.05). There were no significant changes in C-reactive protein (CRP), sCD14, or lipopolysaccharide binding protein (LBP). Conclusion. Rosuvastatin treatment decreased oxLDL and increased monocyte TLR4 expression. The addition of an exercise training program resulted in a decrease in inflammatory monocyte percentage and oxLDL, suggesting an additive anti-inflammatory benefit. There was no abnormal sustained increase in CK or ALT suggesting that a combination of rosuvastatin and exercise training did not negatively influence muscle or liver health.

Degree

Ph.D.

Advisors

Flynn, Purdue University.

Subject Area

Kinesiology

COinS