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高胆固醇吸收:动脉样硬化心血管疾病的危险因素?
Piia Simonen1, Katariina Öörni2, Juha Sinisalo1
1Heart and Lung Center, Cardiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Atherosclerosis
|June 8, 2023
概括
高胆固醇吸收,一种影响三分之一的人口的情况,显著增加了动脉样硬化心血管疾病 (ASCVD) 的风险. 用组合治疗优化降脂疗法对于预防ASCVD事件至关重要.
科学领域:
- 心脏病学 心脏病学
- 代谢科学 代谢科学
- 遗传学 遗传学 是一个
背景情况:
- 升高的低密度脂蛋白胆固醇 (LDL-C) 是动脉样硬化心血管疾病 (ASCVD) 的已知危险因素.
- 新出现的证据强调了胆固醇代谢,特别是胆固醇吸收在ASCVD风险中的作用.
- 了解不同的胆固醇代谢概况是完善预防策略的关键.
研究的目的:
- 调查不同胆固醇代谢特征,特别是高胆固醇吸收,是否有助于动脉动脉生成.
- 探索关联胆固醇代谢与ASCVD风险的潜在机制.
- 评估遗传,代谢和临床因素对这种关联的影响.
主要方法:
- 对基因转运物质基因变异 (ABCG5,ABCG8,NPC1L1) 的遗传研究的综述.
- 分析与胆固醇合成和消除相关的代谢数据.
- 检查基于人群的研究和降脂干预措施的结果.
主要成果:
- 在ABCG5/ABCG8的功能丧失变化导致高胆固醇吸收,低合成,低消除,并增加ASCVD风险.
- 在NPC1L1中功能丧失的变异导致胆固醇吸收低,合成高,排泄增加,并降低ASCVD风险.
- 对于高胆固醇吸收的人来说,单独使用他类药物是不够的;建议使用组合治疗 (他类药物 + 胆固醇吸收抑制剂).
结论:
- 高胆固醇吸收率 (>60%),在约三分之一的人群中存在,是动脉动脉的,并增加ASCVD风险.
- 固醇载体中的遗传变异显著影响胆固醇吸收和ASCVD风险.
- 包括胆固醇吸收抑制在内的个性化降脂策略对于有效预防ASCVD至关重要.
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