• Lipídeos:Lipídeos:
– Ácidos graxos• Cadeias saturadas, mono ou poliinsaturadas
– Triglicerídeos• Forma de armazenamento
– Fosfolipídios• Constituintes estruturais de membrana
– Colesterol• Precursor de hormônios esteróides, ácidos biliares,
vitamina D, constituinte de membrana
Aspectos Gerais
FUNÇÕES DOS LIPÍDIOS
FONTE DE ENERGIA ISOLANTE TÉRMICO FUNÇÃO HORMONAL PROTEÇÃO MECÂNICA FUNÇÃO ESTRUTURAL LUBRIFICANTE FUNÇÃO IMPERMEABILIZANTE
Lipoproteins• Function: Transport of fat soluble substances
• Types: 1) Chylomicron
2) VLDL
3) LDL
4) HDL
ChylomicronTriglycerides
3 Fatty Acids Glycerol
Adipose Skeletal Heart Blood(storage) Muscle (energy)
(energy) Liver
Chylomicron Remnant
Liver
VLDL• = Very Low Density Lipoprotein• Made in: the liver from excess dietary carbohydrate
and protein along with the Chylomicron remnant• Secreted into: the bloodstream• Rich in: TGs• Function: Deliver TGs to body cells• Contains apo B100• Similar to Chylomicrons, but made by different tissues
LDL
• = Low Density Lipoprotein• Made in: the Liver as VLDL• Arise from: VLDL once it has lost a lot of its TG’s• Secreted into: the bloodstream• Rich in: Cholesterol• Function: Deliver cholesterol to all body cells
HDL
• = High Density Lipoprotein• Made in: the Liver and Small Intestine• Secreted into: the bloodstream• Function: Pick up cholesterol from body cells
and take it back to the liver = “reverse cholesterol transport”
• Potential to help reverse heart disease
Composition of the four major lipoprotein classes
9
Placa de AteromaAcumulo de lipídios modificados
Ativação das células endoteliais
Ativação das células inflamatórias
Proliferação e síntese da matriz
Formação da capa fibrosa
Ruptura da placa
Agregação das plaquetas
Trombose
Migração das células inflamatórias
Recrutamento das células musculares lisas
Cardiovascular Disease (CVD)• Main type of CVD is Atherosclerosis (AS)• Endothelial dysfunction is one of earliest
changes in AS• Mechanical, chemical, inflammatory mediators
can trigger endothelial dysfunction:– High blood pressure – Smoking (free radicals that oxidatively damage
endothelium)– Elevated homocysteine– Inflammatory stimuli– Hyperlipidemia
Endothelial Dysfunction( endothelial activation, impaired endothelial-dependent
vasodilation)
• endothelial synthesis of PGI2 (prostacylcin), & NO (nitric oxide)– PGI2 = vasodilator, platelet adhesion/aggregation– NO = vasodilator, platelet & WBC (monocyte) adhesion
• Adhesion of monocytes onto endothelium --> transmigration into subendothelial space (artery wall) --> change to macrophages
• Endothelial dysfunction --> increased flux of LDL into artery wall
Know Your Lipid Profile
Total Cholesterol < 200 mg/dl
LDL-Cholesterol < 100 mg/dl
HDL-Cholesterol ≥ 60 mg/dl
Triglycerides < 150 mg/dl
Fasting Blood Level Ideal, Healthy Level
Know Your Diabetes, Metabolic Risk
Blood Glucose < 110 mg/dl 110-125 mg/dl ≥ 126 mg/dl
2 hr GTT < 140 mg/dl 140-200 mg/dl > 200 mg/dl
Triglyceride < 150 mg/dl > 150 mg/dl Typically elevated
HDL ≥ 60 mg/dlM < 40 mg/dlF < 50 mg/dl
Typically low
Fasting Healthy Pre-Diabetes Diabetes (Metabolic Syndrome)
The Metabolic Syndrome
Abdominal Obesity Men Women
> 40 inch waist> 35 inch waist
Triglycerides ≥ 150 mg/dL
HDL cholesterol Men Women
< 40 mg/dL< 50 mg/dL
Blood Pressure ≥ 130/ 85 mm Hg
Fasting Blood Glucose 110-125 mg/dL
Prevalence of major risk factors in Great Britain/England
Plasma HDL-cholesterol in groups differing in level of habitual activity
4 VEZES NA SEMANA É MAIS EFETIVO DO QUE 3 VEZES NA SEMANA
COMBINAÇÃO DE ALTO VOLUME E ALTA INTENSIDADEMOSTRA MAIOR EFEITO SOBRE O PERFIL LIPIDICO
(at 60 % VO2max) or a high-intensity exercise group (at 80 % VO2max). Both exercising groups completed three 400 kcal sessions weekly for 24 weeks. By setting the session volume in calories, the overall training volume was controlled. Participants were instructed to maintain their dietary habits. It was reported that significant lipid profile improvements occurred only in the high-intensity group, with significant decreases (p\0.05) in total cholesterol (from 6.02 to 5.48 mmol/L), LDL cholesterol (from 4.04 to 3.52 mmol/L) and non-HDL cholesterol (from 4.58 to 4.04 mmol/L). The evidence suggests that a
O’Donovan G, Owen A, Bird S, et al.
Changes in cardiorespiratory fitness and coronary heart disease risk factors following 24 wk of moderate- or high-intensity exercise of equal energy cost. J Appl Physiol. 2005;98(5):1619–25.
EXERCÍCIOS AERÓBICOS
Triglyceride clearance at 72 h was significantly (p\0.05) greater following 50 % 1 RM (-14.6 mg/dL) and 75 % 1 RM (-10.7 mg/dL) than following 90 % 1 RM (?9.5 mg/dL) and 110 % 1 RM (?12.1 mg/dL). Further, increases in HDL cholesterol were significantly greater following 50 % 1 RM and 75 % 1 RM than following 110 % 1 RM (p = 0.004 and 0.03, respectively).
Lira F, Yamashita A, Uchida M, et al. Low and moderate, rather than high intensity strength exercise induces benefit regarding plasma lipid profile. Diabetol Metab Syndr. 2010;2:31.
EXERCÍCIOS DE RESISTÊNCIA MUSCULAR
Há efeitos agudos do exercício: 24 a 48 horas depois LDL HDL
ASSOCIAÇÃO DO EXERCÍCIO DE PERDA DE PESO CONTRIBUI MAIS COM O
CONTROLE LIPÍDICO
MECANISMOS PELO QUAL O EXERCÍCIO CONTRIBUI