Effectiveness of statins vs. exercise on reducing postprandial hypertriglyceridemia in dyslipidemic population: A systematic review and network meta-analysis.

Abstract

BACKGROUND:

Individuals at risk of suffering cardiovascular disease (CVD) present with larger increases in blood triglyceride (TG) concentration after a high-fat meal than do healthy individuals. These postprandial hypertriglyceride levels are an independent risk factor for CVD. Prescription of statins and a bout of prolonged exercise are both effective in lowering postprandial hypertriglyceride levels. We aimed to evaluate the comparative effectiveness of statins vs. a bout of aerobic exercise in reducing fasting and postprandial TG (PPTG) concentrations in individuals at high risk of developing CVD.

METHODS:

Thirty-seven studies from a systematic literature search of the PubMed, EMBASE, and Cochrane databases were included in this review. The selected studies conducted trials involving statin therapy (n = 20) or a bout of aerobic exercise (n = 19) and measured their impact on PPTG levels as the outcome. Two studies analyzed both treatments and were included in duplicate. The meta-analysis was constructed using a random-effects model to calculate the mean difference (MD). The Student t test was used to compare the data sets for statins vs. exercise.

RESULTS:

Overall, statin and exercise interventions showed similar reductions in PPTG levels, with an MD of -0.65 mmol/L for statins (95% confidence interval (95%CI): -0.54 to -0.77; p < 0.001) and -0.46 mmol/L for exercise (95%CI: -0.21 to -0.71; p < 0.01). However, statins lowered fasting TG levels more than exercise (MD = -1.54 mmol/L, 95%CI: -2.25 to -0.83; p = 0.009).

CONCLUSION:

Although aerobic exercise is effective in lowering blood TG levels, statins seem to be more efficient, especially in the fasted state. A combination of exercise and statins might reveal a valuable approach to the treatment and prevention of CVD. More studies are required to determine the underlying mechanisms and the possible additive effects of these interventions.

• Authors: Laura Alvarez-Jimenez, Alfonso Moreno-Cabañas, Miguel Ramirez-Jimenez, Felix Morales-Palomo, Juan F Ortega, Ricardo Mora-Rodriguez
• Journal: Journal of sport and health science (J Sport Health Sci) Vol. 11 Issue 5 Pg. 567-577 (09 2022) ISSN: 2213-2961 [Electronic] China
• PMID: 34298253 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021. Production and hosting by Elsevier B.V.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Triglycerides

Topics

• Cardiovascular Diseases (prevention & control)
• Exercise
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Hypertriglyceridemia (drug therapy)
• Network Meta-Analysis
• Triglycerides