Investigating the effect of interval training on blood sphingolipid levels: the SphingoFIT study

What is it about?

Overnutrition, reduced energy expenditure and chronic inflammation stimulate triglyceride storage. Once the triglyceride stores are saturated, lipids in excess are redirected to form sphingolipids. However, sphingolipid accumulation promotes peripheral insulin resistance and atherosclerosis. Failure to manage this sphingolipid overload eventually results in diabetes mellitus and coronary artery diseases. In primary prevention, a score combining the blood level of four sphingolipids outperformed the 2019 SCORE of the European Society of Cardiology in terms of cardiovascular risk prediction. The same score predicted cardiovascular mortality beyond low-density lipoprotein cholesterol in secondary prevention. Little is known about therapeutic modalities to lower sphingolipid levels. If circulating sphingolipids are to be screened in clinical practice, providing patients with evidence-based sphingolipid-lowering interventions is essential. As exercise is a powerful means to prevent and treat cardiometabolic diseases, exercise interventions are ideal candidates for mitigating sphingolipid levels in a cost-effective, safe, and patient-empowering manner. Therefore, this 2-arm, monocentric, randomised controlled trial aims to explore whether and to what extent an 8-week fitness-enhancing training programme can lower serum sphingolipid levels of middle-aged adults at elevated cardiometabolic risk (n= 98, 50% females).

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Photo by Ashim D’Silva on Unsplash

Photo by Ashim D’Silva on Unsplash

Why is it important?

Only one non-powered non-randomised pilot study investigated the effect of 12 weeks of moderate-intensity continuous training in patients with obesity or type 2 diabetes on a limited panel of sphingolipid species (n=7). It showed a reduction in sphingolipid concentrations following the exercise intervention. This finding is supported by the fact that exercise stimulates fatty acid β-oxidation, which redirects lipids toward energy production purposes. Circulating sphingolipids have been reported to be negatively associated with cardiorespiratory fitness, a potent health marker. However, clinical practice cannot be based on a non-powered, non-randomised pilot study. This is why a randomised controlled trial is necessary.

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