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Arteriosclerosis, Thrombosis, and Vascular Biology. 1991;11:973-984

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Arteriosclerosis and Thrombosis, Vol 11, 973-984, Copyright © 1991 by American Heart Association

ARTICLES

The role of insulin and body fat in associations of physical activity with lipids and lipoproteins in a biethnic population. The San Luis Valley Diabetes Study

EJ Mayer, CM Burchfiel, RH Eckel, JA Marshall, WL Haskell and RF Hamman
Department of Preventive Medicine and Biometrics, Denver 80262.

It has been postulated that the positive effects of physical activity on high density lipoprotein cholesterol (HDL-C) and HDL-C subfraction 2 (HDL-C2) are mediated through insulin action because increased activity lowers insulin levels and lower insulin levels are associated with higher HDL-C. These relations were evaluated in a rural population of Hispanic and non-Hispanic white (NHW) adults in Colorado. Included were 138 men and 152 women with normal glucose tolerance confirmed by World Health Organization criteria. Total physical activity was assessed by 7- day recall interviews. No significant associations were observed among women. Among men, activity was inversely associated with fasting insulin (r = -0.17, p less than 0.05). From analysis of covariance models including the interaction term activity x ethnicity, total HDL-C was 43.4 mg/dl (95% confidence interval [CI] = 39.1, 47.7) in the low tertile of activity and 50.4 mg/dl (95% CI = 46.3, 54.5) in the high tertile for NHW men, after adjustment for fasting insulin, fasting glucose, body mass index (BMI), waist to hip ratio (WHR), and age. For Hispanic men, adjusted HDL-C was 43.4 mg/dl (95% CI = 38.6, 48.2) and 49.1 mg/dl (95% CI = 44.0, 54.2) in the low and high tertiles, respectively. Adjusted HDL-C2 levels were 52% higher in the most compared with the least active NHW men, whereas there was no difference by activity for Hispanic men. Higher adjusted mean levels of HDL-C3 were observed for the high compared with the low activity tertile in both ethnic groups. Ethnicity-specific models showed that for NHW men, activity explained 12% (p = 0.01), fasting insulin explained 5% (p = 0.05), and BMI explained 6% (p = 0.04) of the variability in total HDL- C, after adjustment for fasting glucose, WHR, and age. These models confirmed that effects of insulin and body fat did not explain the observed associations between activity and total HDL-C and its subfractions.


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