OBJECTIVE: In obese patients, we hypothesized physical exercise (PE) to affect lipids through its intrahepatic fat accumulation-lowering effect, associated with a decrease of total body fat (Fat%) and even weight (Mass). DESIGN AND SETTING: Thirty seven sedentary, non-diabetic women (BMI median 34.8) from our out-patient department were tested. Elimination criteria: recent weight reduction, lipid-influencing or heart rate-modifying medication. PARTICIPANTS: 50 entering, 37 finishing, 7 excluded for processing failure, 6 did not fulfill the protocol. INTERVENTIONS: PE protocol: 60 min supervised trainings, intensity at 65% of VO2max, modified by the clamp heart rate test. Median of total training hours was 34 during 115 days (median). MAIN OUTCOME MEASUREMENTS: an effect of PE on total cholesterol (CH), triglycerides (TG), HDL-cholesterol (HDL_C), LDL-cholesterol (LDL_C), index of atherogenity (IA), atherogenic index of plasma (AIP), maximum peak oxygen consumption (VO2max), Mass, body mass index (BMI), waist circumference (Waist) and Fat%. RESULTS: Statistically significant differences at start (_s) and the end (_e) of PE (p<0.05): AIP -0.049, Mass -3.6 (kg), BMI -1.7 (kg/m2), Waist -2.5 (cm), Fat% -2.5, VO2max 2.92 (L.min-1kg-1). Correlation coefficients, Pearson's between Gaussian distributed (Gd-v) variables and Spearman´s (non Gd-v) statistically significant (p<0.05): IA and BMI, IA and Mass, IA and Waist, IA and Fat%, LDL and BMI, LDL and Mass, LDL and Fat%, LDL and Waist, IA and VO2max, LDL_C and VO2max. CONCLUSIONS: PE improves lipid profile towards production of antiatherogenic particles more likely due to changes in anthropometric parameters than in improvement of physical fitness.

3rd Department of Medicine 1st Faculty of Medicine Charles University and General Faculty Hospital Prague Czech Republic